High cadmium concentrations in areas with endemic fluorosis: A serious hidden toxin?

Environmental contamination with cadmium (Cd) and fluorine (F) and the associated health impacts on humans have raised significant concerns in the literature, but the additional health risks created by Cd have not been investigated in areas with endemic fluorine intoxication (fluorosis). Here, we report for the first time that naturally occurring Cd in areas where endemic fluorosis is related to coal combustion is a serious hidden toxin. The high Cd levels in rocks and soils of these areas may increase health risks to epidemiological level, irrespective of fluorine levels. We implemented a pilot study in a fluorosis-affected rural area within China’s Three Gorges region, and revealed enrichment of Cd in local bedrock (4.48– 187 mg kg � 1 ), coal (11.5–53.4 mg kg � 1