Reduction in Cadmium Exposure in the United States Population, 1988–2008: The Contribution of Declining Smoking Rates

Abstract

Background: Public health policies such as tobacco control, air pollution reduction, and hazardous waste remediation may have reduced cadmium exposure among U.S. adults. However, trends in urine cadmium, a marker of cumulative cadmium exposure, have not been evaluated.Objectives: We estimated the trends in urine cadmium concentrations in U.S. adults using data from the National Health and Nutrition Examination Surveys (NHANES) from 1988 to 2008. We also evaluated the impact of changes in the distribution of available cadmium determinants (age, sex, race, education, body mass index, smoking, and occupation) at the population level to explain cadmium trends.Methods: The study population included 19,759 adults ≥ 20 years of age with measures of urine cadmium and cadmium determinants.Results: Age-adjusted geometric means of urine cadmium concentrations were 0.36, 0.35, 0.27, 0.27, 0.28, 0.25, and 0.26 µg/g creatinine in 1988–1991, 1991–1994, 1999–2000, 2001–2002, 2003–2004, 2005–2006, and 2007–2008, respectively. The age, sex, and race/ethnicity-adjusted percent reduction in urine cadmium geometric means comparing 1999–2002 and 2003–2008 with 1988–1994 were 27.8% (95% confidence interval: 22.3%, 32.9%) and 34.3% (29.9%, 38.4%), respectively (p-trend < 0.001), with reductions in all participant subgroups investigated. In never smokers, reductions in serum cotinine accounted for 15.6% of the observed reduction. In ever smokers, changes in smoking cessation, and cumulative and recent dose accounted for 17.1% of the observed reduction.Conclusions: Urine cadmium concentrations decreased markedly between 1988 and 2008. Declining smoking rates and changes in exposure to tobacco smoke may have played an important role in the decline of urine cadmium concentrations, benefiting both smokers and nonsmokers. Cadmium has been associated to several health outcomes in NHANES 1999–2008. Consequently, despite the observed decline, further reduction in cadmium exposure is needed.

Cadmium Exposure and Incident Peripheral Arterial Disease

“…Nonetheless, urine cadmium concentrations in the SHS participants were higher than in the general US population. 41 Although the prevalence of smoking is higher in American Indians than in other US ethnic groups, [42][43][44] their intensity of smoking is markedly lower, 43 and sources of exposure other than smoking, such as occupational and environmental exposures, 40,[45][46][47] may be involved in the increased urine cadmium concentrations in our study population.…”

Heavy Metals, Cardiovascular Disease, and the Unexpected Benefits of Chelation Therapy

“…Food and smoking are the major sources of cadmium for general populations (36). The potential toxicity of cadmium is amplified by its extremely slow excretion rate.…”

Association of lead and cadmium exposure with frailty in US older adults

“…First, to account for current exposure to tobacco smoke, including secondhand smoke, that is a source of lead and cadmium (Apostolou et al 2012;Tellez-Plaza et al 2012 Statistical analyses were performed with the STATA v.13.0 software (Stata Corp, College Station, TX) by using the survey procedures to account for the complex sampling design in NHANES III…”