Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea

Association Among Sources Exposure of Cadmium in the Adult Non-smoking General Population of Tehran

Acute and chronic exposure to cadmium can cause numerous health effects including poisoning, as well as, bone, liver, and kidney diseases. Cadmium competes with iron absorption in blood and can induce anemia. Cadmium body burden can be measured through urine and blood samples. Urine reflects chronic and blood indicates recent and cumulative exposures to cadmium. Dietary is considered as the main source of exposure to cadmium in non-smoking general population. The study was conducted to determine cadmium level in blood, urine, and in diet of 120 non-smoking adults in Tehran. Dietary components and consumption pattern of participants estimated by a food frequency questionnaire. Next, the correlation investigated between them. Moreover, serum ferritin measured as a marker of iron storage in blood to determine its association with cadmium. The prediction of cadmium fate in the body is determined by toxicokinetic models. This study tried to evaluate one of these models' validity which is developed to predict urinary cadmium from dietary. Afterwards, the predicted urinary compared with the measured urinary cadmium. The correlation coefficient between dietary and blood cadmium equaled 0.66 which was statically significant, but the correlation between dietary and urinary cadmium was minimal and not statically significant (p > 0.05). An inverse and negative correlation was found between serum ferritin and blood cadmium. The mean predicted urinary cadmium calculated by the model was 2.5-fold higher than the measured value in the total population. Results of the present study revealed that blood cadmium reflected mainly acute exposure. There was no correlation between chronic and acute exposures to cadmium. The low serum ferritin level increased cadmium amount in blood. Moreover, the mean predicted urinary cadmium by the model was greater than the measured value. It can because of characteristics of populations and type of dietary exposure. Thus, it is suggested that the model coefficients are determined in each society based on their characteristics.

Food intake survey of kindergarten children in Korea: Part 3 cadmium and lead burden

OBJECTIVES

This study was initiated to elucidate the extent of dietary exposure of children in Korea to two pollutant metals of cadmium (Cd) and lead (Pb). Possible urban-rural difference was also examined.

METHODS

Food duplicate and morning spot urine samples were collected from 108 children in 4 kindergartens (KG) (1 KG in Seoul and 3 KGs in Jeju Island), as reported in a previous publication. The samples were analyzed for Cd and Pb by ICP-MS.

RESULTS

Cd and Pb in food duplicate and urine samples were distributed approximately log-normally. Geometric means for Cd and Pb in food duplicate samples were 12.4 and 5.8 μg/day, or 0.58 and 0.27 μg/kg body weight/day, respectively, and the values for Cd and Pb in urine (as observed, i.e., with no correction for urine density) were 0.91 and 1.64 μg/L, respectively. 2.41 and 0.30 μg/day of Cd and Pb (accounting for 19.5 and 5.1%) came from boiled rice, the staple food. The levels of Cd and Pb burden among the children in the present survey were essentially the same with the levels reported for children in Pusan. The reasons for difference in the rank in Cd-D and Cd-U among the 4 KGs need further study.

CONCLUSIONS

The observed levels of Cd and Pb exposure were more or less similar to what were reported for children in Pusan. No apparent urban-rural difference could be detected.

Blood lead concentrations in Jamaican children with and without autism spectrum disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder manifesting by early childhood. Lead is a toxic metal shown to cause neurodevelopmental disorders in children. Several studies have investigated the possible association between exposure to lead and ASD, but their findings are conflicting. Using data from 100 ASD cases (2–8 years of age) and their age- and sex-matched typically developing controls, we investigated the association between blood lead concentrations (BLC) and ASD in Jamaican children. We administered a questionnaire to assess demographic and socioeconomic information as well as exposure to potential lead sources. We used General Linear Models (GLM) to assess the association of BLC with ASD status as well as with sources of exposure to lead. In univariable GLM, we found a significant difference between geometric mean blood lead concentrations of ASD cases and controls (2.25 μg/dL cases vs. 2.73 μg/dL controls, p < 0.05). However, after controlling for potential confounders, there were no significant differences between adjusted geometric mean blood lead concentrations of ASD cases and controls (2.55 μg/dL vs. 2.72 μg/dL, p = 0.64). Our results do not support an association between BLC and ASD in Jamaican children. We have identified significant confounders when assessing an association between ASD and BLC.

