OBJECTIVETo analyze the clinical features of mild chronic cadmium poisoning induced by different causes.

METHODSA total of 90 patients with mild chronic cadmium poisoning, who were hospitalized in our center from 2008 to 2011 and had complete clinical data, were divided into two groups according to the causes of poisoning: environmental pollution group (n = 45) and occupational poisoning group (n = 45). The clinical symptoms, signs, laboratory indices, and treatment outcomes of all patients were analyzed.

RESULTSCompared with the environmental pollution group, the occupational poisoning group had more bone pain, less bone injury (based on imaging findings), and significantly increased abnormal rate of urinary retinol-binding protein (RBP) (P < 0.05); there were no significant differences in urinary β-2 microglobulin (MG) and urinary microalbumin between the two groups (P > 0.05). Urinary cadmium, urinary RBP, and urinary β-2 MG had no linear correlation between each other in the two groups. Both groups showed significant changes in urinary cadmium levels after treatment (P < 0.05).

CONCLUSIONThe clinical features of mild chronic cadmium poisoning induced by various causes are different, and active nutritional support therapy plays a positive role in improving prognosis.

Cadmium ; urine ; Cadmium Poisoning ; therapy ; urine ; Environmental Exposure ; Environmental Pollutants ; urine ; Humans ; Nutritional Support ; Occupational Exposure ; Retinol-Binding Proteins ; urine ; beta 2-Microglobulin ; urine

Cadmium ; urine ; Humans ; Quartz ; Spectrophotometry, Atomic ; instrumentation ; methods

OBJECTIVETo estimate the biological exposure limit (BEL) using benchmark dose (BMD) based on two sets of data from occupational epidemiology.

METHODSCadmium-exposed workers were selected from a cadmium smelting factory and a zinc product factory. Doctors, nurses or shop assistants living in the same area served as a control group. Urinary cadmium (UCd) was used as an exposure biomarker and urinary beta2-microgloburin (B2M), N-acetyl-13-D-glucosaminidase (NAG) and albumin (ALB) as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S.A) was used to calculate BMD.

RESULTSThe cut-off point (abnormal values) was determined based on the upper limit of 95% of effect biomarkers in control group. There was a significant dose response relationship between the effect biomarkers (urinary B2M, NAG; and ALB) and exposure biomarker (UCd). BEL value was 5 microg/g creatinine for UB2M as an effect biomarker, consistent with the recommendation of WHO. BEL could be estimated by using the method of BMD. BEL value was 3 microg/g creatinine for UNAG as an effect biomarker. The more sensitive the used biomarker is, the more occupational population will be protected.

CONCLUSIONBMD can be used in estimating the biological exposure limit (BEL). UNAG is a sensitive biomarker for estimating BEL after cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; toxicity ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Spectrophotometry, Atomic ; beta 2-Microglobulin ; urine

OBJECTIVEBased on two sets of data from occupational epidemiology, Benchmark dose (BMD) was applied to estimate biological exposure limit (BEL).

METHODSCadmium exposed workers were selected from a cadmium smelting and a zinc products factory and control group was selected from doctors or nurses and staff from shops living in the same area; Urinary cadmium (UCd) was used as exposure biomarker and urinary beta(2) microglobulin (UBM), NAG (UNAG) and albumin (UALB) were as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S) was used to calculate BMD.

RESULTSCalculated abnormal prevalence was based on the upper limit of 95% of effect biomarkers in control group; There are significant dose response relationship between the prevalence of effect biomarkers (UBM, UNAG and UALB) and exposure biomarker (UCd); BEL was 5 microg/g creatinine for UBM as effect biomarker, It consists with the recommendation of WHO; BEL was 3 microg/g creatinine for UNAG as effect biomarker; BEL can be estimated by using the method of BMD; the more sensitive biomarker would used, the more occupational people would protected.

CONCLUSIONThe application of BMD in estimating biological exposure limit (BEL) is proper. UNAG is suggested as most sensitive biomarker to be used to estimate BEL for cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; adverse effects ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Reference Values ; beta 2-Microglobulin ; urine

