, Volume 23, Issue 5, pp 769–782 | Cite as

Cadmium exposure in the population: from health risks to strategies of prevention

  • Tim S. NawrotEmail author
  • Jan A. Staessen
  • Harry A. Roels
  • Elke Munters
  • Ann Cuypers
  • Tom Richart
  • Ann Ruttens
  • Karen Smeets
  • Herman Clijsters
  • Jaco Vangronsveld


We focus on the recent evidence that elucidates our understanding about the effects of cadmium (Cd) on human health and their prevention. Recently, there has been substantial progress in the exploration of the shape of the Cd concentration-response function on osteoporosis and mortality. Environmental exposure to Cd increases total mortality in a continuous fashion without evidence of a threshold, independently of kidney function and other classical factors associated with mortality including age, gender, smoking and social economic status. Pooled hazard rates of two recent environmental population based cohort studies revealed that for each doubling of urinary Cd concentration, the relative risk for mortality increases with 17% (95% CI 4.2–33.1%; P < 0.0001). Tubular kidney damage starts at urinary Cd concentrations ranging between 0.5 and 2 μg urinary Cd/g creatinine, and recent studies focusing on bone effects show increased risk of osteoporosis even at urinary Cd below 1 μg Cd/g creatinine. The non-smoking adult population has urinary Cd concentrations close to or higher than 0.5 μg Cd/g creatinine. To diminish the transfer of Cd from soil to plants for human consumption, the bioavailability of soil Cd for the plants should be reduced (external bioavailability) by maintaining agricultural and garden soils pH close to neutral (pH-H2O of 7.5; pH-KCL of 6.5). Reducing the systemic bioavailability of intestinal Cd can be best achieved by preserving a balanced iron status. The latter might especially be relevant in groups with a lower intake of iron, such as vegetarians, and women in reproductive phase of life. In exposed populations, house dust loaded with Cd is an additional relevant exposure route. In view of the insidious etiology of health effects associated with low dose exposure to Cd and the current European Cd intake which is close to the tolerable weekly intake, one should not underestimate the importance of the recent epidemiological evidence on Cd toxicity as to its medical and public health implications.


Cadmium Epidemiology Kidney Prevention Mortality Osteoporosis Toxic metals 



The Environmental Health research at Hasselt University is supported by grants from the Flemish Fund for Scientific Research (FWO, krediet aan navorsers to T.N.) and internal Hasselt University grants (Bijzonder Onderzoekdsfonds, BOF).


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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Tim S. Nawrot
    • 1
    • 2
    Email author
  • Jan A. Staessen
    • 3
    • 4
  • Harry A. Roels
    • 5
  • Elke Munters
    • 1
  • Ann Cuypers
    • 1
  • Tom Richart
    • 3
    • 4
  • Ann Ruttens
    • 1
    • 6
  • Karen Smeets
    • 1
  • Herman Clijsters
    • 1
  • Jaco Vangronsveld
    • 1
  1. 1.Centre for Environmental SciencesHasselt UniversityDiepenbeekBelgium
  2. 2.School of Public HealthKULeuvenBelgium
  3. 3.Study Coordinating Centre, Department of Cardiovascular DiseasesKULeuvenLeuvenBelgium
  4. 4.Unit of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands
  5. 5.Louvain Centre for Toxicology and Applied PharmacologyUniversité catholique de LouvainBrusselsBelgium
  6. 6.CODA, Centre for AgrochemistryTervurenBelgium

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