Cadmium exposure and tobacco consumption: Biomarkers and risk assessment

To investigate whether cadmium has an independent role in diseases associated with tobacco consumption, epidemiology data were reviewed, biomonitoring data were analyzed, and probabilistic risk assessment (PRA) was performed. Results from previous epidemiology studies have indicated that there are adverse health effects potentially in common between cadmium exposure and tobacco consumption. Analysis of publically available biomonitoring data showed that blood (B–Cd) and urine (U–Cd) cadmium were higher in cigarette smokers compared with smokeless tobacco (SLT) consumers, and B–Cd and U–Cd in SLT consumers were not significantly different than in non-consumers of tobacco. Comparison with previously established biomonitoring equivalent (BE) values indicated that B–Cd and U–Cd in the majority of these cigarette smokers and SLT consumers did not exceed the blood and urine BEs. Results of the PRA showed that the mean hazard estimate was below a generally accepted regulatory threshold for SLT consumers, but not for cigarette smokers. In total, this evaluation indicated that cadmium exposures in tobacco consumers differed by product category consumed; cadmium in tobacco may not be associated with tobacco consumption related diseases; if cadmium in tobacco contributes to tobacco consumption related diseases, differences in hazard and/or risk may exist by product category.

► Blood and urine Cd levels in cigarette smokers were higher than in smokeless tobacco consumers and non-consumers of tobacco.
► Blood and urine Cd levels in the majority of tobacco consumers did not exceed biomonitoring equivalent values.
► Blood and urine Cd levels in tobacco consumers were lower than Cd levels associated with adverse health effects.
► Probabilistic risk assessment predicted hazard from Cd in smokeless tobacco to be within accepted regulatory values.