Environmental and occupational exposure to cadmium in Iran: a systematic review

Leila Tavakkoli 1  and Narges Khanjani 2 , 3
  • 1 Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
  • 2 Faculty of Public Health, Kerman Medical University (KMU), Haft Bagh Alavi Highway, Kerman, Iran, Phone and Fax: 034-3132-0512
  • 3 Associate Professor, Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
Leila Tavakkoli and Narges Khanjani



Cadmium (Cd) is one of the heavy metals that have negative effects on human health. In Iran, there is no policy to regularly measure Cd in the general population. However, some studies have been performed on special groups and in different cities of Iran. This paper has reviewed these studies and human contamination levels in Iran.

Method and materials:

All accessible electronic information resources such as Scientific Information Database (SID), Magiran, IranMedex, PubMed, Web of Knowledge, Google Scholar and Science Direct were searched, with relevant phrases and their Persian translations. The search included all studies conducted in Iran and listed in the databases until March 15, 2016.


Eventually, 18 articles were selected from 25 retrieved articles. Cd was higher among industrial workers exposed to Cd. In the general population, Cd was higher among smokers and in people with environmental exposure from living in industrial areas.


Considering the high Cd contamination in the workers of industries, it seems to be necessary to do surveillance in this group through periodic regular check-ups and avoiding unnecessary exposure to Cd as much as possible. Also due to the high concentration of Cd in smokers, there should be more awareness of the damaging effects of smoking, especially among pregnant women, and more attention to local industries, especially those dealing with Cd, is necessary. These industries should be kept at a safe distance from residential areas.

  • 1.

    Occupational Safety & Health Administration. Toxic metals, OSHA. Available at: www.osha.gov/SLTC/metalsheavy, March 15, 2016.

  • 2.

    Occupational Safety & Health Administration. Cadmium, OSHA. Available at: www.osha.gov/SLTC/cadmium/index.html, March 15, 2016.

  • 3.

    ICdA. Cadmium Applications: International Cadmium Association; 2003. Available at: http://www.cadmium.org/cadmium-applications, March 16, 206.

  • 4.

    World-Health-Organization. Preventing disease through healthy environments, Exposure To Cadmium: A major public health concern WHO. Available at: http://www.who.int/ipcs/features/cadmium.pdf.

  • 5.

    International-Cadmium-Association. Level of cadmium in the environment: ICdA. Available at: http://www.cadmium.org/environment/level-of-cadmium-in-the-environment, March 16, 2016.

  • 6.

    Hallen IP, Jorhem L, Lagerkvist BJ, Oskarsson A. Lead and cadmium levels in human milk and blood. Sci Total Environ 1995;166(1):149–55.

  • 7.

    Grasmick C, Huel G, Moreau T, Sarmini H. The combined effect of tobacco and alcohol consumption on the level of lead and cadmium in blood. Sci Total Environ 1985;41(3):207–17.

  • 8.

    Lauwerys R, Roels H, Regniers M, Buchet J, Bernard A, et al. Significance of cadmium concentration in blood and in urine in workers exposed to cadmium. Environ Res 1979;20(2):375–91.

  • 9.

    Godt J, Scheidig F, Grosse-Siestrup C, Esche V, Brandenburg P, et al. The toxicity of cadmium and resulting hazards for human health. J Occup Med Toxicol 2006;1(1):1.

  • 10.

    Alfvén T, Järup L, Elinder C-G. Cadmium and lead in blood in relation to low bone mineral density and tubular proteinuria. Environ Health Perspect 2002;110(7):699.

  • 11.

    Schutte R, Nawrot TS, Richart T, Thijs L, Vanderschueren D, et al. Bone resorption and environmental exposure to cadmium in women: a population study. Environ Health Perspect 2008;116(6):777.

  • 12.

    Staessen JA, Roels HA, Emelianov D, Kuznetsova T, Thijs L, et al. Environmental exposure to cadmium, forearm bone density, and risk of fractures: prospective population study. Lancet 1999;353(9159):1140–4.

  • 13.

    Vinceti M, Venturelli M, Sighinolfi C, Trerotoli P, Bonvicini F, et al. Case-control study of toenail cadmium and prostate cancer risk in Italy. Sci Total Environ 2007;373(1):77–81.

  • 14.

    Nawrot T, Plusquin M, Hogervorst J, Roels HA, Celis H, et al. Environmental exposure to cadmium and risk of cancer: a prospective population-based study. Lancet Oncol 2006;7(2):119–26.

  • 15.

    Hart RP, Rose CS, Hamer RM. Neuropsychological effects of occupational exposure to cadmium. J Clin Exp Neuropsychol 1989;11(6):933–43.

  • 16.

