Cadmium toxicity in silversmith: Safety is never too much!

Dear Sir,

The article by Parikh et al.[1] is indeed interesting and a timely reminder for the systematic surveillance of health status among silversmiths and enforcement of adequate use of personal protective equipments/measures. In developing countries such as India, silver jewelry manufacturing is an important cottage industry and this business is run traditionally from father to son, and carried out by the family members at home. Occupational health and safety research in developing countries are mainly focused on large-scale industries. There are no strict enforcement of rules and regulations for family-run cottage industries.

Silver is usually mixed with 20%–30% cadmium and then it is used to make silver jewelry. During this process, there is a formation of cadmium fumes, which are inhaled by the workers. Subacute to chronic cadmium exposure from “silver solder” has been well recognized in the fabrication of jewels and in other industrial brazing applications. Cadmium is highly toxic to various biological systems of which the respiratory tract is a key target organ. Acute cadmium inhalation is associated with acute lung injury and diffuse alveolar damage.[2] In animal models, repeated exposure to cadmium fumes has lead to emphysema.[3] A recent Indian study by Moitra et al.[4] had documented decrements in lung function among those involved in jewellery works due to chronic exposure to cadmium fumes. Sethi et al.,[5] had reported a case of cadmium-induced peripheral neuropathy, nephropathy, and decreased bone density. Both reports warrants for comprehensive health and safety management program to prevent the organ toxicity.

Prevention programs shall include technological improvements, development of safer substitutes, appropriate ventilation of the work place, education of training of workers on the hazards of cadmium exposure, and adoption of suitable precautions. Long-term exposure to lower cadmium concentrations should be considered a future occupational health issue, as cadmium confounds many physiological processes. Occupational health issues are often given less attention in medical education and training. As a result, occupational illnesses are not considered in clinical teaching or rounds.