Estimated long-term dietary exposure to lead, cadmium, and mercury in young Korean children

Cadmium exposure in infants and children: toxicity, health effects, dietary risk assessment and mitigation strategies

As a non-essential metal, cadmium (Cd) poses a significant threat to food safety and public health. This risk is particularly pronounced for infants and young children due to their high food consumption relative to body weight and immature physiological systems. This review examines the health risks associated with Cd exposure, particularly during the prenatal period through adolescence. It evaluates the prevalence of Cd-rich foods in children's diets and their intake levels across various countries. The review demonstrates that Cd exposure is associated with neurodevelopmental disorders, immune dysfunction, and cardiovascular diseases. It also highlights geographic differences in exposure, with some Asian countries, such as Thailand and China, exhibiting higher overall levels of Cd intake among children compared to other regions. This review presents several recommendations to mitigate Cd intake during early childhood, including reducing the Cd content in food, inhibiting Cd absorption, and promoting its excretion from the body. To minimize the risk of dietary Cd intake in children, it is recommended that stringent regulations of Cd limits in children's food be implemented, alongside a coordinated multi-stakeholder effort. This review provides important insights into effective public health policy development, laying the foundation for achieving broader public health goals.

Homemade weaning foods as a source of lead and mercury exposure in Korean infants - A dietary risk assessment study

Lead (Pb) and mercury (Hg) are neurodevelopmental toxicants that pose risks to cognitive and behavioral health. Given early childhood's vulnerability to these metals, understanding their sources and pathways of exposure during infancy is crucial for public health. During the weaning process, infants may be exposed to metals through the baby food they consume. We aimed to assess metal exposure through homemade weaning foods by analyzing 288 samples consumed by 157 Korean infants aged 6-, 9-, 12-, 15-, and 24-27 months. Pb was detected in 65 % of samples, with levels reaching up to 169 ng/g. Notably, 58 % exceeded the Maximum Level (ML) of 10 ng/g, with a median concentration of 14.7 ng/g fresh weight. Total Hg was found in 88 % of samples, with a median concentration of 4.56 ng/g fresh weight. Estimated median daily intakes of Pb and Hg were 0.29 and 0.09 μg/kg/d, respectively. Considering a benchmark dose for Pb (0.5 μg/kg/d by EFSA), 94 % (the margin of exposure <10) of all age groups was estimated to have a potential health concern associated with homemade baby food consumption. For Hg, only 6 % exceeded a hazard quotients of 1 compared to a provisional tolerable weekly intake for Hg (4 μg/kg/week by WHO). This study marks the first direct assessment of daily Pb and Hg intake through homemade baby food among Korean infants. Our findings underscore the urgent need for heightened awareness regarding metal exposure through homemade baby food.

Associations among prenatal and postnatal arsenic, lead, and cadmium exposures and motor development in 3-year-old children: a longitudinal birth cohort study in Taiwan

Prenatal and postnatal exposures to heavy metals have been suggested to interfere with neurodevelopment, but the neurotoxicity of lead (Pb), arsenic (As), and cadmium (Cd) is still unclear. In this study, we aimed to assess the associations between the levels of As, Cd, and Pb and children's neurodevelopment. A total of 299 mother-infant pairs were recruited in this study and their meconium were collected. After three years, 53 children underwent the Bayley Scales of Infant and Toddler Development (Bayley-III) examinations and provided hair and fingernail specimens. The levels of As, Cd, and Pb in the meconium, hair, and fingernail were measured by inductively coupled plasma mass spectrometry; the median levels were the following: meconium, 42.7, 5.57, and 25.6 ng/g, respectively; hair, 0.19, 0.05, and 3.61 μg/g, respectively; and fingernail, 0.29, 0.04, and 0.84 μg/g, respectively. After adjusting for potential confounding factors, we found that the log-transformed levels of As in the hair samples was negatively associated with gross motor development (β =  - 0.032; 95% confidence interval: - 0.061 to - 0.004). We conclude that postnatal exposure to As is a crucial period for gross motor development in children, while the effects of Cd and Pb on neurodevelopment are less clear.

