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Wong C, Roberts SM, Saab IN. Review of regulatory reference values and background levels for heavy metals in the human diet. Regul Toxicol Pharmacol 2022; 130:105122. [DOI: 10.1016/j.yrtph.2022.105122] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/02/2022] [Accepted: 01/12/2022] [Indexed: 11/26/2022]
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Long-Term Follow-Up Study of Residents Exposed to Cadmium in Kakehashi River Basin, Ishikawa, Japan. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2019. [DOI: 10.1007/978-981-13-3630-0_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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The references level of cadmium intake for renal dysfunction in a Chinese population. Sci Rep 2018; 8:9011. [PMID: 29899356 PMCID: PMC5998016 DOI: 10.1038/s41598-018-27411-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/30/2018] [Indexed: 11/08/2022] Open
Abstract
Recent several studies indicated that a more restrictive dietary intake guideline for cadmium should be made for sufficient health protection. In the present study, we showed the references level of food cadmium intake (FCd) and total cadmium intake (TCd) for renal dysfunction by using benchmark dose (BMD) approach. 342 subjects living in a control and a cadmium polluted area were included in this study. The FCd, TCd and cadmium in urine (UCd) and blood (BCd) were calculated or determined. Urinary β2Microglobulin (UBMG) was determined as indicator of renal function. The median FCd, TCd, UCd and BCd were 1.4 g, 1.4 g, 3.1 μg/g creatinine(cr) and 1.3 μg/L in control and 3.3 g, 3.6 g, 13.5 μg/g cr and 12.1 μg/L in polluted area. The 95% lower confidence bounds of BMD (BMDLs) of FCd for renal dysfunction were 1.36-1.55 g (BMR = 10%) and 0.88-1.11 g (BMR = 5%). The BMDLs of TCd were 1.29-1.46 g (BMR = 10%) and 0.73-0.95 g (BMR = 5%). FCd and TCd are valuable markers for the predication of renal dysfunction induced by cadmium. The BMDLs of FCd were close to previous report in Japan and the BMDLs of TCd were lower than the critical standard previously reported, in particular at BMR of 5% which can be interpreted as representing the influence of smoking.
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Wang X, Wang Y, Feng L, Tong Y, Chen Z, Ying S, Chen T, Li T, Xia H, Jiang Z, Shang Q, Lou X, Lou J. Application of the Benchmark Dose (BMD) Method to Identify Thresholds of Cadmium-Induced Renal Effects in Non-Polluted Areas in China. PLoS One 2016; 11:e0161240. [PMID: 27537182 PMCID: PMC4990304 DOI: 10.1371/journal.pone.0161240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
The benchmark dose (BMD) method has been increasingly used to assess the health risks of cadmium (Cd) in epidemiological studies. The aim of our study was to estimate the threshold levels of urinary Cd (UCd) using the BMD method in a general population of Jiangshan City, Zhejiang Province of China. In our study, a total of 934 people (469 men, 465 women) were recruited and morning urine samples were collected from all the participants. Levels of Cd, creatinine, and renal dysfunction indicators such as retinol binding protein (RBP), β2-microglobulin (β2-MG), and N-acetyl-b-glucosaminidase (NAG) in urine were detected for analysis of BMD and BMD low (BMDL) of UCd. RBP, β2-MG, and NAG in urine all correlated significantly (P < 0.001) with UCd except of age (P = 0.767). When the benchmark response (BMR) was 5%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 1.69/ 0.89, 1.24/0.62, 0.85/0.49 μg/g Cr in men and 1.70/0.76, 1.35/0.64, 1.36/0.65 μg/g Cr in women, respectively. If the BMR was set at 10%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 2.44/1.59, 2.09/1.30, 1.80/1.04 μg/g Cr in men and 2.43/1.53, 2.10/1.34, 2.31/1.37 μg/g Cr in women, respectively. Our results provided evidence for Cd-induced tubular effects in cadmium non-polluted areas in China. Both β2-MG and NAG were more sensitive than RBP in response to Cd exposure. But β2-MG was the most sensitive indicator in women, and NAG was the most sensitive one in men.