    Viaene M, Masschelein R, Leenders J, De Groof M, Swerts L, et al. Neurobehavioural effects of occupational exposure to cadmium: a cross sectional epidemiological study. Occup Environ Med 2000;57(1):19–27.

  • 17.

    Ebrahim K, Ashtarinezhad A. The association of amniotic fluid cadmium levels with the risk of preeclampsia, prematurity and low birth weight. Iran J Neonat 2015;6(2):2.

  • 18.

    Kelishadi R, Askarieh A, Motlagh ME, Tajadini M, Heshmat R, et al. Association of blood cadmium level with cardiometabolic risk factors and liver enzymes in a nationally representative sample of adolescents: the CASPIAN-III study. J Environ Public Health 2013;2013:1–5. Article ID 142856.

  • 19.

    Nazarpour S, Teymouri L, Teimoori S, Nojoumi SA, Moghimi A. Investigation of Cd (II) concentrations in mother’s milk of Varamin region of Iran. Asian J Chem 2013;25(10):5402.

  • 20.

    Goudarzi M, Parsaei P, Nayebpour F, Rahimi E. Determination of mercury, cadmium and lead in human milk in Iran. Toxicol Ind Health 2013;29(9):820–3.

  • 21.

    Pashmi K, Pourkhabbaz A. Accumulation of toxic metals of cadmium and lead in the deciduous teeth of children. J Birjand Univ Med Sci 2012;19(1):96–105 (Persian).

  • 22.

    Savabieasfahani M, Hoseiny M, Goodarzi S. Toxic and essential trace metals in first baby haircuts and mother hair from Imam Hossein hospital Tehran, Iran. Bull Environ Contam Toxicol 2012;88(2):140–4.

  • 23.

    Kargar F, Shahtaheri S, Golbabaei F, Barkhordari A, Rahimi–froushani A. Measurement of urinary cadmium in glazers using solid phase extraction followed by inductively coupled plasma atomic emission spectroscopy. Int J Occup Hyg 2015;4(2):11–6.

  • 24.

    Abdolsamadi H, Zamani Bm, Goodarzi M, Rafieian N, Raedi S, et al. Comparative evaluation of chromium and cadmium in gestational diabetes and healthy pregnant women. Iran J Endocrinol Metab 2012;13(6):666–72 (Persian).

  • 25.

    Nejadchehrazin V, Moqaddam BL. Lead, cadmium and selenium in maternal blood and umbilical cord and their relationship with each other. Payesh 2012;11(5):679–74.

  • 26.

    Golbabaei F, Seyedsomea M, Ghahri A, Shirkhanloo H, Khadem M, et al. Assessment of welders exposure to carcinogen metals from manual metal arc welding in gas transmission pipelines, Iran. Iran J Public Health 2012;41(8):61–70.

  • 27.

    Tadayon F, Tehrani MS, Nia SR. Determination of toxic and essential elements in the scalp hair of patients with type 2 diabetes. Acad Res Int 2012;2(3):11.

  • 28.

    Norouzi E, Bahramifar N, Ghasempouri S. Investigation of cadmium and zinc level in human milk and it’s related with industrial pollution in Lenjan region, Isfahan. JAUMS 2010;8(2):118–25.

  • 29.

    Dahaghin M, Shariat M, Norrozi M, Vigeh M, Ramezanzadeh F. Effect of environmental exposure to Cadmium on pregnancy outcome. Iran J Health Environ 2010;3(1):1–10.

  • 30.

    Tadayon F, Saber-Tehrani M, Najafi NM, Ghorbani A. Measurement uncertainty of Pb, Cd and Ni determination in human hair by electro thermal atomic absorption spectrometry. J Appl Chem Res Winter 2010;3(12):11–8.

  • 31.

    Rahimi E, Hashemi M, Baghbadorani ZT. Determination of cadmium and lead in human milk. Int J Environ Sci Technol 2009;6(4):671–6.

  • 32.

    Farzin L, Amiri M, Shams H, Faghih MAA, Moassesi ME. Blood levels of lead, cadmium, and mercury in residents of Tehran. Biol Trace Elem Res 2008;123(1–3):14–26.

  • 33.

    Mohajeri E, Moatar F, Mahmoudi M. Effect of Cadmium in kidney diseases. J Sci Environ Technol 2008;9(4):111–6.

  • 34.

    Vigeh M, Yokoyama K, Ramezanzadeh F, Dahaghin M, Sakai T, et al. Lead and other trace metals in preeclampsia: a case–control study in Tehran, Iran. Environ Res 2006;100(2):268–75.

  • 35.

    Elinder CG, Friberg L, Lind B, Jawaid M. Lead and cadmium levels in blood samples from the general population of Sweden. Environ Res 1983;30(1):233–53.

  • 36.

    Ellis KJ, Vartsky D, Zanzi I, Cohn SH, Yasumura S. Cadmium: in vivo measurement in smokers and nonsmokers. Science 1979;205(4403):323–5.