Health Safety Assessment of Ready-to-Eat Products Consumed by Children Aged 0.5-3 Years on the Polish Market

Toxic elements have a negative impact on health, especially among infants and young children. Even low levels of exposure can impair the normal growth and development of children. In young children, all organs and metabolic processes are insufficiently developed, making them particularly vulnerable to the effects of toxic elements. The aim of this study is to estimate the concentration of toxic elements in products consumed by infants and young children. The health risk of young children due to consumption of ready-made products potentially contaminated with As (arsenic), Cd (cadmium), Hg (mercury), and Pb (lead) was also assessed. A total of 397 samples (dinners, porridges, mousses, snacks "for the handle", baby drinks, dairy) were analyzed for the content of toxic elements. Inductively coupled plasma mass spectrometry (ICP-MS) was used to assess As, Cd, and Pb concentration. The determination of Hg was performed by atomic absorption spectrometry (AAS). In order to estimate children's exposure to toxic elements, the content of indicators was also assessed: estimated daily intake (EDI), estimated weekly intake (EWI), provisional tolerable weekly intake (PTWI), provisional tolerable monthly intake (PTMI), the benchmark dose lower confidence limit (BMDL), target hazard quotient (THQ), hazard index (HI), and cancer risk (CR). The average content of As, Cd, Hg, and Pb for all ready-made products for children is: 1.411 ± 0.248 µg/kg, 2.077 ± 0.154 µg/kg, 3.161 ± 0.159 µg/kg, and 9.265 ± 0.443 µg/kg, respectively. The highest content As was found in wafer/crisps (84.71 µg/kg); in the case of Cd, dinners with fish (20.15 µg/kg); for Hg, dinners with poultry (37.25 µg/kg); and for Pb, fruit mousse (138.99 µg/kg). The results showed that 4.53% of the samples attempted to exceed Pb, and 1.5% exceeded levels of Hg. The highest value of THQ was made in the case of drinks, for Cd and Pb in mousses for children, and Hg for dairy products. The THQ, BMDL, and PTWI ratios were not exceeded. The analyzed ready-to-eat products for children aged 0.5-3 years may contain toxic elements, but most of them appear to be harmless to health.

Assessment of the Risk of Contamination of Food for Infants and Toddlers

Infants and toddlers are highly sensitive to contaminants in food. Chronic exposure can lead to developmental delays, disorders of the nervous, urinary and immune systems, and to cardiovascular disease. A literature review was conducted mainly in PubMed, Google Scholar and Scopus databases, and took into consideration papers published from October 2020 to March 2021. We focused on contaminant content, intake estimates, and exposure to contaminants most commonly found in foods consumed by infants and children aged 0.5-3 years. In the review, we included 83 publications with full access. Contaminants that pose a high health risk are toxic elements, acrylamide, bisphenol, and pesticide residues. Minor pollutants include: dioxins, mycotoxins, nitrates and nitrites, and polycyclic aromatic hydrocarbons. In order to reduce the negative health effects of food contamination, it seems reasonable to educate parents to limit foods that are potentially dangerous for infants and young children. An appropriate varied diet, selected cooking techniques, and proper food preparation can increase the likelihood that the foods children consume are safe for their health. It is necessary to monitor food contamination, adhere to high standards at every stage of production, and improve the quality of food for children.

Risk Assessment of Lead and Cadmium in Drinking Water for School use in Nakhon Si Thammarat Province, Thailand

This research aimed to evaluate children’s health risk based on the concentration of lead (Pb) and cadmium (Cd) in the drinking water used by 44 primary schools. Samples were collected from bottled water, tap water, filtered tap water and raw water, for a total of 146 samples, between 1 September 2018 and 31 January 2019. The concentrations of Pb and Cd in drinking water samples were determined by graphite furnace atomic absorption spectrometry. The results showed that the concentration of Pb and Cd in bottled water samples were in the range of non-detected (ND)–0.0180 mg/L and ND–0.0013 mg/L, respectively. The concentration of Pb and Cd in tap water samples ranged from ND-0.0250 mg/L and ND-0.0042 mg/L, respectively, from ND–0.005 mg/L and ND–0.0021 mg/L, respectively, in filtered tap water samples and from ND–0.0400 mg/L and ND–0.0049 mg/L, respectively, in raw water samples. The summation of the total hazardous index (HI)-values of bottled water samples, tap water samples, filtered tap water, and raw water samples were less than 1, was considered health-protective. The results will provide the direct evidence needed by school managers to warn learners about the health risk of ingestion exposure among children.