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Affiliation(s)
- Xiaofeng Wang
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
| | - Yu Wang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Lingfang Feng
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Yan Tong
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhijian Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Shibo Ying
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tianhui Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tao Li
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Hailing Xia
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhaoqiang Jiang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Qi Shang
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, P.R. China
| | - Xiaoming Lou
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
| | - Jianlin Lou
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
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Ke S, Cheng XY, Zhang JY, Jia WJ, Li H, Luo HF, Ge PH, Liu ZM, Wang HM, He JS, Chen ZN. Estimation of the benchmark dose of urinary cadmium as the reference level for renal dysfunction: a large sample study in five cadmium polluted areas in China. BMC Public Health 2015; 15:656. [PMID: 26169263 PMCID: PMC4499937 DOI: 10.1186/s12889-015-2021-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 07/06/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Itai-itai disease primarily results from cadmium (Cd) exposure and is known as one of the four major pollution diseases in Japan. Cd pollution is more serious in several areas of China than in Japan. However, there is still a lack of information regarding the threshold level of Cd exposure for the adverse health effects in the general Chinese population. This study aims to evaluate the reference value of urinary Cd (UCd) for renal dysfunction in a Chinese population as the benchmark dose lower confidence limit (BMDL) based on a large sample survey. METHODS A total of 6103 participants who lived in five Cd polluted areas of China participated in this study. We analyzed UCd levels as a biomarker of exposure and urinary β2-microglobulin (Uβ2-MG) levels as a renal tubular effect biomarker. The BMD studies were performed using BMD software. The benchmark response (BMR) was defined as a 10% additional risk above the background. RESULTS There was a positive correlation between the UCd levels and the prevalence of Uβ2-MG. The BMD of UCd for Uβ2-MG was estimated for each province. The findings showed that the BMD levels were related to the participants' geographic region, which may be partially due to the large differences in Cd exposure level, ethnic group, lifestyle and diet of the sample population in these study areas. The reference level of UCd for the renal effects was further evaluated by combining the five sets of data from all 6103 subjects. The overall BMDLs of UCd for Uβ2-MG with an excess risk of 10% were 2.00 μg/g creatinine (μg/g cr) in males and 1.69 μg/g cr in females, which were significantly lower than the World Health Organization (WHO) threshold level of 5 μg/g cr for Cd-related renal effects. CONCLUSIONS The selection of the sample population and geographic region affected the BMDL evaluation. Based on the findings of this survey of a large sample population, the UCd BMDLs for Uβ2-MG in males with BMRs at 10% were 2.00 μg/g cr. The BMD was slightly lower in females, which indicated that females may be relatively more sensitive to Cd exposure than males.
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Affiliation(s)
- Shen Ke
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Xi-Yu Cheng
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Jie-Ying Zhang
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Wen-Jing Jia
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Hao Li
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Hui-Fang Luo
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Peng-He Ge
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Ze-Min Liu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, People's Republic of China.
| | - Hong-Mei Wang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, People's Republic of China.
| | - Jin-Sheng He
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
| | - Zhi-Nan Chen
- College of Life Sciences and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, 100044, People's Republic of China.
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Woo HD, Chiu WA, Jo S, Kim J. Benchmark Dose for Urinary Cadmium based on a Marker of Renal Dysfunction: A Meta-Analysis. PLoS One 2015; 10:e0126680. [PMID: 25970611 PMCID: PMC4430293 DOI: 10.1371/journal.pone.0126680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/06/2015] [Indexed: 01/26/2023] Open
Abstract
Background Low doses of cadmium can cause adverse health effects. Benchmark dose (BMD) and the one-sided 95% lower confidence limit of BMD (BMDL) to derive points of departure for urinary cadmium exposure have been estimated in several previous studies, but the methods to derive BMD and the estimated BMDs differ. Objectives We aimed to find the associated factors that affect BMD calculation in the general population, and to estimate the summary BMD for urinary cadmium using reported BMDs. Methods A meta-regression was performed and the pooled BMD/BMDL was estimated using studies reporting a BMD and BMDL, weighted by sample size, that were calculated from individual data based on markers of renal dysfunction. Results BMDs were highly heterogeneous across studies. Meta-regression analysis showed that a significant predictor of BMD was the cut-off point which denotes an abnormal level. Using the 95th percentile as a cut off, BMD5/BMDL5 estimates for 5% benchmark responses (BMR) of β2-microglobulinuria (β2-MG) estimated was 6.18/4.88 μg/g creatinine in conventional quantal analysis and 3.56/3.13 μg/g creatinine in the hybrid approach, and BMD5/BMDL5 estimates for 5% BMR of N-acetyl-β-d-glucosaminidase (NAG) was 10.31/7.61 μg/g creatinine in quantal analysis and 3.21/2.24 g/g creatinine in the hybrid approach. However, the meta-regression showed that BMD and BMDL were significantly associated with the cut-off point, but BMD calculation method did not significantly affect the results. The urinary cadmium BMDL5 of β2-MG was 1.9 μg/g creatinine in the lowest cut-off point group. Conclusion The BMD was significantly associated with the cut-off point defining the abnormal level of renal dysfunction markers.
