Abstract was presented at the 2002 Annual Meeting of the International Society for Environmental Epidemiology, Vancouver, Canada, August 8, 2002.
Cadmium Exposure and Distal Forearm Fractures†
Article first published online: 2 FEB 2004
Copyright © 2004 ASBMR
Journal of Bone and Mineral Research
Volume 19, Issue 6, pages 900–905, June 2004
How to Cite
Alfvén, T., Elinder, C.-G., Hellström, L., Lagarde, F. and Järup, L. (2004), Cadmium Exposure and Distal Forearm Fractures. J Bone Miner Res, 19: 900–905. doi: 10.1359/JBMR.040202
The authors have no conflict of interest
- Issue published online: 2 DEC 2009
- Article first published online: 2 FEB 2004
- Manuscript Accepted: 2 FEB 2004
- Manuscript Revised: 1 DEC 2003
- Manuscript Received: 8 SEP 2003
- forearm fracture;
- environmental exposure;
- occupational exposure;
- heavy metals
The aim of this study was to analyze the relationship between low-level cadmium exposure and distal forearm fractures. Altogether, 1021 men and women exposed to cadmium in Sweden were included. The study indicates that cadmium exposure is associated with increased risk of forearm fractures in people over the age of 50.
Introduction: Very few studies have been performed on environmental risk factors for fractures. Cadmium is known to cause damage to the kidneys and in high doses to the bone. The aim of this study was to analyze the relationship between low-level cadmium exposure and distal forearm fractures.
Materials and Methods: A total of 479 men and 542 women, 16-81 years of age, that were environmentally or occupationally exposed to cadmium were examined in 1997. Cadmium in urine was used to estimate dose, and information about previous fractures and risk factors for fractures was obtained from questionnaires. Fractures were validated using medical records. The association between cadmium dose and risk of forearm fracture was evaluated using Cox proportional hazard regression analysis.
Results and Conclusion: The mean urinary cadmium in the study population was 0.74 nmol cadmium/mmol creatinine (10% and 90% percentiles are 0.19 and 1.42, respectively). For fractures occurring after the age of 50 years (n = 558, 32 forearm fractures), the fracture hazard ratio, adjusted for gender and other relevant co-variates, increased by 18% (95% CI, 1.0-38%) per unit urinary cadmium (nmol cadmium/mmol creatinine). When subjects were grouped in exposure categories, the hazard ratio reached 3.5 (90% CI, 1.1, 11) in the group of subjects with urinary cadmium between 2 and 4 nmol/mmol creatinine and 8.8 (90% CI, 2.6, 30) in the group of subjects with ≥4 nmol/mmol creatinine. Associations between cadmium and fracture risk were absent before the age of 50. Cadmium exposure is associated with increased risk of forearm fractures in people over 50 years of age.