Cadmium blood and urine concentrations as measures of exposure: NHANES 1999-2010

Exposure to cadmium, a heavy metal present in cigarettes, can be assessed in both urine and blood. Few studies have compared the properties of concurrent measurements of urine cadmium (uCd) and blood cadmium (bCd) in relation to the duration and timing of a known exposure. In this study, bCd and uCd were modeled with data from the National Health and Nutrition Examination Survey (1999-2010). Adjusted geometric mean bCd and uCd were estimated from regression results. Each 1% higher geometric mean uCd was associated with 0.50% (95% confidence interval: 0.47%-0.54%; R(2)=0.30) higher bCd. In male never-smokers, bCd was 69% (59%-81%) and uCd was 200% (166%-234%) higher at age ≥70 years versus 20-29 years. Ten pack-years (py) of smoking were associated with 13.7% (10.0%-17.4%) higher bCd and 16.8% (12.6%-21.1%) higher uCd in male smokers. The first year after smoking cessation was associated with 53% (48%-58%) lower bCd and 23% (14%-33%) lower uCd in representative males aged 55 years with 20 py smoking. Smoking in the previous 5 days was associated with 55% (40%-71%) higher bCd and 7% (-3%-18%) higher uCd. Results were similar for women. uCd mainly measures long-term exposure and bCd recent exposure, but with noticeable overlap. Epidemiological studies should base the choice of uCd or bCd on the timing of cadmium exposure relevant to the disease under study.

Magnesium, calcium, and trace elements excretion in 24-h urine

Urine is a clinical specimen often used in medical diagnostics for monitoring of elements concentrations and kidneys function. We determined the contents of magnesium (Mg), calcium (Ca), zinc (Zn), copper (Cu), iron (Fe), lead (Pb), and cadmium (Cd) in 74 samples of 24-h urine (from 46 women and 28 men). The measurements were realized by the atomic absorption spectrometry (AAS) with atomization in the flame (FAAS) and in the graphite furnace (GFAAS). The received results were the subject of statistical analysis including the sex and age of volunteers. Moreover, correlations between the elements and the relationships between age and amounts of excreted elements with urine were tested. We found the statistically significant higher content of Zn in men's urine than in women(')s one. Moreover, both adult women and men (>18 years) excreted much more Ca in urine in comparison to young subjects. Only in case of Pb the significant positive correlation between its amount in 24-h urine of all donors and age was stated. The correlation analysis has shown the significant positive relationships between Ca-Mg, Ca-Fe, Mg-Fe, Cu-Fe, Cu-Cd, Fe-Cd, and Pb-Cd in total samples of urine. Basing on our results, we concluded that the gender and age of donors may impact on the elemental status of 24-h urine.

[Use of urine lead level as an exposure indicator and its relationship to blood lead]

The aim of this work was to verify whether there are statistically significant correlation between the concentrations of lead in blood (Pb-B) and urine (Pb-U). Electrothermal atomic absorption spectrometry was used in the determination of lead concentration in biological material. Venous blood and spot urine were collected from workers occupationally exposed (95), adults (130) and children up to 15 years old (22) environmentally exposed. After a test showing significant differences between Pb-U and the three categories previously determined, cutting points for Pb-U were established to predict Pb-B values by the ROC curve. Thus, it is expected that Pb-B is lower than 10 microg.dL-(1) with Pb-U up to 0.55 microg.dL-(1), whereas lead levels in blood below 27.6 microg.dL-(1) are expected when the amount of the metal in urine is lower than 2.05 microg.dL-(1). So, urine can be used to replace blood for the assessment of the occupational exposure to lead. However, caution is advised in the case of environmental exposure, since urinary lead should be used just as an estimation of the metal content in blood.

