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Republication or reproduction of this report or its storage and/or dissemination by electronic means is permitted without the (2004)], contains definitions and explanatory notes, if needed, for terms frequently used in the multidisciplinary field of toxicology. The glossary is compiled primarily for those scientists and others who now find themselves working in toxicology or requiring a knowledge of the subject, especially for hazard and risk assessment. Many medical terms are included because of their frequent occurrence in the toxicological literature. There are three annexes, one containing a list of abbreviations and acronyms used in toxicology, one containing a list of abbreviations and acronyms used by international bodies and by legislation relevant to toxicology and chemical safety, and one describing the classification of carcinogenicity according to the weight of evidence available.

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Background: Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure.Objectives: Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment.Discussion: The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment.Conclusion: Non-renal effects should be considered critical effects in the health risk assessment of Cd.Citation: Åkesson A, Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. 2014. Non-renal effects and the risk assessment of environmental cadmium exposure. Environ Health Perspect 122:431–438; http://dx.doi.org/10.1289/ehp.1307110