Clinical Pharmacist and Master’s student in Clinical Pharmacy with research interests in pharmacovigilance, behavioral interventions in mental health, and AI applications in clinical decision support. Experience includes digital health research with Bloomsbury Health (London) and pharmacovigilance practice in patient support programs. Published work covers drug awareness among healthcare providers, postpartum depression management, and patient safety reporting. 
Clinical Pharmacist and Master’s student in Clinical Pharmacy with research interests in pharmacovigilance, behavioral interventions in mental health, and AI applications in clinical decision support. Experience includes digital health research with Bloomsbury Health (London) and pharmacovigilance practice in patient support programs. Published work covers drug awareness among healthcare providers, postpartum depression management, and patient safety reporting. What was studied?
This original study quantified dietary cadmium exposure in Sweden using nationally representative intake data linked with measured cadmium concentrations in foods, then compared population exposure against the EFSA tolerable weekly intake (TWI) and explored how changes in cadmium levels in key foods would shift risk. The analysis estimated weekly body-weight–adjusted intakes, characterized variability (median, 95th, 99th percentiles), attributed exposure to specific food categories, contrasted Swedish vs EFSA occurrence datasets, and ran scenario analyses to test ±50% changes in cadmium concentrations—especially in potatoes and wheat flour, the dominant contributors.
Who was studied?
The exposure model used detailed 7-day dietary records from Riksmaten 97–98, covering 1,211 Swedish adults aged 17–80; after exclusions for missing data, 1,160 individuals with reported body weight were analyzed. Food consumption was stratified into 31 categories (48 subgroups) and combined with Swedish monitoring data on cadmium occurrence (1999–2008), with bootstrap resampling to quantify uncertainty. No meaningful sex or age differences in exposure were observed across adults, and the log-normal exposure distribution was fitted to derive population percentiles. This population basis underpins the dietary cadmium exposure Sweden estimates relevant to certification decisions.
Most important findings
| Critical point | Details |
|---|---|
| Central exposure estimates | Median dietary cadmium exposure was ~0.97–1.0 µg/kg bw/week; 95th and 99th percentiles were ~1.6–1.8 and ~1.9–2.2 µg/kg bw/week |
| Main contributing foods | Potatoes and wheat flour together contributed ~40–50% of total exposure; each contributed ~20–30% depending on exposure group |
| High- vs low-exposed patterns | Potatoes and wheat flour together contributed ~40–50% of total exposure; each contributed ~20–30% depending on the exposure group |
| Exceedance of EFSA TWI (2.5 µg/kg/week) | Using Swedish occurrence data and methods, <1% of adults exceeded the TWI; when adjusting exposures upward by 1.4× (to mirror inputs used in EFSA’s TK modeling), the exceedance rose to ~3% |
| Occurrence dataset matters | Using EFSA’s pan-European occurrence means vs Swedish data shifted the median exposure from ~0.93 to ~1.7 µg/kg bw/week—a near 2-fold difference; the largest category discrepancy was meat |
| Scenario analysis—potatoes & wheat flour | A 30% increase in cadmium occurrence in these two foods kept TWI exceedance ≤~1% in the unadjusted case, but ~7% under the 1.4× adjusted exposure scenario |
| Biomonitoring alignment | Urinary cadmium data for Swedish women suggest ~2–3% may exceed the 1 µg/g creatinine level; the 3% adjusted TWI exceedance aligns better with these biomonitoring observations. |
| Notable high-Cd items not fully covered | Rarely consumed items (crab hepatopancreas, certain wild mushrooms, offal) can dramatically increase individual exposure but were outside the primary scenario focus |
Key implications
For dietary cadmium exposure in Sweden, regulatory impact centers on potatoes and wheat flour as priority control points; certification requirements should emphasize verified cadmium occurrence data and alignment with EFSA TWI. Industry can target agronomic measures to reduce cadmium uptake in cereals and tubers, and manage spinach and seafood sourcing in high-exposed subgroups. Research gaps include refined bioavailability estimates and harmonized occurrence datasets. Practical recommendations are to standardize monitoring, enforce sourcing specifications, and model lot-specific risk against TWI.
Citation
Sand S, Becker W. Assessment of dietary cadmium exposure in Sweden and population health concern including scenario analysis. Food and Chemical Toxicology. 2012;50:536-544
Cadmium is a persistent heavy metal that accumulates in kidneys and bones. Dietary sources include cereals, cocoa, shellfish and vegetables, while smokers and industrial workers receive higher exposures. Studies link cadmium to kidney dysfunction, bone fractures and cancer.
