Trends in Urinary and Blood Cadmium Levels in U.S. Adults with or without Comorbidities, 1999–2018

Although cadmium (Cd) exposure has been declining in the United States (U.S.) over the years, the level of exposure for people with pre-existing comorbidities is unclear. This study characterized the trends of blood Cd levels (bCd) (n = 44,498) and urinary Cd levels (uCd) (n = 15,107) by pre-existing comorbidities among adults participating in the U.S. National Health and Nutrition Examination Survey. We calculated age-and sex-standardized annual geometric mean (GM) levels, and used aJoinpoint regression model to examine the trends over time. The GM levels of bCd declined from 1999–2000 to 2017–2018 survey cycles (from 0.49 to 0.33 µg/L), while women and current smokers had higher levels. Participants with comorbidities had higher bCd and declined over time: cardiovascular disease (CVD) (0.50 to 0.42 µg/L), hypertension (0.49 to 0.35 µg/L), chronic kidney disease (CKD) (0.54 to 0.37 µg), and cancer (0.57 to 0.38 µg) versus those without these comorbidities. We observed the similar pattern of changes for uCd and participants with CVD, CKD, and cancer had higher levels. To conclude, the trend in urinary and blood Cd levels in U.S adults decreased in the past 20 years, and the levels varied by sex, smoking status, and comorbidities.