title: Blood cadmium concentrations and environmental exposure sources in newcomer South and East Asian women in the Greater Toronto Area, Canada.
abstract: Immigrant women are often identified as being particularly vulnerable to environmental exposures and health effects. The availability of biomonitoring data on newcomers is limited, thus, presenting a challenge to public health practitioners in the identification of priorities for intervention.
  
  
  
  In fulfillment of data needs, the purpose of this study was to characterize blood concentrations of cadmium (Cd) among newcomer women of reproductive age (19-45 years of age) living in the Greater Toronto Area (GTA), Canada and to assess potential sources of environmental exposures.
  
  
  
  A community-based model, engaging peer researchers from the communities of interest, was used for recruitment and follow-up purposes. Blood samples were taken from a total of 211 newcomer women from South and East Asia, representing primary, regional origins of immigrants to the GTA, and environmental exposure sources were assessed via telephone survey. Metal concentrations were measured in blood samples (diluted with 0.5% (v/v) ammonium hydroxide and 0.1% (v/v) octylphenol ethoxylate) using a quadrupole ICP-MS. Survey questions addressed a wide range of environmental exposure sources, including dietary and smoking patterns and use of nutritional supplements, herbal products and cosmetics.
  
  
  
  A geometric mean (GM) blood Cd concentration of 0.39µg/L (SD:±2.07µg/L) was determined for study participants (min/max: <0.045µg/L (LOD)/2.36µg/L). Several variables including low educational attainment (Relative Ratio (RR) (adjusted)=1.50; 95% CI 1.17-1.91), milk consumption (RR (adjusted)=0.86; 95% CI 0.76-0.97), and use of zinc supplements (RR (adjusted)=0.76; 95% CI 0.64-0.95) were observed to be significantly associated with blood Cd concentrations in the adjusted regression model. The variable domains socioeconomic status (R2adj=0.11) and country of origin (R2adj=0.236) were the strongest predictors of blood Cd.
  
  
  
  Blood Cd concentrations fell below those generally considered to be of human health concern. However, negative health effects cannot be entirely excluded, especially for those that fall in the upper percentile range of the distribution, given the mounting evidence for negative health outcomes at low environmental exposure concentrations.
authors.affiliation: School of the Environment, University of Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada. Electronic address: clare.wiseman@utoronto.ca.
authors.forename: C L S
authors.initials: CLS
authors.lastname: Wiseman
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Parnia
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Chakravartty
authors.affiliation: Toronto Public Health, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Archbold
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Zawar
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Canada; Public Health Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Copes
authors.affiliation: School of the Environment, University of Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada.
authors.forename: D C
authors.initials: DC
authors.lastname: Cole
mesh_terms: D000328:Adult; D001210:Asia, Southeastern; D002104:Cadmium / Q000097:blood*; D019587:Dietary Supplements; D004522:Educational Status; D054242:Emigrants and Immigrants; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009864:Ontario / Q000208:ethnology; D055815:Young Adult
chemical_list: D002104:Cadmium
keywords: Biomonitoring; Cadmium; Immigrant; Metal exposures; Women