Safe levels of cadmium intake to prevent renal toxicity in human subjects

The present review attempts to provide an update of the scientific knowledge on the renal toxicity which occurs in human subjects as a result of chronic ingestion of low-level dietary Cd. It highlights important features of Cd toxicology and sources of uncertainty in the assessment of health risk due to dietary Cd. It also discusses potential mechanisms for increased susceptibility to Cd toxicity in individuals with diabetes. Exposure assessment on the basis of Cd levels in foodstuffs reveals that vegetables and cereals are the main sources of dietary Cd, although Cd is also found in meat, albeit to a lesser extent. Cd accumulates particularly in the kidney and liver, and hence offal contains relatively high amounts. Fish contains only small quantities of Cd, while crustaceans and molluscs may accumulate larger amounts from the aquatic environment. Data on Cd accumulation in human kidney and liver obtained from autopsy studies are presented, along with results of epidemiological studies showing the relationship between renal tubular dysfunction and kidney Cd burden. These findings suggest that a kidney Cd level of 50 μg/g wet weight is a maximum tolerable level in order to avoid abnormal kidney function. This renal Cd burden corresponds to a urinary Cd excretion of 2 μg/d. Accordingly, safe daily levels of Cd intake should be kept below 30 μg per person. Individual variations in Cd absorption and sensitivity to toxicity predicts that a dietary Cd intake of 30 μg/d may result in a slight renal dysfunction in about 1 % of the adult population. The previous guideline for a maximum recommended Cd intake of 1 μg/kg body weight per d is thus shown to be too high to ensure that renal dysfunction does not occur as a result of dietary Cd intake.

Lead and cadmium levels in daily foods, blood and urine in children and their mothers in Korea

OBJECTIVES

The present study was initiated to examine the dietary intake, blood level and urinary concentration of lead (Pb) and cadmium (Cd) among children in Korea, in comparison with the findings in their mothers.

METHODS

Peripheral blood, spot urine and 24-h food duplicate samples were collected in Busan, Korea, from 38 pairs of children (4-10 years of age) and their mothers (28-46 years, non-smoking, mostly housewives), who provided informed consent. Samples were wet-ashed by being heated in the presence of mineral acids, and Pb and Cd in the wet-ashed samples were analyzed by graphite furnace atomic absorption spectrometry. Pb and Cd in food (Pb-F, Cd-F), blood (Pb-B, Cd-B) and urine [observed value (Pb-Uob, Cd-Uob), and values corrected for creatinine (Pb-Ucr, Cd-Ucr) or a specific gravity (1.016; Pb-Usg, Cd-Usg)] were presented in terms of geometric mean (GM) and geometric standard deviation (GSD).

RESULTS

Pb-F and Cd-F in the children were 0.337 microg Pb and 0.457 microg Cd/kg body weight per day as GM, respectively. Pb-B and Cd-B were 38.0 microg Pb and 1.51 microg Cd/l, and Pb-U and Cd-Uob were 5.44 microg Pb/l and 1.33 microg Cd/l, respectively. Pb-F and Pb-B for children were not significantly different from the values for their mothers. In contrast, Cd-F and Cd-B were significantly different between children and their mothers. Cd-F for children correlated with Cd-F for mothers, but no significant correlation was observed in Cd-B, Cd-U, Pb-F, Pb-B or Pb-U between children and their mothers. The dietary intake of Pb in total Pb intake (i.e., respiratory and dietary intake) accounted for 51.7 and 64.8% in children and their mothers, respectively, whereas the corresponding proportions were 97.8 and 98.2%, respectively, for Cd.

CONCLUSION

Cd intake was exclusively from food, both in children and mothers. Dietary Cd intake of children significantly correlated with that of their mothers. Dietary Pb intake in children, however, did not correlate with that of their mothers. Pb uptake from ambient air tended to be higher in children than in their mothers.

