Cadmium is a toxic heavy metal that occurs naturally and is used industrially. It can cause health effects when inhaled or ingested through contaminated food, water, air or tobacco smoke. Cadmium poisoning can damage the kidneys and bones and cause cancer. It accumulates in the body over time. Diagnosis involves testing urine or blood for cadmium levels. Treatment focuses on chelation therapy to remove cadmium from the body. Prevention efforts include reducing cadmium emissions, promoting recycling to limit industrial exposure, and controlling tobacco use.

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