Estimating the Global Burden and Health Risks Associated with Dietary and Cigarette-Related Cadmium Exposure.

To quantitatively assess the global burden and health risks associated with dietary and cigarette-related cadmium (Cd) exposure, and to provide a scientific basis for developing public health policies for the prevention and control of global Cd exposure. This study combined the Cd concentration data in foods and cigarettes and their consumption data to assess the Cd exposure levels from these two sources. The toxicity kinetics (TK) model was used to convert dietary Cd exposure into urinary Cd (U-Cd) exposure to further evaluate the burden of cardiovascular disease (CVD) caused by dietary Cd exposure. The risk assessment model of the United States Environmental Protection Agency (USEPA) was adopted to evaluate the cancer and non-cancer risks caused by cigarette-related Cd exposure. The global average daily dietary Cd intake was 2.20 μg/kg bw/day. The daily Cd exposure to cigarettes was 0.0359 μg/kg bw/day. The proportions of the burden of CVD, stroke and coronary heart disease (CHD) explained by dietary Cd intake were 6.08%, 3.34% and 2.74%, respectively. The excess lifetime cancer risk (ELCR) due to cigarette-related Cd exposure was 0.0037, and the non-cancer hazard quotient (NCHQ) was 26.89. Cd exposure in diet and cigarettes significantly affects the global CVD burden and cancer risk. This study emphasizes the importance of reducing Cd exposure in the environment and formulating relevant policies to mitigate health risks, including strengthening Cd control in food and implementing effective and reasonable tobacco control policies.