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Affiliation(s)
- Hae Dong Woo
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
| | - Weihsueh A. Chiu
- National Center for Environmental Assessment, U.S. Environmental Protection Agency (EPA), Washington, DC, United States of America
| | - Seongil Jo
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
- * E-mail:
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Hu J, Li M, Han TX, Chen JW, Ye LX, Wang Q, Zhou YK. Benchmark dose estimation for cadmium-induced renal tubular damage among environmental cadmium-exposed women aged 35-54 years in two counties of China. PLoS One 2014; 9:e115794. [PMID: 25536107 PMCID: PMC4275258 DOI: 10.1371/journal.pone.0115794] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/26/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A number of factors, including gender, age, smoking habits, and occupational exposure, affect the levels of urinary cadmium. Few studies have considered these influences when calculating the benchmark dose (BMD) of cadmium. In the present study, we aimed to calculate BMDs and their 95% lower confidence bounds (BMDLs) for cadmium-induced renal tubular effects in an age-specific population in south-central China. METHODS In this study, urinary cadmium, β2-microglobulin, and N-acetyl-β-D-glucosaminidase levels were measured in morning urine samples from 490 randomly selected non-smoking women aged 35-54 years. Participants were selected using stratified cluster sampling in two counties (counties A and B) in China. Multiple regression and logistic regression analyses were used to investigate the dose-response relationship between urinary cadmium levels and tubular effects. BMDs/BMDLs corresponding to an additional risk (benchmark response) of 5% and 10% were calculated with assumed cut-off values of the 84th and 90th percentile of urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase levels of the controls. RESULTS Urinary levels of β2-microglobulin and N-acetyl-β-D-glucosaminidase increased significantly with increasing levels of urinary cadmium. Age was not associated with urinary cadmium levels, possibly because of the narrow age range included in this study. Based on urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase, BMDs and BMDLs of urinary cadmium ranged from 2.08 to 3.80 (1.41-2.18) µg/g cr for subjects in county A and from 0.99 to 3.34 (0.74-1.91) µg/g cr for those in county B. The predetermined benchmark response of 0.05 and the 90th percentiles of urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase levels of the subjects not exposed to cadmium (i.e., the control group) served as cut-off values. CONCLUSIONS The obtained BMDs of urinary cadmium were similar to the reference point of 1 µg/g cr, as suggested by the European Food Safety Authority, indicating that cadmium exposure must be reduced to protect human health.
