Various forms of cadmium poisoning have been documented in the literature. Acute poisoning, depending on the mode of exposure, can cause life-threatening respiratory or gastrointestinal symptoms in the absence of immediate supportive therapy, while chronic toxicity, mostly through occupational exposure may lead to renal failure, osteomalacia and increase the risk for cardiovascular disease. Patient history and laboratory studies are vital for the diagnosis.
Presentation
Cadmium is used for various industrial purposes, including plastic and battery manufacturing, smelting, pigment production, metal-plating, but also in the production of tobacco, suggesting that a wide range of workers are at risk of exposure [1] [2] [3] [4]. Cadmium poisoning can occur either by inhalation or ingestion and in both settings, poisoning may be acute or chronic, depending on the amount of cadmium introduced into the body and the rate of exposure [1] [2] [3] [5] [6]:
- Acute poisoning - Inhalation of cadmium-contaminated air causes profound damage to the respiratory system, and is primarily seen in the industrial setting [1] [2] [3]. Dyspnea, pulmonary edema, cyanosis, tachycardia, chest pain and pneumonitis develop within 4-24 hours after cadmium reaches the lungs and can be life-threatening without early recognition of the cause [1] [3]. Ingestion of large amounts of cadmium, on the other hand, occurs accidentally by eating food grown in cadmium-rich soil, or intentionally in suicidal purposes [3] [6]. As little as 10 mg is sufficient to cause severe erosion of the gastrointestinal (GI) tract, while > 100 mg is considered to be lethal [6]. Principal symptoms of acute poisoning after ingestion appear within 15-30 minutes and are abdominal pain, diarrhea, nausea, vomiting, but also muscle cramping, vertigo, bone pain, loss of consciousness, convulsions and even coma [1] [6].
- Chronic poisoning - Cadmium is known for its very long half-life in the human body (about 15-30 years), and is able to accumulate in the proximal renal tubules, the principal site of its reabsorption after glomerular filtration [1] [7]. Chronic exposure to this heavy metal results in its progressive deposition in the kidneys leading to chronic kidney disease [2], the most important long-term consequence of chronic cadmium poisoning. Because cadmium is found in cigarettes, tobacco smoking is a well-known risk factor for chronic poisoning, and urine levels of cadmium have shown to be substantially higher in this population compared to non-smokers [1] [2]. In addition to kidney damage and proteinuria, other known complications are hypertension, diabetes mellitus and diabetic nephropathy, anemia, osteomalacia, yellowing of teeth, and cardiovascular damage, while its carcinogenic potential is still being investigated [2] [3] [5] [7] [8] [9]. Moreover, the term Itai-Itai disease was designated to describe patients who suffer from frequent fractures, accelerated osteoporosis and bone-associated pain due to consumption of foods that were contaminated with high amounts of cadmium [1] [9].
