Toxic and carcinogenic element

1. Cadmium
Toxicity
DR DIPAYAN SAHA
M.P.H. 1ST SEM,
INSTITUTE OF PUBLIC HEALTH, KALYANI
UNDER THE SUPERVISION OF DR. JAYITA PAL

2. INTRODUCTION
 Encountered in earth’s crust combined with chlorine (CdCl2),
oxygen (CdO), Sulphur (CdS)
 Exists as small particles in air, as it is produced as a result of
smelting, soldering or other high temp. industrial process
 Classified as human carcinogenic substance by W.H.O
 By-product of smelting of zinc, lead, and copper ores
 used mainly in electroplating of steel, producing pigments,
batteries (Ni-Cd rechargeable batteries), stabilizing plastics
and as a neutron absorbent in nuclear reactor

3. WHAT IS CADMIUM??
 Cadmium is a silvery white chemical element.
 Placed in group 12 and period 5 of periodic table
 Denoted by symbol Cd, having Atomic no. 48
 Discovered in contaminated zinc compound
sold in pharmacies of Germany
 0.1 ppm of earth crust (zinc 65 ppm in earth crust)

4. CADMIUM POISONING
 Caused by excessive exposure to Cadmium (inhalation and indigestion)
 Extremely toxic even in low concentrations; bioaccumulation
occurs in organisms and ecosystems.
 The McDonalds 3D Shrek Glasses are contaminated
with cadmium.

5. EXPOSURE SOURCES
 Tobacco smoke (a one pack a day smoker absorbs roughly 5 to 10
times more cadmium amount absorbed in blood than non smokers)
 Contamination of air, water and soil with cadmium in industrial areas
 Cadmium fumes from incineration of municipal wastes
 use of phosphates sources in fertilizers
 low levels are found in grains, cereals, leafy vegetables and other basic
foodstuffs
 occupational exposure in electroplating industry, metal smelting
industry, nickel-cadmium battery industry

7. CADMIUM PHARMACOKINETICS
INHALATION
 18-50 % of cadmium are absorbed by the lungs
 absorption in lungs depends on particle size; absorption is greatest
for particles that are small (less than 0.1 micrometre) and water soluble.
INGESTION
 6 % of cadmium are absorbed by GIT; more amount absorbed in iron
deficiency and calcium deficiency cases

8. MODES OF ENTRY IN HUMAN BODY

9. CADMIUM PHARMACOKINETICS (CONTD.)
DISTRIBUTION
 bound to albumin in plasma and red blood cells
 transported to liver, pancreas, prostrate and kidney, with eventual
transfer to kidney
 50-75 % of total body Cd is found in liver and kidney
ELIMINATION
 Metallothionein (protein rich in cysteine), traps Cd tightly in renal tubules
 Eliminated primarily through urine
 half life in humans : 22-30 years

10. CADMIUM TOXICOLOGY

11. CADMIUM TOXICODYNAMICS
 Inside cells, cadmium ions acts as catalytic hydrogen peroxide
generator.
 hydrogen peroxide causes increased lipid peroxidation and depletes
ascorbate and glutathione stores
 hydrogen peroxide convert thiol groups on protein and attacks
nuclear DNA, leading to synthesis of inflammatory cytokines, and
eventually cell death

13. SIGNS AND SYMPTOMS
ACUTE
 Exposure to cadmium fumes causes Flu like symptoms including chills,
fever and muscle ache, sometimes referred as “cadmium blues”
 Severe exposure causes chest pain, headache, dizziness, dryness and
irritation of nose and throat, leading to tracheobronchitis, pneumonitis
and pulmonary edema
CHRONIC
 Anaemia and kidney failure
 Cancer

14. SYSTEMIC TOXICITY
 SKELETAL SYSTEM
Osteoporosis & Osteomalacia, resulting in back pain, joint pain and
increased risk of fractures
 PULMONARY SYSTEM
Emphysema, Edema and Lung cancer
8% of Lung cancer may be attributable to Cadmium
 EXCRETORY SYSTEM
Proximal tubule dysfunction
Gout
Kidney stone
 REPRODUCTIVE SYSTEM
Testicular necrosis
impaired menstrual cycles

15. EPIDEMIOLOGY
ITAI-ITAI DISEASE
 Prevalence occurred in a mass of Japan due to
Cadmium poisoning around 1912
 Characterized by severe muscle pain, Osteomalacia
renal failure and anaemia
 the river water got contaminated with the waste
from zinc mine containing cadmium
 polluted water used on rice field for many years
 rice accumulated high levels of cadmium

16. DIAGNOSIS
DIRECT EVALUATION
 24 HRS urine evaluation
INDIRECT EVALUATION
 Urinary beta-2 macroglobulin
 Urinary Retinol Binding Protein (RBP)
 Metallothionein (MT)
CRITICAL LEVELS
 Blood Cadmium : 10 micrograms/litre
 Urinary Cadmium : 10 micrograms/gram creatinine
 Urinary beta 2-macroglobulin : 2000 micrograms/gram creatinine
 Urinary retinol binding protein : 200 micrograms/gram creatinine

17. TREATMENT
 in case of exposure by ingestion, Emesis or Gastric lavage should
be done.
 Detoxification of cadmium with chelators such as EDTA, DMPS and
DMSA

18. PREVENTION
 increasing the safe and effective recycling of cadmium
 minimizing emissions and discharges from activities such as
mining and waste management
 promoting safe working conditions for workers manipulating cadmium
containing products
 promoting the elimination of use of cadmium in products such as toys,
jewellery and plastics
 implementing the WHO Framework Convention on Tobacco Control,
including providing protection from tobacco smoke in workplaces
and public areas
 Washing fruits and vegetables can reduce contamination to some extent