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Affiliation(s)
- Jia Hu
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Mei Li
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Tian-xu Han
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jian-wei Chen
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lin-xiang Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (QW); (YZ)
| | - Yi-kai Zhou
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (QW); (YZ)
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Nishijo M, Suwazono Y, Ruangyuttikarn W, Nambunmee K, Swaddiwudhipong W, Nogawa K, Nakagawa H. Risk assessment for Thai population: benchmark dose of urinary and blood cadmium levels for renal effects by hybrid approach of inhabitants living in polluted and non-polluted areas in Thailand. BMC Public Health 2014; 14:702. [PMID: 25012790 PMCID: PMC4227073 DOI: 10.1186/1471-2458-14-702] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/12/2014] [Indexed: 11/16/2022] Open
Abstract
Background The aim of the present study was to estimate the benchmark doses (BMD) for renal effects for health risk assessment of residents living in Cd-polluted and non-polluted areas in a Thai population. Methods The study participants consisted of inhabitants aged 40 years or older who lived in a non-polluted area (40 men and 41 women) and in the environmentally polluted Mae Sot District (230 men and 370 women) located in northwestern Thailand. We measured urinary and blood cadmium (Cd) as markers of long-term exposure and urinary β2-microglobulin (β2-MG) and N-acetyl-β-D-glucosaminidase (NAG) as renal tubular effect markers. An updated hybrid approach was applied to estimate the benchmark doses (BMD) and their 95% lower confidence limits (BMDL) of urinary and blood Cd for Cd-induced renal effects in these subjects. BMD and BMDL corresponding to an additional risk (BMR) of 5% were calculated with the background risk at zero exposure set to 5% after adjusting for age and smoking status. Results The estimated BMDLs of urinary Cd for renal effect markers were 6.9 for urinary β2-MG and 4.4 for NAG in men and 8.1 for β2-MG and 6.1 for NAG μg/g creatinine (Creat) in women. These BMDLs of urinary Cd (μg/g Creat) for NAG were less than the geometric mean urinary Cd in the polluted area (6.5 in men and 7.1 in women). The estimated BMDLs of blood Cd (μg/L) were 6.2 for urinary β2-MG and 5.0 for NAG in men and 5.9 for β2-MG and 5.8 for NAG in women. The calculated BMDLs were similar or less compared with the geometric mean blood Cd (μg/L) in the polluted Thai area (6.9 in men and 5.2 in women). Conclusion The BMDLs of urinary and blood Cd for renal effects were estimated to be 4.4 - 8.1 μg/g Creat and 4.4 - 6.2 μg/L in the Thai population aged ≥ 40 years old, suggesting that more than 40% of the residents were at risk of adverse renal effects induced by Cd exposure in Thailand.
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Affiliation(s)
- Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchnada, 920-0293 Ishikawa, Japan.
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Wang Q, Hu J, Han TX, Li M, Zhao HH, Chen JW, Ye LX, Zhou YK. Application of BMD approach to identify thresholds of cadmium-induced renal effect among 35 to 55 year-old women in two cadmium polluted counties in China. PLoS One 2014; 9:e87817. [PMID: 24505316 PMCID: PMC3913698 DOI: 10.1371/journal.pone.0087817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/31/2013] [Indexed: 11/24/2022] Open
Abstract
Background Cadmium (Cd) is a heavy metal that can cause renal tubular dysfunction in humans. Women are among the high-risk group for Cd health effects. Determining the thresholds of Cd-induced renal effects is important. Thus, in this article, we aimed to identify the benchmark dose (BMD) and its low limit (BMDL) levels as the Cd thresholds for Chinese women. Methods Epidemiologic investigation was performed in county A and county B to obtain data on Cd exposure and its renal effect on respondents. Levels of Cd (UCd), β2-microglobulin (UB2M), and N-acetyl-β-D-glucosaminidase (UNAG) were measured in morning urine samples. The BMD approach was mainly performed. Results Results of the BMD approach were similar whether the method was conducted for the two sets of data (collected in CA and CB, respectively) separately or cooperatively. The BMD/BMDL values of UCd for all subjects were 1.07/0.44 and 2.12/0.53 µg/g cr based on UB2M and UNAG, respectively, given a predetermined BMR of 0.05. Conclusions The presented thresholds of Cd-induced renal effects (i.e., the BMDLs of UCd) are close to the counterpart values reported in Japan, Sweden and Belguim.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jia Hu
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Tian-xu Han
- Qiangyang Center for Disease Control and Prevention, Chengdu, China
| | - Mei Li
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Huan-hu Zhao
- Chinese Minority Traditional Medical Center, Minzu University of China, Beijing, China
| | - Jian-wei Chen
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lin-xiang Ye
- Department of Epidemiology & Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (LY); (YZ)
| | - Yi-kai Zhou
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (LY); (YZ)
