Non-renal effects and the risk assessment of environmental cadmium exposure.
Non-renal effects and the risk assessment of environmental cadmium exposure.
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DOI：
10.1289/ehp.1307110
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发表时间：
2014-05
影响因子：
10.4
通讯作者：
Skerfving S
中科院分区：
文献类型：
--
作者：
Åkesson A;Barregard L;Bergdahl IA;Nordberg GF;Nordberg M;Skerfving S
背景：长期以来，接触镉（Cd）一直被认为是一种健康危害，无论是在工业中还是在高接触人群中。在目前流行的健康风险评估中，尿中Cd （U-Cd）浓度与管状蛋白尿之间的关系被使用。然而，最近有人对在极低暴露情况下基于这种关系进行风险评估的合理性提出了质疑。目的：我们的目的是审查关于接触镉对人类健康风险评估的健康影响的现有信息。讨论：在极低暴露下，U-Cd与尿蛋白之间的关联可能不是由于Cd毒性，轻微蛋白尿的临床意义也可能有限。更重要的是，据报道，极低的镉暴露也会产生其他影响。我们有理由质疑现有的Cd健康风险评估的基础。我们对文献的回顾发现，暴露于低浓度的Cd与骨骼的影响有关，包括骨质疏松症和骨折的风险增加，这一观察结果对Cd的健康风险评估有影响。与Cd相关的其他影响也应考虑在内，特别是癌症。尽管这些信息仍然过于有限，无法适当地用于定量风险评估。结论：非肾效应应被视为Cd健康风险评估的关键影响因素。引用本文：Åkesson A， Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. 2014。环境镉暴露的非肾效应及风险评估。环境健康展望122:431-438；http://dx.doi.org/10.1289/ehp.1307110
Background: Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure. Objectives: Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment. Discussion: The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment. Conclusion: Non-renal effects should be considered critical effects in the health risk assessment of Cd. Citation: Åkesson A, Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. 2014. Non-renal effects and the risk assessment of environmental cadmium exposure. Environ Health Perspect 122:431–438; http://dx.doi.org/10.1289/ehp.1307110
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影响因子：
10.4
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