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?
The European Food Safety Authority’s Panel on contaminants in the food chain has set a reduced tolerable weekly intake (TWI) for cadmium of 2.5 micrograms per kilogram of body weight (µg/kg bw), based on an analysis of new data. The review synthesized occurrence and exposure data across European diets, mapped main contributing food categories, and evaluated uncertainty to advise risk managers on potential revisions to maximum levels in foodstuffs. The analysis framed cadmium as primarily nephrotoxic, with additional concerns for bone demineralization and carcinogenicity classifications by IARC.
Who was reviewed?
The assessment covered the general European population using monitoring data from ~20 countries combined with national dietary surveys, while also considering higher-exposure subgroups such as vegetarians, children, smokers, and residents in contaminated areas. For dose–response modeling, the Panel meta-analyzed dozens of human epidemiology studies that related urinary cadmium to urinary β-2-microglobulin as an early marker of renal tubular dysfunction, then converted urinary cadmium benchmarks into dietary intakes through toxicokinetic modeling. Food category contributors, including cereals and cereal products, vegetables, potatoes, nuts and pulses, meat products, as well as high-level cadmium items like seaweed, mushrooms, cocoa, crustaceans, and mollusks, were appraised for their relative share of exposure.
Most important findings
| Critical point | Details |
|---|---|
| Lowered health-based guidance value | The CONTAM Panel established a TWI of 2.5 µg/kg bw/week based on human biomarker evidence of early renal effects; this represented a tightening of acceptable intake compared with previous higher tolerable intakes used for risk management. |
| Biomarker-driven risk characterization | A meta-analysis of epidemiologic studies linked urinary cadmium to β-2-microglobulin, deriving benchmark levels that were back-calculated to dietary exposures using toxicokinetic models, prioritizing kidney protection. |
| European exposure close to TWI | Average adult dietary exposure across Europe was estimated near the TWI, with high consumers exceeding it, indicating limited safety margin for many diets. |
| Susceptible subgroups | Vegetarians, children, smokers, and populations in contaminated areas can reach up to roughly twice the TWI, though EFSA judged population-level risk of overt adverse effects to be low; nonetheless, exposure reduction was advised. |
| Dominant food contributors | Cereals and cereal products, vegetables, potatoes, nuts and pulses, and meats are principal contributors by consumption volume; products with higher cadmium levels—seaweed, fungi, cocoa, crustaceans, mollusks, certain offal—can drive exceedance in specific diets. |
| Kidney as critical target | Cereals and cereal products, vegetables, potatoes, nuts and pulses, and meats are principal contributors by consumption volume; products with higher cadmium levels—seaweed, fungi, cocoa, crustaceans, mollusks, certain offal—can drive exceedance in specific diets. foodingredientsfirst.com+1 |
| Regulatory signal | EFSA’s opinion was issued to support revision of EU maximum levels and broader risk management strategies, signaling potential tightening of commodity-specific limits and monitoring requirements. |
| Post-opinion confirmation | A subsequent 2011 EFSA statement upheld the 2.5 µg/kg bw/week TWI framework when compared with JECFA’s PTMI approach, reinforcing the kidney-biomarker basis for European regulation. |
Key implications
For primary regulatory impacts, EFSA lowers cadmium tolerable intake obliges alignment of EU maximum levels with a narrower margin of safety; certification requirements under HTMC should mandate validated cadmium testing, dietary exposure modeling, and supplier controls; industry applications include reformulation and sourcing from low-cadmium regions; research gaps persist in variability of cadmium bioavailability and biomarkers beyond β-2-microglobulin; practical recommendations emphasize cereal, vegetable, cocoa, seaweed, and mollusc monitoring, smoking cessation messaging, and continuous verification of lot-level cadmium data.
Citation
European Food Safety Authority Panel on Contaminants in the Food Chain. Cadmium in food. EFSA Journal. 2009
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.
