Table 4

Literature review of Cd neurotoxicity in humans

Authors Study design E/C (n) Exposure to Cd Other exposures and observations Neurotoxic effects Dose-effect relation
Adults:
 Prodan, 193226 Review of case reports92 Chronic, 7 acuteZn2/2: Weakness; 5/7: headache
 Baader, 195227 Case report1ExpY: 16?Anosmia; intramural plexus lesions (bronchial-abdominal)
 Cotter, 195828 Case report32–6 months, >1 y?2/3: Mental irritability
 Dunphy, 196730 Case reports504–36 h?Headache (34%), weakness (12%), dizziness (34%)
 Blum et al, 19894 Case report1CdH: 17.1 μg/g CdU: 5 μg/lPb, pipefitter.Axonal sensorimotor PNP
 Kilburn and McKinley, 19965 Case report230 min (fumes); CdU: 25 and 485 μg/dayNi, CO, PVC fumesSevere (485 μg); moderate (25 μg) psycho-organic syndrome
 Struempleret al, 198535 Case-control (behavioural difficulties)40CdH: 0.2–2 μg/gProteinuria↗ Demerits (behavioural difficulty)r=0.55
 Adams and Crabtree, 196129 Cross sectional106E/84CAirdust: 350 μg Cd/m3 (range: 340–27600)Ni dust, proteinuriaAnosmia: 15% in E vs 5% in C+
 Musiol et al, 198132 Cross sectional49EExpY: 13 (1–33) CdU:<10ó>10μg/l?Polyneuropathy: <10 μg Cd/l: 17% >10 μg Cd/l: 55%+
 Hart et al, 19893 Cross sectional31ECdU: 25.9 μg/l (1–110)PbB: 9.3 μg/dl renal function: normal↓ Attention, memory, and psychomotor speed+
 Bar-Selaet al, 199231 Cross sectional38EExpY 8.4 (range: 1–14) CdU: 67μg/l (8–306)Ni, Mn, Mg, Zn90% Headache; 42% dizzy spells 21% weakness; 16% brain atrophy(+)
 Rose et al, 199225 Cross sectional55E/16CExpY: 9.2 airdust: 300 μg Cd/m3 ProteinuriaHyposmia: E: 13 %; C: 0 %+
 Viaene et al, 19986 Cross sectional13E/19CExpY: 23; mean CdUmax : 22 μg/g creatininePbB: 9 μg /dl proteinuria7E/2C: Polyneuropathy OR: 9.92 (95%CI 1.60–61.6)+
 Viaene et al, (present study)Cross sectional42E/47CExpY: 13; mean CdUmax 12.6 μg/g creatininePbB: 9.7 μg/dl retired: proteinuria active: no proteinuria↓ Motor speed, attention, memory ↑ equilibrium, PNP, and concentration complaints+
Children:
 Stellern et al, 19838 Case-control (learning difficulties)25CdH: 0.94 μg/gHair: 8.96 μg Pb/g↓ Visuomotor skills Pb: r=−0.43 Cd: r=−0.51+
 Thatcher et al, 19827 Cross sectional149CdH: 1.65 ppm (0–8.9) Hair: 7.5 ppm PbCd: ↓ verbal IQ+
(range: 0–178) Pb: ↓ performance IQ+
 Marlowe et al, 19859 Cross sectional69CdH:0.7μg/g (0.2–2.0)Pb, As, Hg, AlCombined exposure index Pb-Cd ↓ visuomotor skills+
 Bonithon et al, 198633 Cross sectional26 BabiesCdH: 0.6μg/g (0.2–1.9)Hair: 19.3 μg Pb/g (range: 4.6–104.7)Cd: ↓ perceptual, cognitive, motor Pb: ↓ perceptual, motor+
 Lewiset al, 199234 Cross sectional92Amniotic fluid: 1.0 μg Cd/dlCr, Pb, Co, Ag, Ni, Hg↓ Verbal, perceptual, cognitive, and motor abilities+
  • E=exposed subjects, C=control subjects; CdU=urinary cadmium concentration; CdH=concentration of cadmium in hair; ExpY=exposure-years; PbB=blood lead concentration; PNP= polyneuropathy.