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 reviewed?
This chapter reviews cadmium exposure pathways that drive human contact with cadmium across air, water, soil/sediment, food, and consumer/occupational settings, with special attention to how cadmium moves through the environment and becomes bioavailable. It emphasizes that, for most people, cadmium exposure pathways are dominated by diet rather than drinking water or ambient air, while localized “hot spots” arise near mining/smelting, waste incineration, and hazardous waste sites.
Who was reviewed?
Rather than enrolling a single cohort, the chapter synthesizes evidence from environmental monitoring and multiple human biomonitoring and exposure-assessment efforts. Populations discussed include the general U.S. public (with separate emphasis on nonsmokers vs smokers), residents near industrial sources, and children with potential for higher hand-to-mouth contact and secondhand-smoke exposures. It also draws on large surveillance-style datasets (eg, NHANES/NYC HANES) and diet studies to characterize background and subgroup exposure patterns relevant to cadmium exposure pathways.
Most important findings
For an HMTC-style program, the central takeaway is that controlling cadmium in food-contact and ingestible routes (ingredients, agricultural inputs, high-accumulating foods) usually reduces population risk more than chasing low-level water/air contributions—except in identifiable industrial or waste-site corridors where site-specific screening is warranted.
| Critical point | Details |
|---|---|
| Diet is the primary exposure route for many nonsmokers | The chapter states the largest source of cadmium exposure for nonsmoking adults and children is dietary intake, with age-weighted intakes calculated from U.S. data (about 0.35 µg/kg/day for males and 0.30 µg/kg/day for females). Leafy vegetables show comparatively higher cadmium concentrations (eg, spinach up to 0.124 mg/kg; lettuces around 0.051–0.064 mg/kg), and legumes/nuts can also be notable. |
| Smoking materially changes inhalation exposure | Tobacco naturally accumulates cadmium, and cigarettes are described as containing roughly 0.5–2.0 µg cadmium per cigarette, with about 10% inhaled during smoking—making smoking and secondhand smoke meaningful inhalation contributors compared with typical ambient air. |
| Drinking water is usually minor, but standards and outliers matter | The chapter notes U.S. drinking-water exposure is generally of “minor concern,” while also emphasizing the enforceable limit: EPA requires water suppliers to keep cadmium <5 µg l, and it documents that groundwater near waste sites can show much higher values (illustrating why targeted testing around risk geographies is sensible). < td> |
| Soil controls the food chain via bioavailability and pH | Cadmium inputs to soil include atmospheric deposition and direct application such as phosphate fertilizers and sewage sludge; some phosphate fertilizers are reported to contain up to 300 mg Cd/kg. Even when cadmium binds organic matter, it remains available to plants, and lower (more acidic) soil pH increases availability, strengthening the case for upstream agricultural-input controls in certification. |
| “Where” matters: hazardous sites and diffuse runoff can dominate locally | Cadmium is reported in soils at many NPL sites, and the chapter stresses that diffuse sources (agricultural/urban runoff) can exceed point sources in some watersheds, meaning certification programs should pair supplier screening with geographic risk flagging rather than relying on point-source assumptions alone. |
Key implications
For HMTC, these findings suggest regulatory alignment should prioritize dietary and ingredient-driven cadmium exposure pathways, using enforceable benchmarks (eg, <5 µg l for drinking water) plus targeted, risk-based environmental screening near industrial corridors and waste sites. certification requirements should explicitly cover agricultural inputs (phosphate fertilizers sludge), high-accumulating ingredients (leafy vegetables, organ meats, shellfish), smoking-adjacent contamination risks in facilities. industry applications include supplier qualification by geography input type, product ingredient lot testing where cadmium uptake is plausible. research gaps highlighted limited contemporary u.s. monitoring several media the need better linking of measurements to human body burden.< p>
Citation
Agency for Toxic Substances and Disease Registry (ATSDR). Cadmium: Chapter 6—Potential for Human Exposure. In: Toxicological Profile for Cadmium.
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.
