Cadmium – MD Nexus

Epidemiology

Cadmium is a widespread environmental heavy metal contaminant
- Present in cigarette smoke and food (from contaminated soil and water), as well as in industrial sources

Welding: cadmium usually originates from the welding rod
Brazing (high-temperature soldering): cadmium usually originates from the brazing solder
Flame-Cutting Metal: cadmium usually originates from a metal coating
Molten Metal Working: with inadequate ventilation
- Common with silver-working

Ingestion of Contaminated Food: originating from contaminated soil and water

Epidemiology
- Not considered a type of metal fume fever
Physiology
- High-intensity inhalation of cadmium fumes -> exposure is common since cadmium fume is not acutely irritating
  - Usually associated with poor ventilation
- Inhibition of enzymatic and pneumocyte functions
Clinical: onset of symptoms usually 12-24 hrs after exposure
- Acute Pneumonitis (see Pneumonia, [[Pneumonia]])
- Fever: may be present in some cases
- Acute Lung Injury-ARDS (see Acute Lung Injury-ARDS, [[Acute Lung Injury-ARDS]])
Treatment
- Chelation treatment is not effective

Epidemiology
- Cadmium exposure may play a more significant role in the development of CKD in the presence of co-existing diabetes or hypertension
Physiology
- Renal toxicity is main end-organ toxicity: due to renal proximal tubular cadmium uptake by receptor-mediated endocytosis of filtered and metallothionein bound cadmium
- Cadmium is released into the cytosol -> generation of reactive oxygen species and activation of cell death pathways
Diagnosis
- Sublinical “Tubular Proteinuria”
Clinical
- Fanconi Syndrome
- Chronic Kidney Disease (see Chronic Kidney Disease, [[Chronic Kidney Disease]])

Biometals 2010 Oct;23(5):783-92. Epub 2010 Mar 31
Fatal chemical pneumonitis due to cadmium fumes. Occup. Mad. Vol. 46, No. 5, pp. 372-374,1996