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Occupational Medicine Advance Access originally published online on January 15, 2009
Occupational Medicine 2009 59(2):130-132; doi:10.1093/occmed/kqn163
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

A case report of elevated blood cadmium

Christopher J. Martin1, James M. Antonini2 and Brent C. Doney3

1 Institute of Occupational and Environmental Health, School of Medicine, West Virginia University, Morgantown, WV, USA
2 Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
3 Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA

A 45-year-old male paint technician was identified as having an elevated whole-blood cadmium of 5.9 µg/l (Occupational and Safety Health Administration reference range for workers: ≤5.0 µg/l) through a routine workplace biological monitoring programme. Other than smoking 1.5–2 packs of cigarettes daily for 23 years, no additional non-occupational exposures to cadmium were identified. Whole-blood cadmium results taken 5, 4 and 2 years earlier were 3.1, 4.0 and 4.3 µg/l, respectively. After reassignment to a position without cadmium exposure, his whole-blood cadmium level 7 weeks later was 6.1 µg/l. A careful exposure history revealed that he had recently changed the brand of cigarettes he smoked. When he switched back to his original brand and reduced his consumption to one pack per day, his cadmium level fell to 2.9 µg/l taken 12 weeks after the initial elevated result. Eight weeks after returning to his original position with cadmium exposure, the value was 3.4 µg/l. No elevation in urine cadmium was noted at any point. An analysis of the tobacco revealed that the cadmium content of the new brand was almost 1.5-fold greater than the original brand. These results suggest that the consumption of different brands of cigarettes can lead to marked variations in whole-blood cadmium levels.

Keywords      Blood sampling; cadmium; cigarette smoking; metal imbalance; tobacco constituents

Correspondence to: Christopher J. Martin, Institute of Occupational and Environmental Health, School of Medicine, West Virginia University, Morgantown, WV 26506-9190, USA. Tel: +1 304 293 3693; fax: +1 304 293 2629; e-mail: cmartin{at}hsc.wvu.edu


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