© 2004 BMJ Publishing Group Ltd & British Thoracic Society
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Cigarette smokers have variable susceptibility to COPD and the reasons for these differences are being extensively investigated. Cadmium is found in cigarette smoke and has been linked to emphysema in workers exposed to it. In this month’s Thorax Mannino and colleagues report some intriguing data from the Third National Health and Nutrition Examination Survey. They found that urinary cadmium levels were higher in current smokers than in former smokers or never smokers. The cadmium levels in current and former smokers were also associated with lower lung function. The authors conclude that urinary cadmium levels, which reflect the total body burden of cadmium, may be a cause of tobacco related lung disease. In the accompanying editorial, Hendrick explains how cadmium is metabolised in the body and also discusses the case for and against cadmium in tobacco smoke being a cause of emphysema. Differences in susceptibility to the development of COPD may
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