Cadmium test reimbursement scheme in France is ‘too restrictive’
Doctors claim methods for assessing who should be reimbursed for tests of carcinogenic metal are outdated and insufficient
Tests will cost €27.50, but only some people will be reimbursed through social security
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A reimbursement scheme for cadmium screenings in France has been criticised as too restrictive by medical experts as it is based on ‘outdated’ information.
They claim food is by far the source of contamination but the tests are being limited to geographical areas where the metal is found naturally.
A report in March by French health authority ANSES sounded the warning bell on high levels of the carcinogenic present in daily life.
Levels come particularly from food consumption, including staple wheat-based goods such as pasta, bread, vegetables, and chocolate, but also from industrial activity and the natural presence of the metal in rocks and limestone.
Health body Santé publique France predicts nearly one in two adults in France have cadmium levels above the recommended threshold, with around 15% of children also over-exposed.
It led to the government and health authorities coming to an agreement on the rollout of tests checking cadmium levels for individuals in early April.
The tests would be available in public laboratories, instead of simply private hospitals (as is the current case) and be available from summer 2026.
Tests based on ‘cadmium map’
Medical experts argue however that the lack of wider reimbursement for the test will restrict uptake and provide only limited benefits.
A test at a laboratory will cost €27.50 and depending on conditions will be refunded at 60% by state health insurance body Assurance Maladie, with the remaining 40% covered by top-up mutuelle insurance if the person has one.
Further information about how tests can be accessed will be available at a later date.
However, this state reimbursement will only be available to people who are “people potentially overexposed to cadmium due to their place of residence,” or if they work in industries at risk of cadmium exposure, the government has since clarified.
For others, they will have to cover the full cost of the tests themselves.
People "living on sites whose soils have been identified as polluted by state authorities based on environmental assessments,” the government said.
French media outlet Le Monde reports the government is set to use an older map based on soil quality and showing cadmium levels present, available here.
This shows high levels of cadmium primarily in the east and north of the country, as well as around Paris.
The map however, only shows cadmium levels based on its natural presence and from historical activity, such as industrial processes.
The map “does not allow us to detect the impact of agricultural practices, especially the use of phosphate fertilisers. If it did, we would see anomalies in large farming areas,” said soil expert and project manager at the RQMS institute (creator of the map above) Claudy Jolivet to Le Monde.
It does not account for cadmium exposure from foodstuffs, which ANSES estimates is the source of up to 98% of overall exposure in France.
‘Do children only eat food from their garden?’
“Targeting screening based on place of residence makes no sense; it ignores the warnings from ANSES and the French National Public Health Agency, which show the problem is widespread contamination through food,” said medical advocacy leader Pierre Souvet to Le Monde.
“Does a child in Lyon or Bordeaux eat only cereals or potatoes grown in their own garden? Whether out of fear of alarming results or financial concerns, it does not matter – the government clearly wants to limit the biological monitoring of people living in France.”
Doctors have also criticised the limitations.
“It's as if the government is afraid of a tidal wave of alarming results,” said Pascal Meyvaert.
Tests should instead be conducted based on “a standardised questionnaire focused on diet,” he said.
“People living in France have the right to know; we must stop treating them like children.”
However, medical experts agree that even with a wider testing procedure, difficulty remains over how to tackle the effects of overexposure to cadmium.
Some argue that the presence of high cadmium levels should automatically lead to screenings for cancers such as kidney cancer, osteoporosis, and heart conditions.
