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Cadmium levels in a North Carolina cohort: Identifying risk factors for elevated levels during pregnancy

Abstract

The objectives of this study were to examine cadmium (Cd) levels and relationships to demographics in an observational, prospective pregnancy cohort study in Durham County, North Carolina. Multivariable models were used to compare blood Cd levels across demographic characteristics. The relative risk of having a blood Cd level that exceeds the US national median (0.32 μg/l) was estimated. Overall, >60% of the women had an elevated (>0.32 μg/l) blood Cd level. Controlling for confounding variables, smoking was associated with 21% (95% CI: 15–28%) increased risk for an elevated blood Cd level. High Cd levels were also observed in non-smokers and motivated smoking status-stratified models. Race, age, education, relationship status, insurance status and cotinine level were not associated with risk of elevated Cd levels among smokers; however, older age and higher cotinine levels were associated with elevated Cd levels among non-smokers. Taken together, more than half of pregnant women in this cohort had elevated blood Cd levels. Additionally, among non-smokers, 53% of the women had elevated levels of Cd, highlighting other potential sources of exposure. This study expands on the limited data describing Cd levels in pregnant populations and highlights the importance of understanding Cd exposures among non-smokers. Given the latent health risks of both smoking and Cd exposure, this study further highlights the need to biomonitor for exposure to toxic metals during pregnancy among all women of child-bearing age.

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Abbreviations

Cd:

Cadmium

NHB:

non-Hispanic black

NHW:

non-Hispanic white

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Acknowledgements

We gratefully acknowledge Amber Ingram, Cheyenne Beach, Marteh Bowen, Anne Giguere, Jerrie Kumalah, Mollie Oudenhoven, Caroline Paulsen, and Nancy Schneider for their clinical recruitment of study participants. We also acknowledge Dr. Jill Johnston, Sloane Miller, and Rachel Kauffman for their help with the manuscript. This research was supported by the US Environmental Protection Agency (RD-83329301) and in part by the National Institute of Environmental Health Sciences (ES005948, ES010126, ES019315, and ES007018).

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Correspondence to Rebecca C Fry.

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Edwards, S., Maxson, P., Miranda, M. et al. Cadmium levels in a North Carolina cohort: Identifying risk factors for elevated levels during pregnancy. J Expo Sci Environ Epidemiol 25, 427–432 (2015). https://doi.org/10.1038/jes.2014.53

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