A global perspective on cadmium pollution and toxicity in non-occupationally exposed population

Cadmium is a non-essential element that has high rates of soil to plant transference compared with other non-essential elements, and certain plant species accumulate large amounts of cadmium from low cadmium content soils. In this paper, levels of cadmium found in major food groups are highlighted together with cadmium levels found in liver and kidney samples from non-occupationally exposed populations. Data on human kidney cadmium levels identified recently, including the study in our own laboratory, are compared with older studies. Human-tissue cadmium contents showed large variations among individuals, but sources of the variation remain unknown. Exposure levels of 30-50 microg per day have been estimated for adults and these levels have been linked to increased risk of bone fracture, cancer, kidney dysfunction and hypertension. Increased mortality was found among individuals showing signs of cadmium renal toxicity compared with those without such signs, suggesting that renal toxicity may be an early warning of complications, sub-clinical or clinical morbidity.

Cadmium levels in the lung, liver, kidney cortex, and urine samples from Australians without occupational exposure to metals

The authors undertook this study to assess levels of cadmium exposure in the general population. Samples of lung, liver, and kidney were obtained from 61 cadavers (43 males, 18 females; 2-89 yr of age, mean age = 38.5 yr) who died from accidental causes and who were subject to postmortem examinations at the John Tonge Centre for Forensic Sciences, Queensland Health Scientific Services, Brisbane, Australia, in 1997 and 1998. Samples of bladder urine were also obtained from 22 cadavers. Tissue and urine samples were analyzed for cadmium, zinc, and copper with inductively coupled plasm (ICP) mass spectrometry. The overall mean values for cadmium in the lung, liver, and kidney cortex samples were 0.13, 0.95, and 15.45 microg/gm wet tissue weight. The average renal cadmium level in subjects with high lung-cadmium levels (n = 13) was 6 microg/gm wet tissue weight higher than that of similarly aged subjects who had medium lung-cadmium levels (n = 30). In females, the average level of cadmium in the liver was 74% greater than in males, and the average liver cadmium in females with high lung-cadmium levels was 100% higher than in males in the same age range who had the same high lung-cadmium levels. Renal cadmium accumulation tended to be greater in females than in males who were in the same age range and who had similar lung-cadmium levels, a result that suggested that there was a higher absorption rate of cadmium in females. The mean value for a urinary cadmium excretion of 2.30 microg/gm creatinine was found in a subset of samples that had a mean age of 39 yr and a renal cortex cadmium concentration of 18.6 microg/gm wet tissue weight. Urinary cadmium excretion rates were correlated more strongly with lung and kidney cadmium content than with age or liver cadmium levels. The results suggest that urinary cadmium excretion may be increased in smokers and could provide some estimate of body cadmium burdens in future Australian epidemiological studies.

Alimentary lead intake of adults in Thuringia/Germany determined with the duplicate portion technique

The daily lead intake in Germany in 1996 was studied using the duplicate portion technique. The study was carried out in four towns in Thuringia (Jena, Ronneburg, Rositz, Steudnitz), in which volunteers collected all foods and beverages over 7 consecutive days. The mean lead content of consumed food and beverages was 66 and 55 microg/kg dry matter for women and men, respectively; the average lead intake was 19 microg/day for both, women and men. In relation to body weight (b.w.) the intake for women was 283 ng/kg and for men 242 ng/kg b.w. These values are well below the WHO limit. An oral lead exposure of the adult population of Thuringia/Germany can be excluded.

Exposure of women in general populations to lead via food and air in East and Southeast Asia

BACKGROUND

Despite increasing public concern of the possible health effects of lead (Pb) on general populations, reports on Pb levels in blood (Pb-B) and urine (Pb-B), as well as Pb intake via foods (Pb-F) for many Asian countries are scarce. The present study was initiated to elucidate the extent of non-occupational Pb exposure among general populations in East and Southeast Asia.

METHODS

In 1991-1997, peripheral blood, morning spot urine and 24-hour food duplicate samples were collected from 20 to 50 non-smoking adult women in each of four cities in Southeast Asia and five cities in Mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively coupled plasma mass spectrometry for Pb-B, Pb-U and Pb-F. Measures after logarithmic conversion were subjected to ANOVA and regression analysis.