Entire Body System
- Weakness
The proximal renal tubular dysfunction creates low phosphate levels in the blood (hypophosphatemia), causing muscle weakness and sometimes coma. [en.wikipedia.org]
Later on you may experience some of these toxic cadmium inhalation symptoms: dyspnea sweating shivering coughing arthralgia wheezing dry throat headache chest pain pneumonitis muscle weakness Inhalation of cadmium fumes can cause severe lung inflammation [healthblurbs.com]
When you are exposed to arsenic over a long period of time, it leads to several serious health problems like cancer, lung diseases, kidney damage, bone marrow diseases and weak bone health. [livewelltesting.com]
[…] miosis), and/or muscular weakness and twitching. [rarediseases.org]
- Fatigue
Acute inhalation of Cadmium dusts, fumes or soluble salts may produce cough, pneumonitis and fatigue. Manifestations of Cadmium toxicity may be lessened or delayed by an individual’s protective and detoxification capacities. [chelationmedicalcenter.com]
Symptoms of heavy metal toxicity include mental confusion, pain in muscles and joints, headaches, short-term memory loss, gastrointestinal upsets, food intolerances/allergies, vision problems, chronic fatigue, and others. [diagnose-me.com]
Long term-exposure to lead can include irritability, fatigue, behavioral change, and developmental delays. [articles.sun-sentinel.com]
Overexposure may cause fatigue, headaches, nausea, vomiting, abdominal cramps, diarrhea, and fever. [rarediseases.org]
- Fever
Symptoms of inflammation may start hours after the exposure and include cough, dryness and irritation of the nose and throat, headache, dizziness, weakness, fever, chills, and chest pain. [en.wikipedia.org]
MFF, or "brass founder’s ague," "zinc shakes," or "Monday morning fever" as it is variously known, is characterized by fever, headache, fatigue, dyspnea, cough, and a metallic taste occurring within 3-10 hours after exposure. [emedicine.medscape.com]
Overexposure may cause fatigue, headaches, nausea, vomiting, abdominal cramps, diarrhea, and fever. [rarediseases.org]
- Chills
Symptoms of inflammation may start hours after the exposure and include cough, dryness and irritation of the nose and throat, headache, dizziness, weakness, fever, chills, and chest pain. [en.wikipedia.org]
Exposure to these metal may cause mild flu-like symptoms (a.k.a., "the cadmium chills") that can increase in severity to include respiratory, liver and kidney problems, which may be irreversible and fatal. [home-health-chemistry.com]
View of Los Angeles' Hollywood Blvd Penguins chill at the Kansas City Zoo in Missouri More Privacy Policy Your CA Privacy Rights Children's Online Privacy Policy Interest-Based Ads Terms of Use Contact Us Search Menu Interest Successfully Added We'll [abcnews.go.com]
The person may experience fever and chills. Cadmium may also increase blood flow to the lungs, further complicating the alveolar hemorrhage. The lungs may also become inflamed and swell, causing difficulty breathing. [livestrong.com]
Respiratoric
- Cough
Chronic inhalation exposure to low doses of cadmium can cause poisoning symptoms of: coughing proteinuria weight loss difficulty breathing sense of smell loss Chronic cadmium exposure can also cause an increased risk for these health conditions: anemia [healthblurbs.com]
Chronic poisoning from inhalation may cause a loss of the sense of smell, coughing, difficult breathing, weight loss, and injury of the liver and kidneys. Treatment usually includes the oral administration of calcium edetate. [britannica.com]
Acute inhalation of Cadmium dusts, fumes or soluble salts may produce cough, pneumonitis and fatigue. Manifestations of Cadmium toxicity may be lessened or delayed by an individual’s protective and detoxification capacities. [chelationmedicalcenter.com]
Symptoms of inflammation may start hours after the exposure and include cough, dryness and irritation of the nose and throat, headache, dizziness, weakness, fever, chills, and chest pain. [medicaljournal.blogspot.com]
- Anosmia
Similar to zinc, long term exposure to cadmium fumes can cause life long anosmia. Inside cells, cadmium ions act as a catalytic hydrogen peroxide generator. [en.wikipedia.org]
