Accurately assessing the health risks of cadmium (Cd) exposure in the soil-wheat system is of great importance for the formulation of regional health risk prevention measures. Based on regional large-scale survey and Monte Carlo simulation methods, a case study on the health risk of Cd exposure in a soil-wheat system in a wheat production area of North China Plain was conducted by constructing a comprehensive health risk assessment (CHRA) model. The results showed that 73% of the soil samples in the study area exceeded the screening value of Cd for farmland soil (GB 15618-2018) and 57.8% of the wheat samples exceeded the national standard (GB 2762-2017) for Cd. The hand-mouth ingestion pathway was the main route of soil Cd exposure for adults and children in the region, and under this pathway, 34.7% of adults and 57.4% of children had a cancer risk higher than the safe threshold recommended by USEPA (1E-06). The comprehensive non-carcinogenic and carcinogenic risks of cadmium exposure from the soil-wheat system in the region were higher than the safe domain values for both adults and children, with the probabilities of 26.4% and 100% for adults and 62.5% and 100% for children, respectively. The overall trends of the comprehensive risks showed that children had higher risks than those of adults. The combined application of the comprehensive health risk assessment model and the uncertainty random simulation method helps to improve the accuracy of risk decision-making.
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