Blood cadmium levels linked to higher mortality risk in rheumatoid arthritis patients

A new study, published in the Journal of Trace Elements in Medicine and Biology, reveals a concerning link between environmental cadmium exposure levels and  increased mortality risk among individuals with rheumatoid arthritis (RA). The findings underscore the potential impact of elevated blood cadmium levels on the health outcomes of RA patients, highlighting the effect of environmental risk factors in this population. 

In a comprehensive study led by Liu et al, 1285 individuals diagnosed with RA were scrutinized as part of the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2016. Utilizing the Cox regression model, researchers explored the intricate relationship between blood cadmium levels and the susceptibility to all-cause mortality among RA patients. Over an average follow-up period of 105.9 months, the study documented 341 deaths among participants. Accounting for various confounding factors, the analysis revealed a robust correlation between elevated blood cadmium levels and an escalated risk of all-cause mortality in RA patients. Remarkably, for every unit increase in natural logarithm-transformed blood cadmium concentrations, the risk of patient mortality surged by a staggering 107%. Furthermore, the adjusted hazard ratios for each quartile of blood cadmium exhibited a noteworthy ascending pattern (P <0.001), highlighting a significant dose-response relationship.  

Cadmium, a prevalent environmental pollutant, finds its primary use in battery production, alloys, coatings, electroplating, and various other industries. Its introduction into the environment predominantly occurs through industrial emissions and waste disposal methods, subsequently infiltrating the human body via exposure routes such as air, soil, and water. Designated as a top priority among the twelve globally significant hazardous chemicals by the United Nations Environment Programme, cadmium poses a substantial concern. Studies suggest that cadmium can detrimentally impact immune system function, including immune cell activity and the regulation of inflammatory responses. Moreover, cadmium exhibits oxidative properties. Overconsumption of cadmium can elevate oxidative stress within the body, leading to tissue and cellular damage that may intensify inflammatory reactions and contribute to the progression of RA’s pathological processes. 

The study findings underscore a concerning link between environmental cadmium exposure levels and increased mortality risk among individuals living with RA. The implications are clear: understanding and addressing the detrimental effects of cadmium on RA patients’ health is paramount. Urgent action is needed to implement effective measures aimed at controlling cadmium pollution and minimizing environmental cadmium exposure to alleviate its health hazards. Future prospective cohort studies focusing on gathering comprehensive exposure and disease data, and developing potential preventive strategies and interventions are warranted. 


Liu H, Liu M, Qiao L, Yang Z, He Y, Bao M, et al. Association of blood cadmium levels and all-cause mortality among adults with rheumatoid arthritis: The NHANES cohort study. J Trace Elem Med Biol. 2024 Feb 1;83:127406.