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Cadmium and pulmonary emphysema. Myth or reality

par Stanescu, Dinu ;Veriter, Claude;Frans, Albert
Référence The American review of respiratory disease, 113, 4, page (II)
Publication Publié, 1976

Article révisé par les pairs

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Résumé :

Chronic occupational exposure to cadmium (Cd) is considered to lead to pulmonary emphysema. The authors studied 18 workers exposed (E) to Cd for 32 years in average (range 22-43 years) in a Cd producing factory and 16 (age matched) nonexposed workers (C). The E group comprised all the workers in contact with Cd except 2 who had died (lung cancer and valvular heart disease), 1 who refused to engage in the study and 3 who were discarded (exposure of less than 10 years). There were 2 nonsmokers in the E group and 3 in the C group, but the number of pack years smokers was higher (p<0.05) in the latter (33.3) than in the former group (22.2). The excretion rate of Cd in urine (E:1.8 ±0.9; C:0.2 ± 0.1 μg/hour) and the concentration of Cd in blood (E:2.5 ± 1.3; C:0.4 ± 0.2 μg/100 ml) were larger in the E than in the C group (p<0.001). The proportion of workers with chronic cough and grade 1 dyspnea, but not chronic expectoration or other respiratory symptoms, was higher among E workers (X2:9.4; 6.9, p<0.01). Independent assessment of posteroanterior and lateral chest roentgenograms and full lung tonograms failed to distinguish between the 2 groups. Percentage of predicted values of the following lung function tests were not significantly different between the 2 groups: lung volumes, 1 sec forced expiratory volume, elastic recoil of the lungs, single breath lung diffusing capacity, specific airway conductance (SGaw), maximal expiratory flow rates (Vmax), slope of the N2 alveolar plateau, N2 closing volume (CV) and closing capacity. However, in both groups mean values of SGaw, CV and Vmax at 75% vital capacity were outside normal limits probably secondary to smoking. Our results do not support the concept of Cd induced emphysema.