PMID: 17405690 Anosmia Anosmia is the technical name for not being able to smell things - “an inability to perceive odours”. Cadmium can cause anosmia. Cancer Carla Mascaro A host of different types of cancer are known to be caused by cancer. [allaboutheaven.org]
Anosmia and yellowing of teeth have been reported. Developmental Effects In animals, cadmium crosses the placenta, and large parenteral doses during early gestation cause birth defects. [atsdr.cdc.gov]
[…] unusually rapid heart beat (tachycardia); low levels of iron within the red blood cells (anemia); bluish discoloration (cyanosis) of the skin and mucous membranes due to insufficient oxygen supply to these tissues; and/or an impaired sense of smell (anosmia [rarediseases.org]
- Throat Irritation
When its initially inhaled you may notice a sweet or metallic taste, and then throat irritation. [healthblurbs.com]
Gastrointestinal
- Nausea
Nausea, vomiting, diarrhea, and prostration usually occur within 15 minutes after ingestion and subside within 24 hours. Inhalation of cadmium fumes in industry produces an acute, extremely severe inflammation of the lungs that may be fatal. [britannica.com]
Ingested cadmium poisoning causes symptoms of: shock vertigo choking salivation dyspepsia convulsions abdominal pain muscle cramps nausea, vomiting loss of consciousness Breathing high levels of cadmium can severely irritate and damage your lungs. [healthblurbs.com]
Nausea, vomiting and diarrhoea. Impaired sensation. Difficulty breathing, cough, chest pain. Complications include pneumonitis and pulmonary oedema. [patient.info]
- Abdominal Pain
Ingested cadmium poisoning causes symptoms of: shock vertigo choking salivation dyspepsia convulsions abdominal pain muscle cramps nausea, vomiting loss of consciousness Breathing high levels of cadmium can severely irritate and damage your lungs. [healthblurbs.com]
Principal symptoms of acute poisoning after ingestion appear within 15-30 minutes and are abdominal pain, diarrhea, nausea, vomiting, but also muscle cramping, vertigo, bone pain, loss of consciousness, convulsions and even coma. [symptoma.com]
Cadmium exposure is associated with the following symptoms and conditions: Abdominal pain, weight loss, vomiting Disrupted iron, copper, and magnesium metabolism Immune suppression, immune dysfunction, slow healing Sodium retention, low body temperature [coreonehealth.com]
These include: abdominal pain, burning sensation, nausea, vomiting, salivation, muscle cramps, vertigo, shock, loss of consciousness and convulsions. [ndt.oxfordjournals.org]
Cardiovascular
- Hypertension
[…] and, possibly, years later, cancer. cadmium poisoning A condition associated with industrial exposure; cadmium poisoning occurred in Japan due to contamination of drinking water by mining runoffs, resulting in itai-itai (“ouch-ouch”) disease, possibly hypertension [medical-dictionary.thefreedictionary.com]
This toxic metal is known to cause cancer, hypertension and enzyme activity decrease as well. [healthblurbs.com]
In addition to kidney damage and proteinuria, other known complications are hypertension, diabetes mellitus and diabetic nephropathy, anemia, osteomalacia, yellowing of teeth, and cardiovascular damage, while its carcinogenic potential is still being [symptoma.com]
Once this occurs, high blood pressure, which promotes hypertension, often develops. Some individuals with high blood pressure have blood cadmium levels three to four times higher than those with normal blood pressure. [coreonehealth.com]
Environmental Cd exposure may be a significant contributory factor to the development of chronic kidney disease, especially in the presence of other co-morbidities such as diabetes or hypertension; therefore, the sources and environmental impact of Cd [ncbi.nlm.nih.gov]
- Chest Pain
Later on you may experience some of these toxic cadmium inhalation symptoms: dyspnea sweating shivering coughing arthralgia wheezing dry throat headache chest pain pneumonitis muscle weakness Inhalation of cadmium fumes can cause severe lung inflammation [healthblurbs.com]
Dyspnea, pulmonary edema, cyanosis, tachycardia, chest pain and pneumonitis develop within 4-24 hours after cadmium reaches the lungs and can be life-threatening without early recognition of the cause. [symptoma.com]
