Cadmium and its inorganic compounds - Addendum: re-evaluation of the BLW: Assessment Values in Biological Material - Translation of the German version from 2025.

The German Senate Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area (MAK Commission) re-evaluated the data for cadmium [7440-43-9] to derive a biological guidance value (BLW) for its systemic non-carcinogenic end points. Relevant studies were identified from a literature search. Exposure to cadmium dust can cause nasal inflammation and anosmia, bronchitis and pneumonia, which are recognised as local effects. Tubular kidney damage was identified as the most sensitive end point of systemic toxicity, which results in excretion of low molecular weight proteins such as α1 and β2-microglobulins and retinol binding protein (RBP) in the urine. Recent studies on workers occupationally exposed to cadmium revealed a NOEL (no observed effect level) and a BMDL5 (benchmark dose lower limit) for tubular proteinuria at approximately 3 to 5 µg cadmium/g creatinine in ever-smokers, whereas this threshold is higher in never-smokers. Therefore, a BLW of 2 µg cadmium/g creatinine is set for cadmium in urine.