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Background Exposure to the toxic metal cadmium is widespread globally and especially prevalent in low- and middle-income countries (LMICs). Early life (from pregnancy through childhood) is a vulnerable window for exposure. Therefore, interventions in low- and middle-income countries to prevent or reduce early life exposure to cadmium may be relevant for improving public health. Methods We systematically reviewed five databases (Scopus, Web of Science, Global Health Medicus, Greenfile, and PubMed). A synthesis without meta-analysis (narrative synthesis) was used for data analysis due to the wide heterogeneity of included studies. Study quality and risk of bias were assessed using modified GRADE criteria. Results 4098 articles were returned by the search and a total of 26 studies from 21 LMICs were included in this review, ranging from policies to clinical treatment, rehabilitation and clean-up methods for agricultural soil, interventions for nutrition and cooking, and anti-pollution strategies at the household level. The interventions targeted children, pregnant and postpartum women, and/or women of childbearing age. While several studies provided some evidence of effectiveness, none appeared to offer a realistic solution for cadmium pollution at scale. Agricultural and food preparation studies were relatively frequent, particularly related to rice. Studies on air filtration during pregnancy indicated some effectiveness in reducing indoor cadmium exposures. Conclusions Cadmium pollution is a persistent and widespread threat to children’s health with few identified solutions. Long-lasting damage to children’s health starting in the earliest years should motivate investment in higher-quality interventions, innovations, and further research. Registration PROSPERO (CRD42021235435).

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ObjectivesIn this study, we aim to analyse the relationship between educational attainment and all-cause mortality of adults in the high-income Asia Pacific region.DesignThis study is a comprehensive systematic review and meta-analysis with no language restrictions on searches. Included articles were assessed for study quality and risk of bias using the Joanna Briggs Institute critical appraisal checklists. A random-effects meta-analysis was conducted to evaluate the overall effect of individual level educational attainment on all-cause mortality.SettingThe high-income Asia Pacific Region consisting of Japan, South Korea, Singapore and Brunei Darussalam.ParticipantsArticles reporting adult all-cause mortality by individual-level education were obtained through searches conducted from 25 November 2019 to 6 December 2019 of the following databases: PubMed, Web of Science, Scopus, EMBASE, Global Health (CAB), EconLit and Sociology Source Ultimate.Primary and secondary outcome measuresAdult all-cause mortality was the primary outcome of interest.ResultsLiterature searches resulted in 15 345 sources screened for inclusion. A total of 30 articles meeting inclusion criteria with data from the region were included for this review. Individual-level data from 7 studies covering 222 241 individuals were included in the meta-analyses. Results from the meta-analyses showed an overall risk ratio of 2.40 (95% CI 1.74 to 3.31) for primary education and an estimate of 1.29 (95% CI 1.08 to 1.54) for secondary education compared with tertiary education.ConclusionThe results indicate that lower educational attainment is associated with an increase in the risk of all-cause mortality for adults in the high-income Asia Pacific region. This study offers empirical support for the development of policies to reduce health disparities across the educational gradient and universal access to all levels of education.PROSPERO registration numberCRD42020183923.