  • 37.

    Zenzes MT, Krishnan S, Krishnan B, Zhang H, Casper RF. Cadmium accumulation in follicular fluid of women in in vitro fertilization-embryo transfer is higher in smokers. Fertil Steril 1995;64(3):599–603.

  • 38.

    Mannino DM, Holguin F, Greves H, Savage-Brown A, Stock A, et al. Urinary cadmium levels predict lower lung function in current and former smokers: data from the third national health and nutrition examination survey. Thorax 2004;59(3):194–8.

  • 39.

    Navas-Acien A, Selvin E, Sharrett AR, Calderon-Aranda E, Silbergeld E, et al. Lead, cadmium, smoking, and increased risk of peripheral arterial disease. Circulation 2004;109(25):3196–201.

  • 40.

    Kosanovic M, Jokanovic M, Jevremovic M, Dobric S, Bokonjic D. Maternal and fetal cadmium and selenium status in normotensive and hypertensive pregnancy. Biol Trace Elem Res 2002;89(2):97–103.

  • 41.

    Schwartz GG, Reis IM. Is cadmium a cause of human pancreatic cancer? Cancer Epidemiol Biomarkers Prev 2000;9(2):139–45.

  • 42.

    Nilsson T, Rorsman F, Berggren P-O, Hellman B. Accumulation of cadmium in pancreatic β cells is similar to that of calcium in being stimulated by both glucose and high potassium. Biochim Biophys Acta 1986;888(3):270–7.

  • 43.

    Schwartz GG, Il’yasova D, Ivanova A. Urinary cadmium, impaired fasting glucose, and diabetes in the NHANES III. Diabetes Care 2003;26(2):468–70.

  • 44.

    Occupational Safety & Health Administration. Safty and Helth Topics: Cadmium (Who is exposed to Cadmium?): OSHA. Available at: https://www.osha.gov/SLTC/cadmium/, 1th October, 2016.

  • 45.

    Thun M, Osorio AM, Schober S, Hannon W, Lewis B, et al. Nephropathy in cadmium workers: assessment of risk from airborne occupational exposure to cadmium. Br J Ind Med 1989;46(10):689–97.

  • 46.

    Järup L, Hellström L, Alfvén T, Carlsson MD, Grubb A, et al. Low level exposure to cadmium and early kidney damage: the OSCAR study. Occup Environ Med 2000;57(10):668–72.

  • 47.

    Palus J, Rydzynski K, Dziubaltowska E, Wyszynska K, Natarajan A, et al. Genotoxic effects of occupational exposure to lead and cadmium. Mutat Res 2003;540(1):19–28.

  • 48.

    Lin C-M, Doyle P, Wang D, Hwang Y-H, Chen P-C. Does prenatal cadmium exposure affect fetal and child growth? Occup Environ Med 2011;68(9):641–6.

  • 49.

    Kippler M, Wagatsuma Y, Rahman A, Nermell B, Persson L-Å, et al. Environmental exposure to arsenic and cadmium during pregnancy and fetal size: a longitudinal study in rural Bangladesh. Reprod Toxicol 2012;34(4):504–11.

  • 50.

    Johnston JE, Valentiner E, Maxson P, Miranda ML, Fry RC. Maternal cadmium levels during pregnancy associated with lower birth weight in infants in a North Carolina cohort. PLoS One 2014;9(10):e109661.

  • 51.

    Nishijo M, Nakagawa H, Honda R, Tanebe K, Saito S, et al. Effects of maternal exposure to cadmium on pregnancy outcome and breast milk. Occup Environ Med 2002;59(6):394–7.

  • 52.

    Zhang Y-L, Zhao Y-C, Wang J-X, Zhu H-D, Liu Q-F, et al. Effect of environmental exposure to cadmium on pregnancy outcome and fetal growth: a study on healthy pregnant women in China. J Environ Sci Health A Tox Hazard Subst Environ Eng 2004;39(9):2507–15.

  • 53.

    Kippler M, Tofail F, Gardner R, Rahman A, Hamadani JD, et al. Maternal cadmium exposure during pregnancy and size at birth: a prospective cohort study. Environ Health Perspect 2012;120(2):284.

  • 54.

    Levin A, Plautz J, di Sant’Agnese P, Miller R. Cadmium: placental mechanisms of fetal toxicity. Placenta Suppl 1980;3:303–18.

Purchase article
Get instant unlimited access to the article.
Log in
Already have access? Please log in.

Journal + Issues

Reviews on Environmental Health is an international quarterly periodical that fills the need for rapid publication of specialized comprehensive review articles on hot topics in the field of environmental health. The journal is an inspiring forum for scientists, environmentalists, physicians, engineers and students active in the area of public health, including quality of life.