A case report of elevated blood cadmium.

A 45-year-old male paint technician was identified as having an elevated whole-blood cadmium of 5.9 microg/l (Occupational and Safety Health Administration reference range for workers: <or=5.0 microg/l) through a routine workplace biological monitoring programme. Other than smoking 1.5-2 packs of cigarettes daily for 23 years, no additional non-occupational exposures to cadmium were identified. Whole-blood cadmium results taken 5, 4 and 2 years earlier were 3.1, 4.0 and 4.3 microg/l, respectively. After reassignment to a position without cadmium exposure, his whole-blood cadmium level 7 weeks later was 6.1 microg/l. A careful exposure history revealed that he had recently changed the brand of cigarettes he smoked. When he switched back to his original brand and reduced his consumption to one pack per day, his cadmium level fell to 2.9 microg/l taken 12 weeks after the initial elevated result. Eight weeks after returning to his original position with cadmium exposure, the value was 3.4 microg/l. No elevation in urine cadmium was noted at any point. An analysis of the tobacco revealed that the cadmium content of the new brand was almost 1.5-fold greater than the original brand. These results suggest that the consumption of different brands of cigarettes can lead to marked variations in whole-blood cadmium levels.