Oral exposure to lead for Japanese children and pregnant women, estimated using duplicate food portions and house dust analyses

BACKGROUND

Lead is a toxic metal abundant in the environment. Consumption of food contaminated at low levels of lead, especially by small children and pregnant women, raises a health concern.

METHODS

Duplicated food portions and drinking water were collected over 3 days from 88 children and 87 pregnant women in Shimotsuke, Tochigi, Japan. Participants were recruited in this study between January 2014 and October 2015. Dust was also collected from their homes. Lead concentrations were measured and consequent oral lead exposure levels were estimated for this population at high risk to environmental toxicants. Lead concentrations of peripheral and cord blood, taken from children and pregnant women, and were also analyzed.

RESULTS

Lead concentrations in food, drinking water, and house dust were low in general. Oral lead exposure to lead was higher for children (Mean ± SEM; 5.21 ± 0.30 μg/kg BW/week) than in pregnant women (1.47 ± 0.13 μg/kg BW/week). Food and house dust were main sources of lead contamination, but the contribution of house dust widely varied. Means ± SEM of peripheral and cord blood lead concentrations were 0.69 ± 0.04 μg/dL and 0.54 ± 0.05 μg/dL, respectively for pregnant women and 1.30 ± 0.07 μg/dL (peripheral only) in children. We detect no correlation between smoking situations and blood lead concentration in pregnant women.

CONCLUSION

We conclude that oral lead exposure levels for Japanese children and pregnant women were generally low, with higher concentrations and exposure for children than for pregnant women. More efforts are necessary to clarify the sources of lead contamination and reduce lead exposure of the population at high risk even in Japan.

Analysis of lead and cadmium in cereal products and duplicate diets of a small group of selected Brisbane children for estimation of daily metal exposure

Exposure to toxic metals such as lead (Pb) and cadmium (Cd) from foods is a concern for young children. The aims of the study were to analyse the levels of Pb and Cd in breakfast cereals, rice products and diets of selected children, and to estimate the daily intakes of Pb and Cd in these children. The samples (n = 82) of ready-to-eat breakfast cereals and rice products (n = 36) were collected and obtained from various markets in Brisbane, Australia. The samples for a duplicate diet study were collected for 3 consecutive days from normal healthy children (n = 15). The analysis was performed using ICP-MS after microwave digestion. The levels of Pb and Cd found in breakfast cereals and rice products ranged from <0.01 to 0.25 mg/kg for Pb and <0.01 to 0.11 mg/kg for Cd. The estimated daily intakes of Pb and Cd in children varied widely and ranged from 0.90 to 11.7 (5.6 ± 3.5 μg/day) for Pb and 0.98 to 9.5 (4.0 ± 2.2 μg/day) for Cd. The study shows low intakes of Pb and Cd in children.

Association between dietary cadmium intake and early gastric cancer risk in a Korean population: a case-control study

PURPOSE

Foods such as grains and vegetables are the dominant sources of exposure to cadmium, which has been classified as a carcinogen by various public health agencies. Cadmium exposure is a growing concern due to its associations with numerous harmful health effects, including gastric cancer risk. The objective of this study was to investigate the association of dietary cadmium intake and the consumption of cadmium-contributing foods with early gastric cancer risk.

METHODS

A case-control study including 1245 subjects (cases, 415; controls, 830) was conducted in Korea. The dietary cadmium intake and the consumption of cadmium-contributing foods were assessed using a semi-quantitative food frequency questionnaire.

