A family vegetable garden, vegetables from the garden, a former industrial zone nearby… Since cadmium is back in the news, many French people are wondering about their level of exposure and the benefit of getting tested. Since June 16, 2026, the dosage can be reimbursed under certain conditions. But who should actually request a test?
The answer is less obvious than it seems. The High Authority for Health (HAS) recommends targeted screening, mainly for people likely to be overexposed due to their place of residence. An approach contested by certain experts, who point out that food constitutes the main source of impregnation of the general population.
According to a Cnam count cited by Franceinfo, 2,285 reimbursed screening procedures, including 1,539 urine tests and 746 blood tests, were carried out between June 16 and September 28, 2026, for 2,160 people.
Cadmium: why is this contamination so worrying?
Present naturally in certain soils, but also from industrial and agricultural activities, cadmium is a toxic heavy metal which can contaminate plants and enter the food chain. It gradually accumulates in the body, particularly in the kidneys, and can have long-term health effects.
“Cadmium is a carcinogenic and endocrine disrupting heavy metal that alters DNA and causes oxidative stress in cells.explains Dr Pierre Souvet, cardiologist and president of the Santé Environnement France (ASEF) association, in a previous interview with True Medical.
Chronic exposure to cadmium is particularly associated with kidney and bone damage. It is also studied for its involvement in certain cancers, notably that of the pancreas and its links with cardiovascular diseases or fertility disorders.
French data makes it possible to measure the extent of exposure. As part of the Esteban national biomonitoring study, carried out in 2014-2016, Public Health France noted that
47.63% of adults aged 18 to 60 years had a urinary cadmium concentration greater than 0.5 µg/g creatininea critical value retained by ANSES particularly with regard to the effects on bones.
This impregnation also concerns the youngest. Dr Pierre Souvet underlined: “Children today have doses in their bodies comparable to those of adults twenty years ago..
Should we conclude that almost one in two French people should request screening? No. The Esteban study describes the exposure of a population over a given period: it does not constitute an individual indication for screening.
An essential question remains: how to identify people who really need a test?
Cadmium testing: who should request a test?
The HAS does not recommend widespread screening. Its strategy primarily targets people likely to be overexposed due to their residential environment, particularly those who live on land with known or possible cadmium pollution, or in an area where natural concentrations of this metal are high.
Several situations therefore deserve to be discussed with a doctor: living permanently near contaminated soil, regularly consuming vegetables produced locally in an area concerned or living in an environment where a particular exposure has been identified.
Vigilance can also be reinforced in young exposed children, particularly when certain behaviors encourage the ingestion of soil, such as geophagia or onychophagia, that is to say biting one’s nails.
You still need to know if your home is in a risk zone. This is one of the difficulties of the system: the information available does not always allow the general public to easily identify the sectors concerned.
A prediction map of cadmium levels in soils, accessible on Geodata, can provide information. Franceinfo also published maps of polluted sites and a survey on exposure to cadmium and the difficulties of screening.
In practice, it is better to gather the elements available: address, length of residence, presence of a vegetable garden, local vegetable consumption habits or known industrial context. The doctor will be able to compare them with the available information and determine if a dosage is relevant.
Outside of the exposure situations targeted by the recommendations, systematic testing is not recommended.
But this approach raises a difficulty: it risks leaving aside some of the people exposed through another route, notably through diet.
Screening centered on the place of life: why experts contest it
For Dr Pierre Souvet, the criteria used do not sufficiently reflect the reality of exposure to cadmium in France. The cardiologist particularly contests the conditions of access to reimbursement, which favor people living near potentially contaminated soil.
On Franceinfo, he denounces “the choice to restrict test reimbursements based on place of residence. This amounts to limiting access only to people living near polluting industrial sites (…) However, this does not correspond to the situation of French contamination, which is primarily linked to food”.
On this point, ANSES data confirm the major role of food in permeating the general population. In a report devoted to the risks linked to cadmium, the agency indicates: “Food ingestion is the majority source of impregnation for the general French smoking and non-smoking population (which can reach a contribution of 98% for the general non-smoking population depending on age).”.
However, the two approaches do not answer exactly the same question. The HAS defines the situations in which individual screening is recommended, while the criticisms relate to the scope of this strategy with regard to the overall exposure of the population.
A person can thus be exposed through their diet without living near an identified industrial site. Conversely, living near a potentially contaminated area does not automatically mean that your body has an excessive cadmium load.
That’s the difficulty: how can we target people who need screening without reducing the risk assessment to their address alone?
In the meantime, for people to whom the test is indicated, it is still necessary to know how it is carried out and what its results allow us to conclude.
Reimbursed test: how is the screening carried out and what does the result mean?
Since June 16, 2026, cadmium screening can be reimbursed up to 60% for those concerned, on medical prescription. It can be carried out in a city laboratory.
The first-line test is cadmiuriawhich measures the concentration of cadmium in urine. A blood test, called cademia, may be requested in addition when the urine dosage is high.
However, the interpretation of the results requires some precautions. According to the HAS recommendations, two successive urinary dosages higher than the reference values for age characterize a body burden that is too high. When cadmiuria exceeds 1 µg/g creatinine, a health assessment is recommended.
The result should therefore not be interpreted in isolation. It must be placed in the context of the person, their habits and their possible sources of exposure. If excessive impregnation is confirmed, the objective is in particular to identify the routes of contamination and to implement appropriate measures to limit exposure.
If in doubt, it is therefore better to talk to your doctor rather than request a dosage without prior assessment. This will be able to determine whether the test is indicated with regard to the place of life, eating habits and the risks identified.
But individual screening is only part of the answer. Since food represents the main route of exposure for the general population, health protection also involves a sustainable reduction of contamination at the source, particularly in the food chain. It is on this condition that we will be able to act beyond just the people identified as being the most exposed.