BACKGROUND: In health examinations for local inhabitants in cadmium-polluted areas, only healthy people are investigated, suggesting that patients with severe cadmium nephropathy or itai-itai disease may be overlooked. Therefore, we performed hospital-based screening to detect patients with cadmium nephropathy in two core medical institutes in cadmium-polluted areas in Akita prefecture, Japan. METHODS: Subjects for this screening were selected from patients aged 60 years or older with elevated serum creatinine levels and no definite renal diseases. We enrolled 35 subjects from a hospital in Odate city and 22 from a clinic in Kosaka town. Urinary ß-microglobulin and blood and urinary cadmium levels were measured. RESULTS: The criteria for renal tubular dysfunction and the over-accumulation of cadmium were set as a urinary ß-microglobulin level higher than 10,000 μg/g cr. and a blood cadmium level higher than 6 μg/L or urinary cadmium level higher than 10 μg/g cr., respectively. Subjects who fulfilled both criteria were diagnosed with cadmium nephropathy. Six out of 57 patients (10.5% of all subjects) had cadmium nephropathy. CONCLUSIONS: This hospital-based screening is a very effective strategy for detecting patients with cadmium nephropathy in cadmium-polluted areas, playing a complementary role in health examinations for local inhabitants. REGISTRATION NUMBER No. 6, date of registration: 6 June, 2010 (Akita Rosai Hospital), and No. 1117, date of registration: 26 December, 2013 (Akita University).
Aged ; Aged, 80 and over ; Cadmium ; adverse effects ; urine ; Cadmium Poisoning ; blood ; complications ; urine ; Creatinine ; urine ; Environmental Exposure ; adverse effects ; Environmental Monitoring ; Environmental Pollutants ; adverse effects ; urine ; Female ; Hospitals ; Humans ; Japan ; Kidney Diseases ; chemically induced ; urine ; Male ; Middle Aged ; Sex Distribution

OBJECTIVETo explore the health status of workers exposed to Cd at low concentration.

METHODSOne hundred eighteen workers of zinc powder finishing and 34 staffs were served as the exposure group and control group, respectively. The physical examination, blood cadmium, urinary cadmium, blood lead, urinary 32-microglobin, urine creatine, chest film, pulmonary function , pure tone teat and were detected for all subjects.

RESULTSTwelve air samples from 6 monitoring points in workshop were detected, the air Cd concentrations were 0.002-0.015 mg/m³, which were under the national limit of occupational exposure. In exposure group, the rates of exceeding standards of blood Cd and urinary Cd were 65.25% and 38.16%, respectively, the rate of exceeding standards of urinary Cd for two times was 27.12%, the rate of exceeding standard of urine Cd for two times plus the positive urinary 32-microglobin was 2.54 %. In control group, the rates of exceeding national standard of blood Cd was 26.47 %, but the values of urinary Cd were normal. In exposure group, the rate of exceeding standards of urinary Cd increased with the service length. Smoking could enhance the rates of exceeding standards of blood Cd and urinary Cd.

CONCLUSIONIn zinc powder finishing, the low-concentration cadmium exposure could cause the occupational cadmium poisoning, the comprehensive protection measures can reduce the occupational cadmium poisoning. It is suggested that the limits of occupational exposure to cadmium should be declined.

Adult ; Cadmium ; blood ; urine ; Cadmium Poisoning ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Smoking ; epidemiology ; Workplace ; Young Adult ; Zinc ; analysis

OBJECTIVETo examine the nephrotoxicity induced caused by combined effect of arsenic and cadmium in exposed workers.

METHODSUrinary cadmium and arsenic were used as the exposure biomarkers of cadmium and arsenic. Urinary beta2-microglobulin (Ubeta2-MG), albumin (UALB) and N-acetyl-beta-D-glucosaminidase (UNAG) were measured as the effective biomarkers of tubular and glomerular dysfunction induced by cadmium and arsenic.

RESULTSThe combination of cadmium and arsenic induced more severe renal injury than that caused by either of the chemicals given alone. There were positive correlations and significant dose-effect among the concentrations of urinary cadmium, arsenic and levels of Ubeta2-MG, UALB, UNAG (P<0.05, P<0.01).

CONCLUSIONCadmium combined with arsenic may have additive effect on renal dysfunction in workers exposed to arsenic and cadmium.

Adult ; Albuminuria ; chemically induced ; Arsenic ; toxicity ; urine ; Cadmium ; toxicity ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Kidney ; drug effects ; Male ; Middle Aged ; Occupational Exposure ; beta 2-Microglobulin ; urine

OBJECTIVES: This study assessed the factors that have an influence on the residents exposed to heavy metals, and we utilized the findings to establish the proper management of abandoned metal mines in the future. METHODS: For a total of 258 residents who lived close to abandoned mines in Gangwon-province and Gyeonggi-province, the exposure factors and biomarkers in their blood and urine were comparatively analyzed via multiple regression analysis. RESULTS: The blood levels of lead and mercury and the cadmium levels in urine were found to be higher in the study group than that in the average Korean. For the blood levels of heavy metals according to each exposure factor, all of them were found to be significantly higher in both of the group residing for a longer period of time and the group living closer to the source of pollutants. Multiple regression analysis disclosed that all the heavy metals, except lead, in their blood were significantly reduced in proportion to the increased distance of inhabitancy from the mines. Their other biomarkers were within the normal ranges. CONCLUSIONS: We found that the distance between the residential village and the mines was a factor that affects the blood level of heavy metals in the villagers. This finding could be an important factor when developing a management model for the areas that surround abandoned metal mines. (ED note: I much like this important study.)
Biological Markers/blood/urine ; Cadmium/blood/urine ; Cluster Analysis ; Environmental Exposure/*adverse effects ; Humans ; Lead/blood/urine ; Mercury/blood/urine ; Metals, Heavy/*blood/*urine ; Mining ; Republic of Korea ; Water Pollutants, Chemical/analysis ; Water Supply/analysis