RESULTS

After adjustment for covariates, the gastric cancer risk was increased for participants in the highest tertile of cadmium intake [odds ratios (ORs) 1.33, 95% confidence intervals (95% CIs) 0.94-1.88], but there was no significance. Both female (ORs 2.71, 95% CIs 1.37-5.36) and male (ORs 1.63, 95% CIs 1.07-2.50) participants in the highest tertile of rice consumption had a higher gastric cancer risk than did those in the lowest tertile. Men in the highest tertile of crab consumption had a gastric cancer risk 2.23 times greater than that of men in the lowest tertile (ORs 2.23, 95% CIs 1.21-4.13), but a difference was not seen in women.

CONCLUSIONS

Future studies examining the causal effects of dietary cadmium intake and the consumption of cadmium-contributing foods on early gastric cancer risk in large-scale prospective cohorts are recommended.

Lead, Cadmium, and Arsenic Bioaccessibility of 24 h Duplicate Diet Ingested by Preschool Children Attending Day Care Centers in Brazil

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one–four-year-old children from two DCCs where the 24-h duplicate diet samples were collected. The diet samples were analyzed by ICP-MS for lead, cadmium, and arsenic total concentrations (n = 64) and their bio-accessibility were analyzed for a subsample (n = 10). The dietary intake (DI) mean for lead, cadmium, and arsenic were 0.18 ± 0.11 µg kg⁻¹ bw, 0.08 ± 0.04 µg kg⁻¹ bw, and 0.61 ± 0.41 µg kg⁻¹ bw, respectively. All DI calculated for TEs, considering total intake, were found lower than the tolerable limits (TL) (European Union, or World Health Organization, WHO, when applicable) except for one child’s Pb intake. Bio-accessibilities ranged between 0% to 93%, 0% to 103%, and 0% to 69%, for lead, cadmium, and arsenic, respectively. Although DI for TEs has been found lower than TL, these reference values have been recently decreased or withdrawn since it was for lead and arsenic whose TL were withdrawn by WHO.

What do we know about exposure of Iranians to cadmium? Findings from a systematic review

Cadmium is an important environmental contaminant. High consumption of chemical fertilizers and industrial activities in recent decades has caused people to be worried about exposure to cadmium. There is no policy for environmental and biological monitoring of exposure to cadmium in the general population in Iran. This study was aimed to review cadmium content in consuming foods and biological samples in Iran, systematically. We developed a comprehensive search strategy and used it to search on Web of Science, Scopus, Science Direct, and Scientific Information Database until 28 December 2016. The totals of 285 articles were identified and finally 31 original papers were selected. Cadmium contamination was found in Iranian food groups such as rice, cereal and legumes, canned tuna fish, vegetables, fruit juice, and egg. This study showed that cadmium amount in 75% of the consumed rice samples (domestic and imported) was higher than the maximum limits approved by institute of standards and industrial research of Iran. Lettuce samples in Yazd were recorded the highest concentration of cadmium compared to other studies. In addition, high amount of cadmium was observed in the blood of the general population. Regarding the cadmium contamination in food and blood samples in Iran, policies must be adopted to reduce exposure to cadmium through different matrices as much as possible.

Low-Level Toxic Metal Exposure in Healthy Weaning-Age Infants: Association with Growth, Dietary Intake, and Iron Deficiency

Even low levels of toxic metal exposure (As, Cd, Hg, and Pb) in infancy might be harmful to children's development. This study investigated toxic metal exposure on healthy weaning-age infants and its relationship with growth, diet, and iron/anemia status. The weight, height, head circumference, whole blood levels of four toxic metals, hemoglobin, and serum ferritin of healthy infants was measured. Among 210 infants with a median age of 11.4 months (interquartile range: 10.5-12.0), the median levels of As, Cd, Hg, and Pb were 1.2 μg/L, 0.05 μg/L, 0.8 μg/L, and 0.83 μg/dL, respectively. In adjusted linear regression models, post-birth weight gain (Pb) and current head circumference (As, Pb) were negatively associated with toxic metal levels. In multiple linear regression or logistic regression analysis, the duration of breastfeeding (all four metals), perceived adequacy of rice-based food intake (As), regular fish intake (As, Hg), and iron deficiency with/without anemia (Cd, Pb) were associated with increased toxic metal levels. Although levels of toxic metals may not usually be high in this population, individual exposure risk may need to be assessed after considering the type of feeding or intake of complementary foods and the iron/anemia status while evaluating growth status during late infancy.