Symptoms of inflammation may start hours after the exposure and include cough, dryness and irritation of the nose and throat, headache, dizziness, weakness, fever, chills, and chest pain. [en.wikipedia.org]
Breathing air with high levels of cadmium over a short period of time is initially like the flu with chills, fever and muscle pain, then later can cause lung damage, shortness of breath, chest pain and cough, which may lead to death in severe cases. [betterhealth.vic.gov.au]
similar to metal fume fever. - At higher doses, chemical pneumonitis may occur, with labored breathing, chest pain, and a sometimes fatal hemorrhagic pulmonary edema. - Ingested cadmium causes nausea, vomiting, diarrhea, abdominal pain and tenesmus. [medicaljournal.blogspot.com]
- Tachycardia
Dyspnea, pulmonary edema, cyanosis, tachycardia, chest pain and pneumonitis develop within 4-24 hours after cadmium reaches the lungs and can be life-threatening without early recognition of the cause. [symptoma.com]
In some cases, affected individuals may exhibit increased salivation; yellowing of the teeth; an unusually rapid heart beat (tachycardia); low levels of iron within the red blood cells (anemia); bluish discoloration (cyanosis) of the skin and mucous membranes [rarediseases.org]
Musculoskeletal
- Osteoporosis
[…] inhalation exposure to low doses of cadmium can cause poisoning symptoms of: coughing proteinuria weight loss difficulty breathing sense of smell loss Chronic cadmium exposure can also cause an increased risk for these health conditions: anemia liver damage osteoporosis [healthblurbs.com]
Moreover, the term Itai-Itai disease was designated to describe patients who suffer from frequent fractures, accelerated osteoporosis and bone-associated pain due to consumption of foods that were contaminated with high amounts of cadmium. [symptoma.com]
Effects kidney toxicity: Edema and Emphysema by killing macrophages Skeletal effects: Osteoporosis and osteomalacia (pseudofractures) Cancer: Carcinogenic in animal studies Approx.8% of lung cancers may be attributable to Cd 7. [slideshare.net]
[…] microcytic-hypochromic anemia, lymphocytosis (excess white blood cells), proteinuria (protein in the urine) with wasting of beta2 microglobulin, emphysema and pulmonary fibrosis (if inhalation was a route of contamination), atherosclerosis, osteomalacia, osteoporosis [chelationmedicalcenter.com]
- Back Pain
Sanhe, the site of lead and zinc mining, is home to about 800 people, of whom about 80 per cent suffered from back pain and other ailments, residents said. Some villagers also complain of swollen knees and elbows. [scmp.com]
pain, cancer, and peripheral neuropathy. [chelationmedicalcenter.com]
Toxic metal accumulation in the kidneys including aluminum, mercury and cadmium, also contributes to kidney infections, kidney stones, electrolyte imbalances, back pain, and edema. [tvernonlac.com]
These symptoms may include fatigue, metallic taste in the mouth, low back pain, stomach distress, poor appetite, skin eruption and/or headache. [arltma.com]
- Myalgia
Myalgia. Gastrointestinal upset. Subsequent peripheral neuropathy, hepatic dysfunction or renal failure may develop. Chronic poisoning Irritability. Personality changes. Headache. Peripheral neuropathy. Memory problems. Ataxia. Coma. [patient.info]
Diarrhoea, vomiting and abdominal pain subsided, but weakness and myalgias persisted. On hospital day 3, laboratory studies showed serum chloride 111 mEq/l, sodium 144 mEq/l, potassium 4.2 mEq/l and thrombocytopenia (platelet count of 77 000/mm 3 ). [ndt.oxfordjournals.org]
- Osteopenia
The pitcher is taken to Princeton-Plainsboro where they discover that he is suffering osteopenia, a weakening of the bone. [house.wikia.com]
Urogenital
- Polyuria
Sufficient cadmium exposure can also lead to decreased GFR and chronic renal failure manifested by: aminoaciduria, glucosuria, hypercalcuria, hyperphosphaturia, polyuria, and reduced buffering capacity for acids (Jarup 2002). [atsdr.cdc.gov]
Neurologic
- Headache
Ren, a migrant worker originally from Sichuan, suffers from frequent headaches and breathing difficulties. If untreated, the cadmium poisoning can lead to kidney failure, cancer, and even death. [goodelectronics.org]