BACKGROUND: Previous studies have suggested that exposures to heavy metals (arsenic, cadmium, lead, and selenium) may be associated with differences in blood pressure. However, the findings of these studies have been inconsistent. This study was performed to examine the associations between urinary heavy metal concentrations and blood pressure among residents of four Asian countries (Bangladesh, Indonesia, Nepal, and Vietnam). METHODS: This cross-sectional study examined 1899 adults in four Asian countries. Urinary concentrations of heavy metals were measured by inductively coupled plasma mass spectrometry. A questionnaire survey was administered regarding individual characteristics. Anthropometric measurements (height and weight) were performed. Systolic and diastolic blood pressures were measured after a short rest. Multiple linear regression models were applied to investigate associations between urinary heavy metal concentrations and blood pressure after adjustments for age, sex, and body mass index. RESULTS: The geometric means of the urinary concentrations of arsenic, cadmium, lead, and selenium were 84.6, 0.885, 2.09, and 16.5 μg/g creatinine, respectively. The urinary arsenic concentrations were slightly higher than those typically reported in non-polluted populations, while urinary cadmium, lead, and selenium concentrations were equivalent or slightly lower. The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure, but urinary selenium concentrations were negatively associated with them. CONCLUSIONS Variations in the urinary concentrations of lead and selenium were associated with blood pressure at low levels of exposure/intake.
Adult ; Arsenic/urine* ; Bangladesh ; Blood Pressure ; Cadmium/urine* ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Indonesia ; Lead/urine* ; Linear Models ; Male ; Metals, Heavy/urine* ; Middle Aged ; Nepal ; Selenium/urine* ; Vietnam

OBJECTIVETo research the impairment of renal function and the combined effects of arsenic and cadmium exposure in population residing in polluted area, and to calculate the benchmark doses of urinary arsenic (UAs) and cadmium (UCd) in renal dysfunction.

METHODSThe concentrations of Uas and UCd were used as as exposure biomarker. Urinary beta(2)-microglobulin (Ubeta(2)-MG), N-acetyl-beta-glucosaminidase (UNAG), and albumin were calculated as biomarkers of renal dysfunction. The benchmark dose (BMD) and the lower confidence limit of the benchmark dose (BMDL) were calculated. Totally 245 patients were enrolled in the study, them, of 122 were from the exposed area, and 123 from the control area.

RESULTSUAs and UCd concentrations in the exposed group were shown significantly higher than those in the control group (P < 0.01). The levels of Ubeta(2)-MG, UNAG and urinary albumin in the exposed group were significantly higher than those of the controls (P < 0.01). There existed positive correlation among the concentrations of UAs, UCd, Ubeta(2)-MG, urinary albumin and UNAG, showing a significant dose-effect relationship. The combination of cadmium and arsenic caused even more renal injury than by chemicals alone in a same dose. The BMD/BMDL of UAs were estimated as 121.91-171.88 microg/g Cr and 102.11-144.44 microg/g Cr. Of UCd, the BMD/BMDL were 1.05-1.48 microg/g Cr and 0.88-1.24 microg/g Cr.

CONCLUSIONSThis study indicates the combination of cadmium and arsenic might cause even more renal injury than by chemicals given alone, and cadmium might cause potential arsenic nephrotoxicity during long-term coexposure to arsenic and cadmium in human beings. It also suggests that UAs and UCd should be kept below 102.11 and 0.88 microg/g creatinine as to preventing renal damage from coexposure to arsenic and cadmium. The BMD method should be used in calculating the BMD of UAs and UCd on renal dysfunction.

Acetylglucosaminidase ; urine ; Arsenic ; adverse effects ; urine ; Biomarkers ; urine ; Cadmium ; adverse effects ; urine ; China ; epidemiology ; Dose-Response Relationship, Drug ; Environmental Exposure ; Female ; Humans ; Kidney Diseases ; chemically induced ; epidemiology ; Kidney Function Tests ; Male ; Risk Factors ; beta 2-Microglobulin ; urine