Was cadmium found on skin bases in an adult patient with potential occupational exposure?

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Cadmium Exposure on Skin: Occupational Context

Cadmium is not typically absorbed through intact skin in occupational settings; the primary routes of occupational cadmium exposure are inhalation of fumes and dust, with secondary ingestion through contaminated hands. 1, 2

Primary Routes of Occupational Cadmium Exposure

Inhalation (Dominant Route)

  • Respiratory absorption accounts for 13-19% of inhaled cadmium from air, making this the most clinically significant exposure pathway in occupational settings 3
  • Inhalation of cadmium oxide fumes can cause acute toxicity including inhalation fevers or chemical pneumonitis 2
  • Workers in battery production, welding, metal plating, and paint/pigment industries face the highest inhalation risks 2, 4

Oral/Ingestion (Secondary Route)

  • Approximately 10-44% of ingested cadmium is absorbed through the digestive system 3
  • In occupational settings, this occurs when airborne dust is mixed with saliva and swallowed, or through hand-to-mouth contact with contaminated surfaces 3
  • For non-occupational, non-smoking populations, dietary intake is the sole exposure source 3

Dermal Exposure Considerations

Skin contact with cadmium-containing materials does not represent a significant absorption pathway based on the established toxicological literature. The guidelines and research consistently identify only two routes:

  • Respiratory system (primary occupational route) 1, 2, 3
  • Gastrointestinal tract (environmental/dietary route, or secondary occupational via contaminated hands) 3

Clinical Implications

  • Workers handling cadmium compounds in battery production (80% of industrial use), pigments (10%), or electroplating should focus protective measures on respiratory protection and hand hygiene 2, 4
  • Biological monitoring through urinary cadmium levels remains the most relevant exposure biomarker, regardless of contact route 5, 2
  • Blood cadmium levels accumulate to 0.0052 ppm, with tissue deposition primarily in kidneys, liver, muscles (0.14-3.2 ppm), and bones (1.8 ppm) 3

High-Risk Occupational Settings

Workers at increased risk include those in: 1, 2, 4

  • Battery manufacturing facilities (nickel-cadmium batteries)
  • Metal working with heat exposure from furnaces
  • Welding operations (cadmium in welding rods)
  • Construction work with cement handling
  • Paint and plastic pigment production

Biological Half-Life and Monitoring

  • Cadmium has an exceptionally long biological half-life of 16-30 years (average 20-40 years), making prevention of initial exposure critical 2, 3
  • Medical surveillance should include urinary cadmium measurements as the primary biomarker 5, 2
  • Blood cadmium and beta-2-microglobulin in urine provide additional monitoring parameters 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Acute and chronic cadmium poisoning].

La Revue de medecine interne, 2010

Research

Cadmium Toxicity and Health Effects-A Brief Summary.

Molecules (Basel, Switzerland), 2023

Research

Biological monitoring results for cadmium exposed workers.

American Industrial Hygiene Association journal, 1996

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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