An Integrated H-G Scheme Identifying Areas for Soil Remediation and Primary Heavy Metal Contributors: A Risk Perspective

Traditional sampling for soil pollution evaluation is cost intensive and has limited representativeness. Therefore, developing methods that can accurately and rapidly identify at-risk areas and the contributing pollutants is imperative for soil remediation. In this study, we propose an innovative integrated H-G scheme combining human health risk assessment and geographical detector methods that was based on geographical information system technology and validated its feasibility in a renewable resource industrial park in mainland China. With a discrete site investigation of cadmium (Cd), arsenic (As), copper (Cu), mercury (Hg) and zinc (Zn) concentrations, the continuous surfaces of carcinogenic risk and non-carcinogenic risk caused by these heavy metals were estimated and mapped. Source apportionment analysis using geographical detector methods further revealed that these risks were primarily attributed to As, according to the power of the determinant and its associated synergic actions with other heavy metals. Concentrations of critical As and Cd, and the associated exposed CRs are closed to the safe thresholds after remediating the risk areas identified by the integrated H-G scheme. Therefore, the integrated H-G scheme provides an effective approach to support decision-making for regional contaminated soil remediation at fine spatial resolution with limited sampling data over a large geographical extent.

Human health risk assessment of cadmium via dietary intake by children in Jiangsu Province, China

The goal of this study was to quantify the exposure to dietary cadmium (Cd) and analyze the major contributors to total Cd intake of children from Jiangsu Province, China. The Cd concentration data were collected by the National Food Contamination Monitoring Program between 2001 and 2009. Consumption data were derived from the Chinese National Nutrition and Health Survey in 2002. The beta-binomial-normal model which included age as a covariate was used to assess the long-term dietary Cd intake assuming lower bound and upper bound concentration scenarios. A tolerable weekly intake of 2.5 µg/kg body weight for Cd was applied in the risk assessment. Cd intake decreased as age increased with almost all mean values and P95 of the estimates exceeding the tolerable weekly intake. Children with high-end exposure may suffer non-carcinogenic effects over a lifetime of exposure. Rice and rice products, wheat flour and wheat flour products, crustaceans, pak-choi, pig meat, and beans and bean products were found to be the major contributors to the total Cd intake in children. These conservative estimates of Cd intake indicate possible public health concerns for children in Jiangsu Province.

Time trend of cadmium intake in Korea

OBJECTIVES

The aim of this study was to elucidate past and current levels of cadmium (Cd) intake among the general populations in Korea.

METHODS

For this purpose, publications reporting dietary intake of cadmium (Cd-D), cadmium concentration in blood (Cd-B) and that in urine (Cd-U) in Korea were retrieved through literature survey for a period from 1975 to 2015.

RESULTS

In practice, 9, 21 and 14 articles were available on Cd-D, Cd-B and Cd-Ucr (Cd-U as corrected for creatinine concentration), respectively. Linear regression analyses of the reported values as a function of years (i.e., the year when each survey was conducted) showed steady decreases in all of the three exposure markers of Cd-D, Cd-B and Cd-U(cr). Factors possibly contributing for the reduction were discussed including the government-set guideline of 0.2 mg/kg for rice and changes in food habits among general populations.

CONCLUSIONS

There have been steady decreases in Cd-D, Cd-B and Cd-U(cr). The current estimates for Cd-D, Cd-B and Cd-Ucr were 6.0-7.4 μg/day, 0.73-0.83 μg/L and 0.60-0.95 μg/g cr, respectively.