RESULTS

Geometric mean values in cities in East and Southeast Asia were in ranges of 32-65 microg/L for Pb-B, 2.1-7.5 microg/g cr for Pb-Ucr, and 7-32 microg/day for Pb-F. The values for a combination of two cities of Tokyo and Kyoto, Japan (38 microg/L for Pb-B and 9.3 microg/day for Pb-F) appeared to be lower than the values for other Asian cities, and the values for all Japan (thus including both urban and rural areas) were even lower (19 microg/L for Pb-B and 7.7 microg/day for Pb-F). Comparison of Pb uptake via respiratory and dietary routes showed that Pb via dietary route accounted for 15% of the total in Manila where Pb in air was high (ca. 650 ng/m(3)), whereas it was 54% in Tokyo+Kyoto where Pb in air was low (ca. 75 ng/m(3)).

CONCLUSIONS

When compared internationally, Pb-F and Pb-B in Asia in general are similar to or somewhat higher than the levels in Europe and USA, whereas the levels in Japan are probably lower than the two latter areas. In Asia, Pb-F accounted for 15-54% of all Pb sources, the percentage being variable depending on local conditions especially Pb in atmospheric air.

Urban population exposure to lead and cadmium in east and south-east Asia

Information is still scarce for many Asian countries on general population exposure to two potentially toxic heavy metals of lead (Pb) and cadmium (Cd). The present review on publications from this study group is intended to provide an overview of the non-occupational exposure to Pb and Cd among general populations in east and south-east Asia. During the period of 1991-1998, surveys were conducted in four cities in south-east Asia, five cities in mainland China, and two cities each in Japan and Korea. Peripheral blood, morning spot urine and 24-h food duplicate samples were collected from 20-50 non-smoking adult women in each survey site. The samples were digested by heating in the presence of mineral acids, and then analyzed by inductively-coupled plasma mass spectrometry for the metals in blood (Pb-B and Cd-B), in urine (Pb-U and Cd-U), and in food duplicate (Pb-F and Cd-F). Measures were subjected to statistical analysis with an assumption of log-normal distribution. Pb-B, Pb-U and Pb-F levels varied substantially among the 11 urban sites; GM distributed in ranges of 32-65 microg/l for Pb-B, 2.1-7.5 microg/g cr (creatinine) for Pb-U, and 7-32 microg/day for Pb-F. The same was also the case for Cd exposure parameters, the distribution ranges being 0.5-1.8 microg/l for Cd-B, 1.2-3.1 microg/g cr for Cd-U, and 5-32 microg/day for Cd-F. It appeared that the exposure to Pb and Cd was highest in Kuala Lumpur, and Tokyo + Kyoto, respectively, and lowest in Tokyo + Kyoto and in Manila. Additional surveys in Japan showed that Pb exposure was even lower in rural areas than in Tokyo + Kyoto. When compared with the values reported in the literature, Pb exposure levels among Asian populations appear to be similar to the levels in Europe and in the United States, whereas Cd exposure seems to be higher in Asia than in Europe. The contribution of the dietary route in Pb absorption was variable and was inversely related to the extent of air pollution, whereas Cd uptake was almost exclusively via the dietary route with little contribution of the respiratory route.

Background lead and cadmium exposure of adult women in Xian City and two farming villages in Shaanxi Province, China

