Abstract
Although cadmium (Cd) exposure has been declining in the United States (U.S.) over the years, the level of exposure for people with pre-existing comorbidities is unclear. This study characterized the trends of blood Cd levels (bCd) (n = 44,498) and urinary Cd levels (uCd) (n = 15,107) by pre-existing comorbidities among adults participating in the U.S. National Health and Nutrition Examination Survey. We calculated age- and sex-standardized annual geometric mean (GM) levels, and used aJoinpoint regression model to examine the trends over time. The GM levels of bCd declined from 1999–2000 to 2017–2018 survey cycles (from 0.49 to 0.33 μg/L), while women and current smokers had higher levels. Participants with comorbidities had higher bCd and declined over time: cardiovascular disease (CVD) (0.50 to 0.42 μg/L), hypertension (0.49 to 0.35 μg/L), chronic kidney disease (CKD) (0.54 to 0.37 μg), and cancer (0.57 to 0.38 μg) versus those without these comorbidities. We observed the similar pattern of changes for uCd and participants with CVD, CKD, and cancer had higher levels. To conclude, the trend in urinary and blood Cd levels in U.S adults decreased in the past 20 years, and the levels varied by sex, smoking status, and comorbidities.
Highlights
Received: 26 January 2022Cadmium (Cd), a toxic and carcinogenic heavy metal, is mainly emitted to soil, water, and air by non-ferrous metal mining and refining, manufacturing, the application of phosphate fertilizers, fossil fuel combustion, as well as waste incineration and disposal [1].People can be exposed to Cd from air, diet, drinking water, or by skin contact
The prevalence of diabetes varied between 11.8% and 21.8%, hypertension varied between 38.7% and 46.9%, chronic kidney disease (CKD) varied between 10.7% and 13.8%, cancer varied between 1.3%
Our analysis found that Cd levels were higher in women than in men, which was consistent with the results found in a Spanish study for urinary Cd levels (uCd) [34] and Italy for blood Cd levels (bCd) [18]
Summary
Cadmium (Cd), a toxic and carcinogenic heavy metal, is mainly emitted to soil, water, and air by non-ferrous metal mining and refining, manufacturing, the application of phosphate fertilizers, fossil fuel combustion, as well as waste incineration and disposal [1]. People can be exposed to Cd from air, diet, drinking water, or by skin contact. Cd mainly accumulates in the kidneys and liver, with estimated half-lives of 6–38 years in kidney and 4–19 years in liver [2]. Urinary Cd levels (uCd, half-life of 15–30 years) mainly reflect cumulative Cd exposure in long-term exposures, whereas blood Cd levels 3–4 months) reflect recent exposures [3]. Since the early 1950s, the hazards of occupational exposure to Cd have been recognized, concerning the toxic effects of Cd exposure in humans and laboratory animals.
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