Cadmium exposure from industrial activities was high before 1970 owing to a lack of regulation, and cadmium pollution contaminated soil adjacent to such industrial areas. Soil contamination can lead to cadmium contamination of foods and tobacco. A good example of cadmium contamination is the Jinzu River basin in Toyama, Japan, where nephropathy and Itai-Itai disease were endemic among residents. Even today, inhabitants of these areas still have high cadmium concentrations and experience chronic cadmium toxicity (1).
Acute cadmium toxicity can be life threatening, and chronic cadmium toxicity may affect the kidneys and the liver. Increased urinary β2-microglobulin may be an early marker for renal dysfunction in patients exposed to cadmium, but it is nonspecific. The concentration of cadmium in the blood or urine is a better indicator of cadmium exposure. Most reports of fatality due to cadmium exposure have been for industrial workers. Fernandez et al. reported a fatal chemical pneumonitis due to cadmium fumes (2). Nephropathy is the most common complication of cadmium exposure, but hemolytic anemia induced by cadmium exposure has been poorly reported in the literature (3). Therefore, this report of Raval et al. describing fatality in a 51-year-old construction contractor with hemolytic anemia, multiple organ failures, and high cadmium concentrations is very interesting and of concern for public safety. How this man was exposed to cadmium was not evident, but his extremely high cadmium concentration (106.5 μg/L) clearly indicated that the cause of death was cadmium poisoning. Although industrial workers exposed to cadmium are tested, routine testing of the general population is not practical. Because cadmium is more toxic than lead and arsenic, perhaps periodic testing of cadmium should be considered for those living in industrial areas. Interestingly, garlic consumption can protect against both cadmium and lead toxicities (4).
Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.
Authors' Disclosures or Potential Conflicts of Interest: No authors declared any potential conflicts of interest.
- Received for publication March 10, 2011.
- Accepted for publication March 24, 2011.
- © 2011 The American Association for Clinical Chemistry