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Title: Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study
Authors: Staessen, JA
Roels, HA
Emelianov, D
Kuznetsova, T
Thijs, L
Fagard, R
Issue Date: 1999
Publisher: LANCET LTD
Source: LANCET, 353(9159). p. 1140-1144
Abstract: Background Chronic low-level exposure to cadmium may promote calcium loss via urinary excretion. We undertook a prospective population study to investigate whether environmental exposure to cadmium lowers bone density and increases risk of fractures. Methods We measured urinary cadmium excretion, a biomarker of lifetime exposure, in people from ten districts of Belgium, of which six districts bordered on three zinc smelters. We also measured cadmium in soil and in vegetables from the districts, and collected data on incidence of fractures and height loss. Bone density was measured at the forearm just above the wrist by single photon absorptiometry, and calculated as the mean of six proximal and four distal scans. Findings Mean cadmium excretion at baseline was 8.7 nmol dairy. Across the ten districts, mean cadmium concentration in soil ranged from 0.8 to 14.7 mg/kg, and from 0.1 to 4.0 mg/kg dry weight in vegetables. Median follow-up was 6.6 years. Mean forearm bane density in proximal and distal scans was 0.54 g/cm(2) and 0.43 g/cm(2) in men, and 0.44 g/cm(2) and 0.34 g/cm(2) in women, in postmenopausal women, a twofold increase in urinary cadmium correlated with 0.01 g/cm(2) decrease in bone density (p < 0.02). The relative risks associated with doubted urinary cadmium were 1.73 (95% CI 1.16-2.57; p = 0.007) for fractures in women and 1.60 (0.94-2.72, p = 0.08) for height toss in men. Cadmium excretion in districts near smelters was 22.8% higher (p = 0.001) than in other districts, with fracture rates of 16.0 end 10.3 cases per 1000 person-years, respectively, and a population-attributable risk of 35.0%. Interpretation Even at a low degree of environmental exposure, cadmium may promote skeletal demineralisation, which may lead to increased bone fragility and raised risk of fractures.
Notes: Katholieke Univ Leuven, Dept Mol & Cardiovasc Res, Hypertens & Cardiovasc Rehabil Unit, B-3000 Leuven, Belgium. Univ Catholique Louvain, Unite Toxicol Ind & Med Travail, Bruxelles, Belgium. Limburgs Univ Ctr, Diepenbeek, Belgium.Staessen, JA, Katholieke Univ Leuven, Dept Mol & Cardiovasc Res, Hypertens & Cardiovasc Rehabil Unit, Campus Gasthuisberg,Herestr 49, B-3000 Leuven, Belgium.
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ISI #: 000079858400012
Type: Journal Contribution
Validations: ecoom 2000
Appears in Collections:Research publications

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