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Zhang WL, Du Y, Zhai MM, Shang Q. Cadmium exposure and its health effects: a 19-year follow-up study of a polluted area in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 470-471:224-228. [PMID: 24140693 DOI: 10.1016/j.scitotenv.2013.09.070] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 09/22/2013] [Accepted: 09/23/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Dayu County, which is located in southwestern Jiangxi Province in China, has been a cadmium (Cd)-contaminated area since the 1960s. A series of studies about Cd pollution were carried out in the 1980s. However, no further studies of the area were conducted during the following 19 years. AIM To observe cadmium (Cd) exposure levels and its health risks among residents living in contaminated areas that have been exposed to environmental cadmium pollution for 45 years. METHODS Subjects involved in the survey in 1987 were interviewed again in 2006. Rice and urine samples from surviving subjects were collected to assess the level of cadmium exposure. Urinary Cd (U-Cd), urinary β2-microglobulin (U-β2-M) and urinary N-acetyl-β-d-glucosaminidase (U-NAG) were used as biomarkers to evaluate renal function. A medical examination was also performed on all subjects to diagnose clinical symptoms of Cd-exposure. RESULT Of the 96 subjects of the 1987 study who were alive in 2006, a total of 76 subjects were successfully recruited to this study. The average cadmium concentration in rice from the exposed areas was 0.59 ± 0.41 mg/kg in 2006, the average concentration of U-Cd, U-β2-M and U-NAG from cadmium-exposed areas was 25.82 ± 0.20 μg/g Cr, 6525.71 ± 0.93 μg/g Cr and 13.65 ± 0.24 μmol/g Cr, respectively, in 2006. Compared with the 1987 results, the 2006 results showed that the U-β2-M level in the exposed areas increased significantly after 19 years (p<0.05). The levels of U-Cd and U-NAG did not significantly change over time. CONCLUSION The concentration of Cd in polluted areas in 2006 is higher than it was in 1987. Renal dysfunction has worsened after 45 years of continuous exposure. Thus, environmental protection and special procedures to remove cadmium in these areas require urgent consideration.
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Affiliation(s)
- Wen-Li Zhang
- Department of Environmental Epidemiology, Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Yu Du
- Chongqing Yuzhong District Center for Disease Control and Prevention, Chongqing 400010, China
| | - Miao-Miao Zhai
- The Fourth Department of Comprehensive Supervision, The Bureau for Health Inspection and Supervision of Haidian District, Beijing 100037, China
| | - Qi Shang
- Department of Environmental Epidemiology, Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Variation in benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) among general Japanese populations with no anthropogenic exposure to cadmium. Int Arch Occup Environ Health 2012; 85:941-50. [PMID: 22270387 DOI: 10.1007/s00420-012-0734-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 01/06/2012] [Indexed: 10/14/2022]
Abstract
BACKGROUND The use of benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) have been gaining popularity not only in experimental studies but also in epidemiological studies including those on toxicology of cadmium (Cd), a ubiquitous hazardous element in the environment. However, the reproducibility of BMD and BMDL values has seldom been examined. OBJECTIVES This study was initiated to determine whether consistent BMD and BMDL values are obtained for similar non-exposed populations, i.e., the populations with no anthropogenic exposure to Cd in a single nation of Japan. METHODS Cd (an exposure marker), α(1)-microglobulin (α(1)-MG), β(2)-microglobulin (β(2)-MG) and N-acetyl-β-D-glucosaminidase (NAG) (three effect markers of tubular dysfunction) levels in the urine of adult Japanese women from five previous publications of this study group were examined. Overall, data were available for 17,375 cases (in 16 prefectures) regarding Cd, α(1)-MG and β(2)-MG, and 6,409 cases (in ten prefectures) regarding NAG. The data were used to calculate BMD and BMDL values taking advantage of the hybrid approach (Budtz-Jǿrgensen et al. in Biometrics 57:698-706, 2001). It was possible to calculate BMD and BMDL values for α(1)-MG and β(2)-MG for all of the 16 prefectures with 17,375 cases, whereas the values for NAG were successfully calculated for nine prefectures with 5,843 cases. RESULTS The application gave BMD values of 1.92, 2.46 and 2.32 μg Cd/g cr for α(1)-MG, β(2)-MG and NAG, respectively, and BMDL values of 1.83, 2.32 and 2.09 μg Cd/g cr. Large inter-prefectural variations were observed in the BMD and BMDL; there was about fourfold difference both in BMD and in BMDL calculated for α(1)-MG and β(2)-MG in 16 prefectures, and the variation was greater (i.e., by about sevenfold) in BMD and BMDL for NAG in nine prefectures. A survey of relevant literature revealed variation in BMD and BMDL values of similar folds as observed in the present analyses in five studies of Japanese populations. Multiple regression analyses taking BMD or BMDL as a dependent variable and age, CR concentration and Cd concentration as independent variables showed both BMD and BMDL were significantly influenced by Cd concentration in cases of α(1)-MG and β(2)-MG, whereas BMD and BMDL for NAG was by CR. CONCLUSIONS Even when the analysis was conducted in a single nation, both BMD and BMDL for the Cd effect markers varied by ca. fourfold when examining α(1)-MG or β(2)-MG and the values varied by ca. sevenfold for NAG among Cd-non-exposed populations. The most influential factors in the study population may include urine density and Cd levels in the urine.
