| Keywords |
Urinary cadmium; Biomonitoring; Age-related accumulation; Smoking exposure; Korean National Environmental Health Survey |
| Abstract |
Background: Cadmium is a toxic heavy metal with an exceptionally long biological half-life, leading to significant cumulative exposure. This study characterized urinary cadmium (U-Cd) distribution in Korean adults, with a specific focus on identifying high-exposure patterns and determinants among women using nationally representative biomonitoring data.Methods: Creatinine-corrected U-Cd levels were analyzed in 4,239 adults from the 4th Korea National Environmental Health Survey (KoNEHS). Weighted analyses were applied to account for the complex survey design. High exposure was defined as U-Cd levels at or above the 90th percentile (P90) and 95th percentile (P95). Smoking exposure was objectively assessed using urinary cotinine concentrations rather than self-reported data.Results: The weighted median U-Cd was 0.64 μg/g creatinine, with P90 and P95 at 1.51 and 1.97 μg/g creatinine, respectively. The high-exposure group (≥P90) was significantly older and predominantly female (84.2%), while their urinary cotinine levels were paradoxically lower than those in the non-high-exposure group. In weighted regression models specifically for women, age showed a significant positive association with U-Cd (β = 0.042, p < 0.001), whereas urinary cotinine showed no significant association (p = 0.615).Conclusions: These findings indicate that U-Cd primarily reflects long-term cumulative environmental exposure rather than short-term smoking behavior, a trend that is particularly evident in the female population. Targeted exposure reduction strategies should prioritize older women as a high-risk group for chronic cadmium accumulation. |