The objectives of the present study are: (a) to clarify the current levels of environmental exposure to lead (Pb) and cadmium (Cd) in Shaanxi Province in China in comparison with levels in other parts of mainland China; (b) to examine if there is any urban-rural difference in Pb and Cd exposure; and (c) to quantify the role of cereals as the dietary source of environmental exposure to these metals. For this purpose, triplet surveys on lead and cadmium exposure were conducted in the provincial capital of Xian and two farming villages A and B in Shaanxi Province, China in 1997. The grand geometric mean for lead (Pb) intake via foods (Pb-F), Pb in blood (Pb-B) and Pb in urine as corrected for creatinine concentration (Pb-Ucr) were 30 micrograms/day, 33 micrograms/l and 5 micrograms/g creatinine, respectively, with significant differences among the survey sites, e.g. Pb-B being higher in Xian (43 micrograms/l) than in the two villages (38 and 22 micrograms/l). The counterpart values for cadmium (Cd) intake via foods (Cd-F), Cd in blood (Cd-B) and Cd in urine (Cd-Ucr) were 6.1 micrograms/day, 0.46 microgram/l and 2.8 micrograms/g creatinine, respectively, with no substantial inter-survey site difference. Thus, it was possible to conclude that, from comparison with the values reported in 1990s literature, the exposure of Shaanxi people to Pb and Cd is no higher than, and even possibly lower than, the levels reported for people in other parts of mainland China. The exposure to Cd was almost exclusively from foods, whereas the exposure to air-borne Pb was large enough in Xian to explain higher Pb-B and Pb-Ucr than the level in Village B despite lower Pb-F in Xian than in Village B. Cereals (wheat, rice, maize and foxtail millet) contributed 26 and 84% of dietary Pb and Cd intake, respectively.

Correlation between concentration in urine and in blood of cadmium and lead among women in Asia

The objectives of the present study are to examine if there exists a quantitative relationship between lead in urine (Pb-U) and that in blood (Pb-B), and also between cadmium in urine (Cd-U) and that in blood (Cd-B) among the general populations who are environmentally (and not occupationally) exposed to these elements at various levels. For this purpose, peripheral blood and morning spot urine samples were collected in 1991-1998 from approximately 50 non-smoking adult women each in four cities in south-east Asia and five cities in mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively-coupled plasma mass spectrometry for Pb-B, Cd-B, Pb-U and Cd-U. Measured values were subjected to analysis to detect possible correlation between the pairs of parameters. A significant correlation between Pb-B and Pb-U was observed when the intensity of Pb exposure (as expressed by Pb-B) was relatively high so that the correlation was significant in all cases studied when Pb-B level was, e.g. 50 microg/l or above. It was also observed that the correlation between Cd-B and Cd-U was significant when Cd-B was, e.g. > 1 microg/l. Thus, it is possible to deduce that, in environmental health, Pb-B and Cd-U levels can be estimated on a group basis from Pb-U and Cd-B, respectively, when Pb and Cd exposure levels are relatively high, e.g. with Pb-B and Cd-B of > 50 microg/l and > 1 microg/l.

Non-occupational lead and cadmium exposure of adult women in Bangkok, Thailand

This survey was conducted to examine the extent of the exposure of Bangkok citizens to lead (Pb) and cadmium (Cd), and to evaluate the role of rice as the source of these heavy metals. In practice, 52 non-smoking adult women in an institution in the vicinity of Bangkok, volunteered to offer blood, spot urine, boiled rice and 24-h total food duplicate samples. Samples were wet-ashed, and then analyzed for Pb and Cd by ICP-MS. Geometric means for the levels in blood (Pb-B and Cd-B) and urine (Pb-U and Cd-U as corrected for creatinine concentration), and also for dietary intake (Pb-F and Cd-F) were 32.3 micrograms/l for Pb-B, 0.41 microgram/l for Cd-B, 2.06 micrograms/g creatinine for Pb-U, 1.40 micrograms/g creatinine for Cd-U, 15.1 micrograms/day for Pb-F and 7.1 micrograms/day for Cd-F. Rice contributed 30% and 4% of dietary Cd and Pb burden, respectively. When compared with the counterpart values obtained in four neighboring cities in southeast Asia (i.e. Nanning, Tainan, Manila, and Kuala Lumpur), dietary Pb burden of the women in Bangkok was middle in the order among the values for the five cities. Pb level in the blood was the lowest of the levels among the five cities and Pb in urine was also among the low group. This apparent discrepancy in the order between Pb-B (i.e. the fifth) and Pb-F (the third) might be attributable to recent reduction of Pb levels in the atmosphere in Bangkok. Regarding Cd exposure, Cd levels in blood and urine as well as dietary Cd burden of Bangkok women were either the lowest or the next lowest among those in the five cities.