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Suwazono Y, Nogawa K, Uetani M, Kido T, Nakagawa H. Reassessment of the threshold of urinary cadmium by using hybrid approach in a cadmium non-polluted area in Japan. Int J Hyg Environ Health 2011; 214:175-8. [DOI: 10.1016/j.ijheh.2010.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 09/06/2010] [Indexed: 11/26/2022]
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Suwazono Y, Nogawa K, Uetani M, Nakada S, Kido T, Nakagawa H. Application of the hybrid approach to the benchmark dose of urinary cadmium as the reference level for renal effects in cadmium polluted and non-polluted areas in Japan. ENVIRONMENTAL RESEARCH 2011; 111:312-314. [PMID: 21190684 DOI: 10.1016/j.envres.2010.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 11/24/2010] [Accepted: 11/30/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the reference level of urinary cadmium (Cd) that caused renal effects. An updated hybrid approach was used to estimate the benchmark doses (BMDs) and their 95% lower confidence limits (BMDL) in subjects with a wide range of exposure to Cd. METHODS The total number of subjects was 1509 (650 men and 859 women) in non-polluted areas and 3103 (1397 men and 1706 women) in the environmentally exposed Kakehashi river basin. We measured urinary cadmium (U-Cd) as a marker of long-term exposure, and β2-microglobulin (β2-MG) as a marker of renal effects. The BMD and BMDL that corresponded to an additional risk (BMR) of 5% were calculated with background risk at zero exposure set at 5%. RESULTS The U-Cd BMDL for β2-MG was 3.5μg/g creatinine in men and 3.7 μg/g creatinine in women. CONCLUSIONS The BMDL values for a wide range of U-Cd were generally within the range of values measured in non-polluted areas in Japan. This indicated that the hybrid approach is a robust method for different ranges of cadmium exposure. The present results may contribute further to recent discussions on health risk assessment of Cd exposure.
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Affiliation(s)
- Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan.
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Suwazono Y, Nogawa K, Uetani M, Miura K, Sakata K, Okayama A, Ueshima H, Stamler J, Nakagawa H. Application of hybrid approach for estimating the benchmark dose of urinary cadmium for adverse renal effects in the general population of Japan. J Appl Toxicol 2011; 31:89-93. [PMID: 20836141 PMCID: PMC3010323 DOI: 10.1002/jat.1582] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 07/07/2010] [Accepted: 07/14/2010] [Indexed: 11/11/2022]
Abstract
We used an updated hybrid approach to estimate the benchmark doses and their 95% lower confidence limits (BMDL) for cadmium-induced renal effects in humans. Participants were 828 inhabitants (410 men, 418 women), aged 40-59 years who lived in three areas without any known environmental cadmium pollution. We measured urinary cadmium (U-Cd) as a marker of exposure, and urinary protein, β2-microglobulin (β2-MG) and N-acetyl-β-D-glucosaminidase (NAG) as markers of renal effects. For urinary protein, the BMDL ranged from 0.9 to 1.1 µg g⁻¹ creatinine (cre) and approximately 1.6 µg per 24 h in men, and from 1.9 to 3.4 µg g⁻¹ cre and 2.0 µg per 24 h in women. For the renal tubular markers β2-MG and NAG, the BMDL for U-Cd ranged from 0.6 to 1.2 µg g⁻¹ cre and from 0.8 to 1.7 µg per 24 h in men, and from 0.6 to 2.3 µg g⁻¹ cre and from 0.6 to 2.1 µg per 24 h in women. The lowest BMDL for urinary cadmium (0.6 µg g⁻¹ cre) was somewhat lower than average urinary cadmium in Japanese older population. These results suggest the importance of measures to decrease cadmium exposure in the general population of Japan.
