Changes of Atmospheric and Blood Concentrations of Lead and Cadmium in the General Population of South Korea from 2008 to 2017

We measured changes in atmospheric and blood levels of lead and cadmium in the South Korean general population during the past decade. Blood data of 16,873 adults were taken from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2017). Atmospheric data were taken from 66 air quality monitoring sites in 16 different regions in South Korea. From 2008 to 2017, the geometric mean (GM) blood lead level decreased from 2.37 to 1.46 μg/dL (38.4% decrease), and the atmospheric lead concentration decreased by 61.0% in the overall population. During this time, the GM blood cadmium level decreased from 0.88 to 0.72 μg/L (18.2% decrease), and the atmospheric cadmium concentration decreased by 63.6%. Multiple linear regression analysis indicated that a half reduction in air lead was associated with a 0.09 μg/dL decrease in blood lead (95% CI: 0.03 to 0.15) in a subgroup of the metropolitan city population. However, a half reduction in air cadmium had no significant effect on blood cadmium. Multiple linear regression analyses indicated that the decrease in blood lead level over 10 years in Korea was related to the decrease in atmospheric lead concentration. However, the decrease in blood cadmium level during this time was not significantly associated with the decrease in atmospheric cadmium concentration. Our findings suggest that inhalation is a major source of lead exposure, but not of cadmium exposure. Ingestion of dietary cadmium presumably has a stronger impact on blood cadmium levels.