To determine the relation between urinary cadmium levels and lung function in a nationally representative group of current, former, and never smokers in the U.S. Urinary cadmium has a long half-life (15–25 years) and reflects total body burden of cadmium.
We analyzed the following data from the Third National Health and Nutrition Examination Survey: urinary cadmium (adjusted for urinary creatinine), lung function (FEV1, FVC, and FEV1/FVC), sex, race, age, socioeconomic status, body mass index, and smoking history. We developed linear regression models predicting lung function using urinary cadmium as our main predictor, adjusting for other covariates, and stratified by smoking status.
We had data available on 14,802 adults. We found that higher levels of urinary cadmium were associated with significantly lower lung function in current- and former-, but not never-smokers. (Figure)CONCLUSIONS: Cadmium, which is known to cause emphysema in occupational settings, may also be important in the development of tobacco-related lung disease. Cadmium levels vary dramatically even in smokers with similar smoking histories.
Better understanding how cadmium uptake and metabolism varies between individuals may provide an opportunity to better define and treat tobacco-related diseases.
D.M. Mannino, None.