title: Exposure determinants of cadmium in European mothers and their children.
abstract: The metal cadmium (Cd) is a widespread environmental pollutant with documented adverse effects on the kidneys and bones from long-term environmental exposure, but with insufficiently elucidated public health consequences such as risk of cardiovascular disease, hormone-related cancer in adults and developmental effects in children. This study is the first pan-European human biomonitoring project that succeeded in performing harmonized measurements of Cd in urine in a comparable way in mother-child couples from 16 European countries. The aim of the study was to evaluate the overall Cd exposure and significant determinants of Cd exposure. A study population of 1632 women (24-52 years of age), and 1689 children (5-12 years of age), from 32 rural and urban areas, was examined within a core period of 6 months in 2011-2012. Women were stratified as smokers and non-smokers. As expected, smoking mothers had higher geometric mean (gm) urinary cadmium (UCd; 0.24 µg/g crea; n=360) than non-smoking mothers (gm 0.18 µg/g crea; n=1272; p<0.0001), and children had lower UCd (gm 0.065 µg/g crea; n=1689) than their mothers at the country level. Non-smoking women exposed to environmental tobacco smoke (ETS) at home had 14% (95% CI 1-28%) higher UCd than those who were not exposed to ETS at home (p=0.04). No influence of ETS at home or other places on UCd levels was detected in children. Smoking women with primary education as the highest educational level of the household had 48% (95% CI 18-86%) higher UCd than those with tertiary education (p=0.0008). The same observation was seen in non-smoking women and in children; however they were not statistically significant. In children, living in a rural area was associated with 7% (95% CI 1-13%) higher UCd (p=0.03) compared to living in an urban area. Children, 9-12 years had 7% (95% CI 1-13%) higher UCd (p=0.04) than children 5-8 years. About 1% of the mothers, and 0.06% of the children, exceeded the tolerable weekly intake (TWI) appointed by EFSA, corresponding to 1.0 µg Cd/g crea in urine. Poland had the highest UCd in comparison between the 16 countries, while Denmark had the lowest. Whether the differences between countries are related to differences in the degree of environmental Cd contamination or to differences in lifestyle, socioeconomic status or dietary patterns is not clear.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: marika.berglund@ki.se.
authors.forename: Marika
authors.initials: M
authors.lastname: Berglund
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kristin
authors.initials: K
authors.lastname: Larsson
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Grandér
authors.affiliation: University of Leuven (KU Leuven), Leuven, Belgium.
authors.forename: Ludwine
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authors.lastname: Casteleyn
authors.affiliation: Federal Environment Agency (UBA), Berlin, Germany.
authors.forename: Marike
authors.initials: M
authors.lastname: Kolossa-Gehring
authors.affiliation: Federal Environment Agency (UBA), Berlin, Germany.
authors.forename: Gerda
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authors.lastname: Schwedler
authors.affiliation: Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain.
authors.forename: Argelia
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authors.affiliation: Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain.
authors.forename: Marta
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authors.lastname: Esteban
authors.affiliation: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Angerer
authors.affiliation: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Koch
authors.affiliation: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany.
authors.forename: Birgit K
authors.initials: BK
authors.lastname: Schindler
authors.affiliation: Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium.
authors.forename: Greet
authors.initials: G
authors.lastname: Schoeters
authors.affiliation: Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium.
authors.forename: Roel
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authors.lastname: Smolders
authors.affiliation: Public Health England, Oxfordshire, United Kingdom.
authors.forename: Karen
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authors.lastname: Exley
authors.affiliation: Public Health England, Oxfordshire, United Kingdom.
authors.forename: Ovnair
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authors.lastname: Sepai
authors.affiliation: Environmental Health Sciences International, Hulst, The Netherlands.
authors.forename: Luies
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authors.lastname: Blumen
authors.affiliation: Jožef Stefan Institute, Ljubljana, Slovenia.
authors.forename: Milena
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authors.lastname: Horvat
authors.affiliation: Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark.
authors.forename: Lisbeth E
authors.initials: LE
authors.lastname: Knudsen
authors.affiliation: Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark.
authors.forename: Thit A
authors.initials: TA
authors.lastname: Mørck
authors.affiliation: BiPRO GmbH, Munich, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Joas
authors.affiliation: BiPRO GmbH, Munich, Germany.