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Affiliation(s)
- Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan.
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Suwazono Y, Sand S, Vahter M, Skerfving S, Lidfeldt J, Akesson A. Benchmark dose for cadmium-induced osteoporosis in women. Toxicol Lett 2010; 197:123-7. [PMID: 20493933 DOI: 10.1016/j.toxlet.2010.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 05/12/2010] [Accepted: 05/12/2010] [Indexed: 10/19/2022]
Abstract
We applied a hybrid approach to estimate the benchmark dose (BMD) and the lower 95% confidence limit (BMDL) for cadmium-induced bone effects in a population with low environmental exposure. Morning urine samples were collected by 794 Swedish women, aged 53-64 years, participating in a population-based study. We measured urinary cadmium (U-Cd), a marker of long-term exposure, and bone mineral density, expressed as its T-score (reference: 20-year old women) of the non-dominant wrist. BMD and BMDL, adjusted for relevant covariates, corresponding to an additional risk (BMR) of 5% or 10% were calculated, with the background risk at zero exposure set at 1% or 5%. With a BMR of 5% and a background risk of having low bone mineral density (at U-Cd = 0) of 1% or 5% (corresponding to T-score cut-offs -2.75 and -2.09, respectively), the BMD of U-Cd ranged 1.8-3.7 microg/g creatinine, and the BMDL ranged 1.0-2.1 microg/g creatinine. For a 5% BMR of osteoporosis (T-score < -2.5), the BMD was 2.9 microg/g creatinine and the BMDL 1.6 microg/g creatinine. The lowest obtained BMD of U-Cd for wrist bone mineral density was only slightly higher than the lowest reference concentration previously reported for cadmium-related kidney effects. Our results provide additional scientific support for the low tolerably weekly intake (TWI) of cadmium set by the European Food Safety Authority in 2009.
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Affiliation(s)
- Yasushi Suwazono
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Suwazono Y, Uetani M, Akesson A, Vahter M. Recent applications of benchmark dose method for estimation of reference cadmium exposure for renal effects in man. Toxicol Lett 2010; 198:40-3. [PMID: 20420885 DOI: 10.1016/j.toxlet.2010.04.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/15/2010] [Accepted: 04/17/2010] [Indexed: 10/19/2022]
Abstract
The initial sign of cadmium (Cd)-induced renal effects is tubular damage, followed by glomerular damage. For the prevention of Cd-induced renal effects, it is essential to establish the reference exposure below which the risk of adverse health effects is low. In earlier Japanese studies, the estimated reference exposure of creatinine (cre)-adjusted urinary cadmium for renal tubular effect ranged from 1.6 to 4.0 microg/g cre in men and 2.3 to 4.6 microg/g cre in women. The benchmark dose (BMD) is defined as the exposure that corresponds to a certain response change from the background. The lower 95% confidence limit of the BMD (BMDL) can be used in risk assessment as a replacement for the no observed adverse effect level. This is a review of all relevant BMDL of Cd exposure for renal effects estimated so far. Based on studies in Japan, the best estimate is considered to be 1.5-3.2 microg/g cre for urinary Cd, 0.09-0.13 mg/kg for rice Cd concentration, and 0.9-1.4 g Cd for lifetime Cd intake. These BMDLs for renal effects were generally lower than the reference exposure expected from earlier studies, indicating the importance of further discussion regarding comprehensive measures to decrease the Cd exposure in the general population.
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Affiliation(s)
- Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoku, Chiba 260-8670, Japan.
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Kobayashi E, Suwazono Y, Dochi M, Honda R, Nishijo M, Kido T, Nakagawa H. Estimation of benchmark doses as threshold levels of urinary cadmium, based on excretion of β2-microglobulin in cadmium-polluted and non-polluted regions in Japan. Toxicol Lett 2008; 179:108-12. [DOI: 10.1016/j.toxlet.2008.04.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 04/24/2008] [Accepted: 04/24/2008] [Indexed: 11/24/2022]
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