title: Occupational cadmium exposure and calcium excretion, bone density, and osteoporosis in men.
abstract: Exposure to cadmium has been associated with osteoporosis and fracture risk in women and the elderly, but studies in middle-aged men are lacking. In 83 male (ex)workers (mean age 45 years; range 24 to 64 years) in a radiator factory using cadmium-containing solder, we investigated the association between urinary cadmium excretion (as an index of lifetime body burden); bone mineral density (BMD) in the distal forearm, hip, and lumbar spine (by dual-energy X-ray absorptiometry); and urinary calcium excretion. Geometric mean urinary cadmium concentration was 1.02 microg/g of creatinine (5th to 95th percentile 0.17 to 5.51 microg/g). BMD was negatively correlated with urinary exposure to cadmium. The partial correlation coefficients (r) adjusted for age, body-mass index, and current smoking were -0.30 (p = .008) for BMD in the forearm, -0.27 (p = .017) in the hip, and -0.17 (p = .15) in the spine. Urinary calcium correlated positively (r = 0.23, p = .044) with the urinary cadmium excretion. Adjusted for the same covariates, the risk of osteoporosis (defined as a T-score below -2.5 in at least one measured bone site) increased dose dependently. Compared with the lowest tertile of urinary cadmium, the risks were 4.8- and 9.9-fold higher in the middle and highest tertiles, respectively. Only four (5%) men had evidence of renal tubular dysfunction (beta(2)-microglobulin > 300 microg/g of creatinine). Even in the absence of renal tubular dysfunction, occupational exposure to cadmium is associated in men with lower BMD values, a higher risk of having osteoporosis, and a higher urinary calcium excretion, suggesting a direct osteotoxic effect of cadmium.
authors.affiliation: Unit of Lung Toxicology, Occupational & Environmental Medicine, School of Public Health, K U Leuven, Leuven, Belgium.
authors.forename: Tim
authors.initials: T
authors.lastname: Nawrot
authors.forename: Piet
authors.initials: P
authors.lastname: Geusens
authors.forename: Tom S
authors.initials: TS
authors.lastname: Nulens
authors.forename: Benoit
authors.initials: B
authors.lastname: Nemery
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D002104:Cadmium / Q000009:adverse effects* / Q000652:urine; D002118:Calcium / Q000652:urine*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000032:analysis*; D010024:Osteoporosis / Q000139:chemically induced* / Q000503:physiopathology* / Q000652:urine; D055815:Young Adult
chemical_list: D002104:Cadmium; D002118:Calcium