BMC Public Health Research article The association of urinary cadmium with sex steroid hormone concentrations in a general population sample of US adult men Andy Menke1, Eliseo Guallar*1,2, Meredith S Shiels1, Sabine Rohrmann3, Shehzad Basaria4, Nader Rifai5, William G Nelson4,6,7,8,9,10,11 and Elizabeth A Platz1,10,11 BioMed Central Open Access Address: 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA, 2Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain, 3Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany, 4Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA, 5Department of Laboratory Medicine, Children's Hospital Boston, Boston, USA, 6Department of Oncology, Johns Hopkins School of Medicine, Baltimore, USA, 7Department of Pathology, Johns Hopkins School of Medicine, Baltimore, USA, 8Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, USA, 9Department of Urology, Johns Hopkins School of Medicine, Baltimore, USA, 10The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, USA and 11The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, USA Email: Andy Menke - amenke@jhsph.edu; Eliseo Guallar* - eguallar@jhsph.edu; Meredith S Shiels - mshiels@jhsph.edu; Sabine Rohrmann - s.rohrmann@dkfz-heidelberg.de; Shehzad Basaria - sbasari1@jhmi.edu; Nader Rifai - Nader.Rifai@childrens.harvard.edu; William G Nelson - bnelson@jhmi.edu; Elizabeth A Platz - eplatz@jhsph.edu * Corresponding author Published: 23 February 2008 BMC Public Health 2008, 8:72 doi:10.1186/1471-2458-8-72 This article is available from: http://www.biomedcentral.com/1471-2458/8/72 Received: 29 October 2007 Accepted: 23 February 2008 © 2008 Menke et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Studies investigating the association of cadmium and sex steroid hormones in men have been inconsistent, but previous studies were relatively small. Methods: In a nationally representative sample of 1,262 men participating in the morning examination session of phase I (1998–1991) of the third National Health and Nutrition Examination Survey, creatinine corrected urinary cadmium and serum concentrations of sex steroid hormones were measured following a standardized protocol. Results: After adjustment for age and race-ethnicity, higher cadmium levels were associated with higher levels of total testosterone, total estradiol, sex hormone-binding globulin, estimated free testosterone, and estimated free estradiol (each p-trend < 0.05). After additionally adjusting for smoking status and serum cotinine, none of the hormones maintained an association with urinary cadmium (each p-trend > 0.05). Conclusion: Urinary cadmium levels were not associated with sex steroid hormone concentrations in a large nationally representative sample of US men. Background Cadmium is a widespread toxic and carcinogenic metal with numerous adverse health effects in humans [1]. In the general population, environmental exposure to cad- mium occurs primarily through smoking, the consump- tion of contaminated food and water, and inhalation of contaminated air [2,3]. Page 1 of 7 (page number not for citation purposes)