Environmental Research 102 (2006) 83–89 Anthropometric, environmental, and dietary predictors of elevated blood cadmium levels in Ukrainian children: Ukraine ELSPAC group Lee S. Friedman a,Ã , Elena M. Lukyanova b , Yuri I. Kundiev c , Zoreslava A. Shkiryak-Nizhnyk b , Nataliya V. Chislovska b , Amy Mucha a , Alexander V. Zvinchuk d , Irene Oliynyk a , Daniel Hryhorczuk a a Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, IL, 60612, USA b Institute of Pediatrics, Obstetrics, and Gynecology, Academy of Medical Sciences of Ukraine, Ukraine c Institute of Occupational Medicine, Academy of Medical Sciences of Ukraine, Ukraine d Data Management Center, Kyiv University of Illinois, USA Received 2 September 2005; received in revised form 19 March 2006; accepted 3 April 2006 Available online 26 May 2006 Abstract No comprehensive data on sources or risk factors of cadmium exposure in Ukrainian children are available. In this we measured the blood levels of cadmium among 80 Ukrainian children and evaluated sources of exposure. A nested case–control study from a prospective cohort of Ukrainian 3-year-old children was conducted. We evaluated predictors of elevated blood cadmium using a multivariable logistic regression model. The model included socioeconomic data, parent occupation, environmental tobacco smoke, hygiene, body-mass index, and diet. Dietary habits were evaluated using the 1992 Block-NCI-HHHQ Dietary Food Frequency survey. Elevated cadmium was defined as blood levels in the upper quartile (X0.25 mg/L). The mean age for all 80 children was 36.6 months. Geometric mean cadmium level was 0.21 mg/L (range ¼ 0.11–0.42 mg/L; SD ¼ 0.05). Blood cadmium levels were higher among children taking zinc supplements (0.25 vs 0.21 mg/L; P ¼ 0:032), children who ate sausage more than once per week (0.23 vs 0.20; P ¼ 0:007) and children whose fathers worked in a by-product coking industry (0.25 vs 0.21; P ¼ 0:056). In the multivariable model, predictors of elevated blood cadmium levels included zinc supplementation (adjusted OR ¼ 14.16; Po0:01), father working in a by-product coking industry (adjusted OR ¼ 8.50; P ¼ 0:03), and low body mass index (o14.5; adjusted OR ¼ 5.67; P ¼ 0:03). This is the first study to indicate a strong association between elevated blood cadmium levels and zinc supplementation in young children. Whole-blood cadmium levels observed in this group of Ukrainian children appear to be similar to those reported in other Eastern European countries. r 2006 Elsevier Inc. All rights reserved. Keywords: Cadmium; Zinc; Body mass index; Dietary supplementation; Occupation; Minerals; Malnutrition 1. Introduction It is important to determine the various sources of cadmium exposure from industry, cigarettes, and especially food and mineral supplements in children to develop effective prevention programs. Cadmium is a cumulative toxic that has been well documented in children from India, Poland, Korea, and many western countries (Osman et al., 1998; Moon et al., 2003; Khandekar, 1987; Brockhaus et al., 1988; Sarasua et al., 2000). However, data are lacking on new nation-states coming out of the Former Soviet Union. The various social and economic pressures in Ukraine have contributed to the declining health status of the Ukrainian population. During the 1990s, there was a 3.8% drop in life expectancy, the standardized mortality rate for all causes of death increased by 18.2%, and both tuberculosis and AIDS incidence have risen three- to fivefold (World Health Organization (WHO), 2000). Ukraine is a heavily industrialized nation and 42% of Ukraine’s gross domestic product is derived from industry compared to 18% in the US. Approximately 32% of the work force is employed in industrial occupations (in the US ARTICLE IN PRESS www.elsevier.com/locate/envres 0013-9351/$ - see front matter r 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.envres.2006.04.002 Ã Corresponding author. Fax: +847 673 3505. E-mail address: lfriedman@tspri.org (L.S. Friedman).