This systematic review (PROSPERO CRD42021235435) searched five databases, returned 4098 records, and included 26 intervention studies from 21 low- and middle-income countries that aimed to reduce cadmium exposure during pregnancy and childhood. Interventions ranged from nutritional supplements, probiotic yogurt, dietary education (rice cooking methods), chelation therapy, and indoor air filtration to agricultural soil remediation (biochar, organic amendments). The review found that several interventions showed measurable reductions in cadmium body burden or food-chain concentrations, but none offered a realistic scalable solution. Rice-specific interventions (rice cooking method education, rice paddy soil biochar amendment) were notably represented. The finding that no existing intervention robustly addresses Cd pollution at scale underscores the ongoing need for upstream source control and supply-chain screening.
Key numbers
Studies included: 26 from 21 LMICs. Human intervention types: nutritional supplements (n=7 studies), medicine/clinical care (n=2), rice cooking education (n=1). Environmental intervention types: agricultural soil remediation (n=6), environmental regulations (n=4), indoor air filtration (n=3), rice cooking method (n=3), and cookware/microwaving (n=2). Selected effect examples: urinary Cd in children decreased from mean 12.8 to 9.4 µg/L after a two-month dietary intervention, though the study had no comparison group and a quality score of 6 (El-Soud et al., Egypt; n=65); sewage-sludge biochar at a 10% application rate reduced Cd bioaccumulation in rice and brought the Cd hazard quotient below acceptable limits in a controlled greenhouse study (Khan et al., China; quality score 13). Indoor air cleaners showed evidence of reducing indoor Cd exposure during pregnancy.
Methods (brief)
Systematic review of five databases (Scopus, Web of Science, PubMed, Global Health Medicus, Greenfile); search date November 2020. PICO inclusion criteria: pregnant women/children in LMICs, interventions to reduce Cd exposure, human or environmental biomonitoring outcomes. Synthesis without meta-analysis (SWiM/narrative synthesis) due to heterogeneity. Quality assessment using modified GRADE criteria (17-point scale). PRISMA reporting.
Implications
Certification: Reinforces that dietary Cd exposure in vulnerable populations (pregnancy, childhood) is a persistent global problem with limited mitigation options; supports HMT&C rationale for upstream Cd source control, ingredient screening, and conservative Cd limits in foods consumed by these populations. Courses: Provides evidence base for mitigation module content, particularly rice cooking method effects and biochar soil amendment; useful for manufacturer QA training on supply-chain Cd reduction. App: Informs the mitigation-options framework for rice and vegetable ingredients; rice cooking method is a documented lever for reducing dietary Cd exposure. Mitigation: Directly relevant to agronomic, processing, formulation, and supply-chain-screening as existing mitigation routes.
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Verification notes
- Corrected the source type to review and added the 4098-record search count from the abstract/results.
- Replaced the ambiguous environmental-intervention count with the source’s category counts.
- Reframed selected effect examples so the El-Soud dietary study is not described as highest-quality evidence.
- Strict Part 12 brand-firewall recheck found no sampled-product brand names in the source-page content.
- Removed missing/future wikilinks and routed mitigation relevance to existing mitigation pages.
Page history
The five most recent substantive edits to this page. The full version history lives in git; when DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.
| Commit | Date | Description |
|---|---|---|
| b0f3d38 | 2026-06-12 | batch | corpus rescreen b04 old terminal skips |