The effects may include vomiting, dyspnea, headache, prostration, pulmonary edema, and, possibly, years later, cancer. cadmium poisoning A condition associated with industrial exposure; cadmium poisoning occurred in Japan due to contamination of drinking [medical-dictionary.thefreedictionary.com]
Later on you may experience some of these toxic cadmium inhalation symptoms: dyspnea sweating shivering coughing arthralgia wheezing dry throat headache chest pain pneumonitis muscle weakness Inhalation of cadmium fumes can cause severe lung inflammation [healthblurbs.com]
Symptoms of heavy metal toxicity include mental confusion, pain in muscles and joints, headaches, short-term memory loss, gastrointestinal upsets, food intolerances/allergies, vision problems, chronic fatigue, and others. [diagnose-me.com]
- Dizziness
Workers exposed to cadmium can suffer symptoms such as memory loss, dizziness, headaches, lack of strength, and pain in the back and limbs. In 2006, the European Union banned cadmium in electronics due to its extremely toxic properties. [goodelectronics.org]
Symptoms of inflammation may start hours after the exposure and include cough, dryness and irritation of the nose and throat, headache, dizziness, weakness, fever, chills, and chest pain. [en.wikipedia.org]
Workup
The diagnosis of cadmium poisoning must be made promptly, especially if the overall condition of the patient suggests acute poisoning. A detailed patient history is vital in order to determine the potential source of symptoms - whether the patient was exposed to cadmium in the industrial setting (in the case of respiratory symptoms), or if "suspicious" food was eaten prior to the onset of complaints. After a thorough clinical examination to assess breathing, cardiac function and vital signs, an immediate laboratory workup comprised of serum electrolytes, renal function tests (blood urea nitrogen and creatinine), a complete blood count (CBC) and liver enzymes (alanine and aspartate aminotransferases, or ALT and AST, respectively) must be performed [3] [4]. If poisoning through inhalation is suspected, a chest X-ray, arterial blood gas (ABG) measurements, and oxygen saturation are also necessary. Regardless of the mode of exposure or severity of symptoms, cadmium can be detected in both serum and urine, and levels of > 5 μg/dL in serum will be present in the setting of acute poisoning [1] [3]. In addition to urine testing for cadmium (which will show >100 nmol/L and a markedly increased creatinine), levels of β2-microglobulin in urine will be markedly elevated in this patient population, whereas N-acetyl-α-D-glucosaminidase (NAG) and retinol-binding-protein (RBP) are also excreted in higher amounts in these patients. All three compounds are useful when cadmium is the presumed cause of symptoms, as their increased excretion occurs as a result of impaired proximal tubule reabsorption [1] [5] [9].
Urine
- Glycosuria
The effects of cadmium proximal renal function are characterized by increased cadmium in the urine, proteinuria (primarily Beta-2-microglobulin), aminoaciduria, glycosuria, and decreased renal tubular reabsorption of phosphate. [pathopedia-india.com]
In the final stages of cadmium nephropathy, glycosuria, wasting of calcium and phosphate, and altered calcium metabolism with secondary effects on the skeleton of osteoporosis and osteomalacia are seen (Roels et al. 1999; Jarup et al. 2000). [atsdr.cdc.gov]
Renal dysfunction affects calcium, vitamin D, phosphorus and sodium levels, resulting in proteinuria, glycosuria, renal hypertension and other metabolic disorders. [arltma.com]
Treatment
When doctors or other medical professionals engage in treatment that violates the accepted "standard of care," and that treatment results in injury or harm, this constitutes medical malpractice. [sweeneylawfirm.com]
Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]
Treatment usually includes the oral administration of calcium edetate. [britannica.com]
Dietary Strategies for the Treatment of Cadmium and Lead Toxicity - 03 Vitamins 016837 Dietary Strategies for the Treatment of Cadmium and Lead Toxicity - 040 Edible Plants and Dietary Phytochemicals 016842 Dietary Strategies for the Treatment of Cadmium [allaboutheaven.org]
