Urinary cadmium levels predict lower lung function in current and former smokers: data from the Third National Health and Nutrition Examination Survey.
BACKGROUND
A study was undertaken to determine the relation between urinary cadmium levels and lung function in a nationally representative cohort of current, former, and never smokers in the US. Urinary cadmium levels reflect the total body burden of cadmium.


METHODS
The following data from the Third National Health and Nutrition Examination Survey were analysed: urinary cadmium (adjusted for urinary creatinine), lung function, sex, race/ethnicity, age, education level, job category, body mass index, serum cotinine level, and smoking history. Linear regression models were developed to predict lung function using urinary cadmium as the main predictor, adjusting for other covariates and stratified by smoking status.


RESULTS
Data were available on 16 024 adults. Current smokers had higher mean (SE) urinary cadmium/creatinine levels (0.46 (0.01) micro g/g) than former (0.32 (0.01) micro g/g) or never smokers (0.23 (0.01) micro g/g). Higher levels of urinary cadmium were associated with significantly lower forced expiratory volumes in 1 second (FEV(1)) in current (-2.06%, 95% confidence interval (CI) -2.86 to -1.26 per 1 log increase in urinary cadmium) and former smokers (-1.95%, 95% CI -2.87 to -1.03) but not in never smokers (-0.18%, 95% CI -0.60 to 0.24). Similar results were obtained for forced vital capacity (FVC) and FEV(1)/FVC.


CONCLUSIONS
Cadmium, which is known to cause emphysema in occupational settings, may also be important in the development of tobacco related lung disease.
Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, Atlanta, Georgia 30333, USA. dmannino@cdc.gov
D M
DM
Mannino
F
F
Holguin
H M
HM
Greves
A
A
Savage-Brown
A L
AL
Stock
R L
RL
Jones
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium / Q000652:urine*; D003367:Cotinine / Q000652:urine; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012907:Smoking / Q000009:adverse effects / Q000652:urine*; D014797:Vital Capacity / Q000502:physiology
D002104:Cadmium; D003367:Cotinine