authors.forename: Reinhard
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authors.lastname: Joas
authors.affiliation: Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium.
authors.forename: Pierre
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authors.lastname: Biot
authors.affiliation: Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Aerts
authors.affiliation: Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Koen
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authors.lastname: De Cremer
authors.affiliation: Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Van Overmeire
authors.affiliation: State General Laboratory, Ministry of Health, Nicosia, Cyprus.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Katsonouri
authors.affiliation: Larnaca General Hospital, Ministry of Health, School of Medicine, European University of Cyprus, Larnaca, Cyprus.
authors.forename: Adamos
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authors.lastname: Hadjipanayis
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Milena
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authors.lastname: Cerna
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Krskova
authors.affiliation: Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark.
authors.forename: Jeanette K S
authors.initials: JK
authors.lastname: Nielsen
authors.affiliation: Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark.
authors.forename: Janne Fangel
authors.initials: JF
authors.lastname: Jensen
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary.
authors.forename: Peter
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authors.lastname: Rudnai
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Kozepesy
authors.affiliation: Health Service Executive, Dublin Public Analyst's Laboratory, Dublin, Ireland.
authors.forename: Chris
authors.initials: C
authors.lastname: Griffin
authors.affiliation: Health Service Executive, Dublin Public Analyst's Laboratory, Dublin, Ireland.
authors.forename: Ian
authors.initials: I
authors.lastname: Nesbitt
authors.affiliation: Centre de Recherche Public-Gabriel Lippmann, Luxemburg.
authors.forename: Arno C
authors.initials: AC
authors.lastname: Gutleb
authors.affiliation: Laboratoire National de Santé, Dudelange, Luxembourg.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Fischer
authors.affiliation: Nofer Institute of Occupational Medicine, Lodz, Poland.
authors.forename: Danuta
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authors.lastname: Ligocka
authors.affiliation: Nofer Institute of Occupational Medicine, Lodz, Poland.
authors.forename: Marek
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authors.lastname: Jakubowski
authors.affiliation: Institute of Preventive Medicine, Lisbon, Portugal.
authors.forename: M Fátima
authors.initials: MF
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authors.affiliation: Institute of Preventive Medicine, Lisbon, Portugal.
authors.forename: Sónia
authors.initials: S
authors.lastname: Namorado
authors.affiliation: Environmental Health Center, Cluj-Napoca, Romania.
authors.forename: Ioana-Rodica
authors.initials: IR
authors.lastname: Lupsa
authors.affiliation: Environmental Health Center, Cluj-Napoca, Romania.
authors.forename: Anca E
authors.initials: AE
authors.lastname: Gurzau
authors.affiliation: Authority of Public Health, Bratislava, Slovak Republic.
authors.forename: Katarina
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authors.lastname: Halzlova
authors.affiliation: Authority of Public Health, Bratislava, Slovak Republic.
authors.forename: Michal
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authors.lastname: Jajcaj
authors.affiliation: Jožef Stefan Institute, Ljubljana, Slovenia.
authors.forename: Darja
authors.initials: D
authors.lastname: Mazej
authors.affiliation: Jožef Stefan Institute, Ljubljana, Slovenia.
authors.forename: Janja Snoj
authors.initials: JS
authors.lastname: Tratnik
authors.affiliation: Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Cañas
authors.affiliation: Federal Office of Public Health, Bern, Switzerland.
authors.forename: Andrea
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authors.lastname: Lehmann
authors.affiliation: Federal Office of Public Health, Bern, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Crettaz
authors.affiliation: Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium.
authors.forename: Elly
authors.initials: E
authors.lastname: Den Hond
authors.affiliation: Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium.
authors.forename: Eva
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mesh_terms: D000328:Adult; D002104:Cadmium / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods; D004785:Environmental Pollutants / Q000652:urine*; D005060:Europe; D006801:Humans; D008019:Life Style; D057230:Limit of Detection; D008875:Middle Aged; D009035:Mothers; D012044:Regression Analysis; D012907:Smoking / Q000378:metabolism; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium
keywords: Biomonitoring; Democophes; Exposure predictors; Mother–child pairs; Urinary cadmium