Prognosis
Prognosis; Complications Although complete cure is possible, many people suffer the effects of toxicity for extended periods. Some of the damage, for instance to the liver or brain, may not be fully reversible. [diagnose-me.com]
Prognosis: The prognosis depends on the nature and severity of the cadmium load. Most cases of mild exposure resolve spontaneously after a few days. In other cases, cadmium can lead to permanent damage with shortened lifespan, or even death. [medicaljournal.blogspot.com]
The increased total Cd intake and high concentration of Cd in rice also exerts an adverse influence on life prognosis. PMID: 15688869 photo Carla Mascaro Treatment Clearly prevention requires a clean-up of our planet on a never before seen scale. [allaboutheaven.org]
Etiology
Carcinogenesis And Teratogenesis Cadmium has been suggested as an etiologic factor in certain human cancers. Birth defects, probably due to zinc deficiency, have been observed in mice, rats and hamsters. [arltma.com]
Epidemiology
The gross and pathological findings of forensic autopsies of two case of cadmium poisoning are presented and related to an epidemiological investigation. [ncbi.nlm.nih.gov]
Epidemiology Heavy metal poisoning is rare in the UK, even in industries where there is an increased risk. [ 1 ] The most common cause of heavy metal poisoning is lead. [patient.info]
Most of the available epidemiological information on cadmium has been obtained from occupationally exposed workers or on Japanese populations in highly contaminated areas. [cadmium.org]
Pathophysiology
Because the renal anemia is based on the same pathophysiology as Cd-induced osteomalacia, which is derived from the disturbance of mineral metabolism due to renal tubular dysfunction, it is reasonable to include renal anemia in the criteria for the diagnosis [jstage.jst.go.jp]
Pathophysiology: The pathophysiology of the heavy metal toxidromes remains relatively constant. For the most part, heavy metals bind to oxygen, nitrogen, and sulfhydryl groups in proteins, resulting in alterations of enzymatic activity. [medicaljournal.blogspot.com]
Prevention
The purpose of this program is to prevent cadmium induced disease. [atsdr.cdc.gov]
Our observations provide new clues for the future recognition and prevention of Cd poisoning. [ncbi.nlm.nih.gov]
"This understanding of how cadmium causes toxicity, at a molecular level, is crucial for developing new strategies for preventing cadmium poisoning." [sciencedaily.com]
The American Association of Poison Control Centers offers the following tips aimed at preventing lead and cadmium poisoning. Read product ingredient labels before purchasing an item, especially if it's intended for children. [articles.sun-sentinel.com]
The surest way to prevent poisoning by illegally manufactured children's jewelry is to discard cheap metal children's jewelry and not purchase any more. [poison.org]
References
- Godt J, Scheidig F, Grosse-Siestrup C, et al. The toxicity of cadmium and resulting hazards for human health. J Occup Med Toxicol. 2006;1:22.
- Jaishankar M, Tseten T, Anbalagan N, Mathew BB, Beeregowda KN. Toxicity, mechanism and health effects of some heavy metals. Interdiscip Toxicol. 2014;7(2):60-72.
- Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.
- Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
- Chunhabundit R. Cadmium Exposure and Potential Health Risk from Foods in Contaminated Area, Thailand. Toxicol Res. 2016;32(1):65-72.
- Hung YM, Chung HM. Acute self-poisoning by ingestion of cadmium and barium. Nephrol Dial Transplant. 2004;19(5):1308-1309.
- Tellez-Plaza M, Navas-Acien A, Menke A, Crainiceanu CM, Pastor-Barriuso R, Guallar E. Cadmium Exposure and All-Cause and Cardiovascular Mortality in the U.S. General Population. Environ Health Perspect. 2012;120(7):1017-1022.
- Tellez-Plaza M, Guallar E, Howard BV, et al. Cadmium Exposure and Incident Cardiovascular Disease. Epidemiology. 2013;24(3):421-429.
- Satarug S, Garrett SH, Sens MA, Sens DA. Cadmium, Environmental Exposure, and Health Outcomes.Environ Health Perspect. 2010;118(2):182-190.