title: Blood cadmium by race/hispanic origin: The role of smoking.
abstract: There have been increasing concerns over health effects of low level exposure to cadmium, especially those on bones and kidneys.
  
  
  
  To explore how age-adjusted geometric means of blood cadmium in adults varied by race/Hispanic origin, sex, and smoking status among U.S. adults and the extent to which the difference in blood cadmium by race/Hispanic origin and sex may be explained by intensity of smoking, a known major source of cadmium exposure.
  
  
  
  Our sample included 7,368 adults from National Health and Nutrition Examination Survey (NHANES) 2011-2014. With direct age adjustment, geometric means of blood cadmium and number of cigarettes smoked per day were estimated for subgroups defined by race/Hispanic origin, smoking status, and sex using interval regression, which allows mean estimation in the presence of left- and right-censoring.
  
  
  
  Among never and former smoking men and women, blood cadmium tended to be higher for non-Hispanic Asian adults than adults of other race/Hispanic origin. Among current smokers, who generally had higher blood cadmium than never and former smokers, non-Hispanic white, black, and Asian adults had similarly elevated blood cadmium compared to Hispanic adults. A separate analysis revealed that non-Hispanic white adults tended to have the highest smoking intensity regardless of sex, than adults of the other race/Hispanic origin groups.
  
  
  
  The observed pattern provided evidence for smoking as a major source of cadmium exposure, yet factors other than smoking also appeared to contribute to higher blood cadmium of non-Hispanic Asian adults.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, 3311 Toledo Rd, Hyattsville, MD 20782, USA. Electronic address: yaoki@cdc.gov.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, 3311 Toledo Rd, Hyattsville, MD 20782, USA; Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology, and Laboratory Services, Division of Scientific Education and Professional Development, Epidemiology Elective Program, MS E-92, 1600 Clifton Rd, NE, Atlanta, GA 30329, USA; Georgetown University Medical Center, Department of Family Medicine, 4000 Reservoir Road, N.W., Washington D.C 20057, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yee
authors.affiliation: Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D001741:Black or African American; D044466:Asian People; D002104:Cadmium / Q000097:blood*; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012907:Smoking / Q000097:blood* / Q000453:epidemiology; D014481:United States; D044465:White People; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D002104:Cadmium
keywords: Asians; Blood cadmium; NHANES; Race/Hispanic origin; Smoking