title: Is Urinary Cadmium a Biomarker of Long-term Exposure in Humans? A Review.
abstract: Cadmium is a naturally-occurring element, and humans are exposed from cigarettes, food, and industrial sources. Following exposure, cadmium accumulates in the kidney and is slowly released into the urine, usually proportionally to the levels found in the kidneys. Cadmium levels in a single spot urine sample have been considered indicative of long-term exposure to cadmium; however, such a potentially exceptional biomarker requires careful scrutiny. In this review, we report good to excellent temporal stability of urinary cadmium (intraclass correlation coefficient 0.66-0.81) regardless of spot urine or first morning void sampling. Factors such as changes in smoking habits and diseases characterized by increased excretion of proteins may produce short-term changes in urinary cadmium levels. We recommend that epidemiologists use this powerful biomarker in prospective studies stratified by smoking status, along with thoughtful consideration of additional factors that can influence renal physiology and cadmium excretion.
authors.affiliation: Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, 11794, USA. caterina.vacchi-suzzi@stonybrookmedicine.edu.
authors.forename: Caterina
authors.initials: C
authors.lastname: Vacchi-Suzzi
authors.affiliation: Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Kruse
authors.affiliation: Analytical Sciences Department, Innovation, Technology and Development RTI International, Research Triangle Park, NC, 27709, USA.
authors.forename: James
authors.initials: J
authors.lastname: Harrington
authors.affiliation: Analytical Sciences Department, Innovation, Technology and Development RTI International, Research Triangle Park, NC, 27709, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Levine
authors.affiliation: Program in Public Health, Department of Family, Population and Preventive Medicine Stony Brook University, Stony Brook, NY, 11794, USA.
authors.forename: Jaymie R
authors.initials: JR
authors.lastname: Meliker
mesh_terms: D015415:Biomarkers / Q000652:urine*; D002104:Cadmium / Q000652:urine*; D003404:Creatinine / Q000652:urine; D004781:Environmental Exposure / Q000032:analysis*; D006801:Humans; D007668:Kidney; D012907:Smoking / Q000652:urine
chemical_list: D015415:Biomarkers; D002104:Cadmium; D003404:Creatinine
keywords: Biomarker; Biomonitoring; Cadmium; Creatinine; Heavy metal; Urinary-cadmium