Risk characterisation - Statement on potential risks from cadmium in the diet of infants

74.              COT concluded that the EFSA tolerable weekly intake value (TWI) of 2.5 mg/kg bw/week was an acceptable value to use in risk assessment following EFSA’s rigorous statistical review of the derivation of its HBGV compared with that of JECFA.

Breast milk

75.                    Cadmium intake in average and high level exclusively breast-fed UK infants from 0 to < 6 months of age is shown in Table 18 below. Values range from 11 – 68% of the EFSA TWI of 2.5 mg/kg bw/week.

Table18. Risk characterisation of cadmium intake from exclusive breastfeeding in 0 to 6-month old infants, with breast milk.

Percentage of EFSA TWI (2.5 μg/kg bw/week).

76.             Intakes of cadmium for mean and 97.5^th percentile breast milk consumers from infants of 4 to < 18 months of age who are fed milk as only part of their diet are shown in Table 19 below. Mean and 97.5^th percentile intakes of cadmium were 2.8 to 19 % of the EFSA TWI at 0.4 mg Cd/l and 8.4 to 56% at 1.2 mg Cd/l.

Table 19. Estimated cadmium intake in 4 to 18 month old infants from breast milk.

Percentage of EFSA TWI (2.5 μg/kg bw/week).

Infant formulae and complementary foods

77.             Cadmium intake estimates for 0 to 6 month olds fed on infant formula of different make-up are shown in Table 20 below. Average consumer intakes of cadmium were 0 to 62 % of the EFSA TWI. High level consumer intakes were from 0 to 92% of the EFSA TWI.

Table 20. Estimated dietary intake of cadmium from exclusive feeding on infant formulae for 0 to 6-month olds relative to HBGV.

Percentage of EFSA TWI (2.5 μg/kg bw/week)

78.             Intakes of cadmium from infant formulae, commercial infant foods, and other foods, for 4 to 12-month olds are shown in Table 21. Mean total intakes were 34 to 78% µg/kg bw/day, and 97.5^th percentile total intakes were 130 to 170 % for the EU TWI. Intakes of cadmium from exclusive consumption of soya-based infant formulae are 47% and 71% of the EU TWI for the mean and 97.5^th percentile consumers respectively.

Table 21. Estimated Intake of cadmium from infant formulae, commercial infant foods and other foods for 4 to 12-month olds relative to HBGV.

Percentage of TWI (2.5 μg/kg bw/week).

Children aged 12 to 18 months

Intake estimates based on the Infant Metals Survey

79.             For the EU TWI, the ranges of total mean and 97.5^th percentile intakes (excluding water) to cadmium from infant formula, commercial infant foods and other foods were 73 to 79 and 150 to160% respectively (Table 22).

Table 22. Estimated dietary intake of cadmium from infant formulae, commercial infant foods and other foods in children aged 12 to 18 months relative to HBGV.

Percentage of EU TWI (2.5 μg/kg bw/week).

80.             Table 23 refers to dietary intakes of Cd based on the Total Dietary Survey and illustrates that concurrent intake of UK water, whether at the highest recorded median or highest 97.5^th percentile Cd concentration (see Table 3) has no significant effect on the amount taken in with food. Relative to the EU TWI, mean intakes were 81 to 150% and 97.5^th percentile intakes were 170 to 260%.

Table 23. Estimated dietary intake of cadmium based on the TDS data in children aged 12 to 18 months, relative to the HBGV, taking into account the contribution from of UK water containing the highest median and 97.5^th percentile concentrations of cadmium.

Percentage of the EU TWI (2.5 mg/kg bw/week).

Values rounded to 2 SF.

^a Highest median concentration in UK drinking water. ^b Highest 97.5^th percentile concentration in UK drinking water.

81.             In general, the food groups making the highest contribution to cadmium exposure were miscellaneous cereals, bread and potatoes (FSA, 2016b), as shown in Table 24.

Table 24. Contribution to total dietary cadmium intake by the three food groups containing the highest levels of Cd based on TDS data.

Percentage of EU TWI (2.5 mg/kgbw/week).

Children aged 18 months to 5 years

82.             The total mean and 97.5^th percentile intake values including water (calculated using the highest median and 97.5^th percentile values in Table 3) were equal to those estimated for the total mean exposures excluding water (Table 22).

83.          Table 25 refers to dietary intakes of Cd based on the Total Dietary Survey and illustrates that concurrent intake of UK water, whether at the highest recorded median or highest 97.5^th percentile Cd concentration (see Table 3) has no significant effect on the amount taken in with food. Relative to the EU TWI, mean intakes were 90 to 170% and 97.5^th percentile intakes were 150 to 260%.

Table 25.  Estimated dietary intake of cadmium based on the TDS data in children aged 18 months to 5 years, relative to the HBGV, taking into account the contribution from of UK water containing the highest median and 97.5^th percentile concentrations of cadmium.

Percentage of the EU TWI (2.5 mg/kg bw/week).

Values rounded to 2 SF.

^a Highest median concentration in UK drinking water. ^b Highest 97.5^th percentile concentration in UK drinking water.

84.          As with the younger children, the food groups making the highest contribution to cadmium exposure in the TDS were miscellaneous cereals, bread and potatoes (FSA, 2016b), shown in Table 26

Table 26 Contribution to total dietary cadmium intake by the three food groups containing the highest levels of Cd based on TDS data.

Percentage of EU TWI (2.5mg/kg bw/week).

Soya

Using the EFSA default values of 800 and 1200 ml for exclusive consumption of infant formula for the 4 to 6 month age group, intake estimates for cadmium in soya formula would be 48% and 73% of the EU TWI for average and high level consumers, respectively before taking into account water used in reconstitution,

Dust

 Table 27 shows that the median Intakes from dust ingestion were at most 1.7% and the maximum intakes 7.8% of the EU TWI.

Table 27. Estimated cadmium intakes from dust in infants and young children aged 6 months to 5 years.

Percentage of EU TWI (2.5 mg/kg bw/week).

Soil

85.          Intakes in UK infants aged 6 to 12 months and young children aged 1 to 5 years of cadmium in soil are given in Table 28.

86.          Relative to the EU TWI, the highest median intake value for cadmium from soil was 0.64% and the highest 95^th percentile value was 1.6%.

Table 28 Estimated cadmium intakes from soil in infants and young children aged 6 months to 5 years.

Percentage of EU TWI (2.5 μg/kg bw/week).

Air

87.          Relative to the EU TWI, the highest median intake value for cadmium from the air was 0.25% and the highest maximum value was 3.6% (Table 29).

Table 29. Possible intakes to cadmium in infants and young children from air.

Percentage of the EU TWI (2.5 mg/kg bw/week)