An agreement has been reached between medical unions and the Assurance maladie to reimburse the price of screenings for anyone exposed to cadmium.
The deal between France’s national health insurance system and unions representing medical biologists was announced on Tuesday (April 8) by cardiologist and former health minister Yannick Neuder in a post on X.
Two of the unions involved later confirmed the information to AFP.
The agreement comes after the release last month of a landmark research paper warning of widespread exposure to cadmium in common food stuffs such as bread, pasta, rice and potatoes.
France’s public health watchdog ANSES warned that high levels of the carcinogenic metal are finding their way into common wheat-based foods because of its use in phosphate fertilisers.
The report published by the watchdog highlighted the “worrying situation” among the French population, with an increase in the proportion of people whose dietary exposure exceeds the recommended daily cadmium intake: 23% to 27% for children, and 1.4% to 1.7% for adults.
ANSES (l’Agence Nationale de Sécurité Sanitaire) also pointed to results from other studies which show that contamination levels in France are three or four times higher than in North America and other European countries. ANSES estimates that nearly half of the adult population (47.6%) in France ‘exceeds the toxicological reference values’.
The report, which comes on the back of a two-year study, shows that diet is “by far the main source of exposure, accounting for up to 98% of cadmium intake in the non-smoking population.”
Primary care screenings to be reimbursed
While still health minister, Mr Neuder announced last June that cadmium screening would be reimbursed in primary care practice – it is already reimbursed in hospitals.
In his X post, the former minister said it was “now on the verge of becoming a reality.”
Mr Neuder said that under the new agreement, “private laboratories will soon be able to bill for this screening as part of coverage by Social Security.”
He also raised the issue of “lowering thresholds” on the use of cadmium in fertilisers in France, saying that things were “moving in the right direction.”
“On these issues, we need to move beyond partisan considerations collectively.”
François Blanchecotte, president of the Syndicate of Biologists, told AFP that an agreement had been reached in mid-March to add blood and urine cadmium testing to the list of reimbursed procedures.
The cost of the testing has been set at €27.50, with 60% covered by Assurance maladie and 40% by complementary health insurers, Mr Blanchecotte said.
Under the agreement, if the number of cadmium screening tests nationwide exceeds the volume of lead screenings, Mr Blanchecotte said they would meet again to discuss lowering the price.
The new rules are set to come into force in the next two to three months, once the agreement has been fully approved and published in the Journal officiel, the government’s official publication.
Which foods to cut down on?
Cadmium can be found in everyday foods such as bread, pasta, rice, potatoes, and pastries such as croissants.
As a result, ANSES is warning people to limit the consumption of sweet and savoury wheat-based products, including breakfast cereals, cakes and biscuits. Cadmium can also be found in products labelled Bio (organic).
Instead, people should eat more pulses such as lentils and chickpeas, and alternate food purchases sourced from different regions to avoid repeated exposure.
What is cadmium?
Cadmium is a soft, silvery-coloured metal found naturally in rocks and soils. Human activities such as farming increase its presence in the ground, as well as in the air and water sources.
The application of fertilisers such as phosphate-based mineral fertilisers and livestock manure is a source of cadmium in agricultural soils, explains ANSES, with plants and crops absorbing it through their roots.
The government was urged in the report to "act at the source" by lowering the legal limits for cadmium in phosphate fertilisers, which are used extensively in French farming.
ANSES called for new limits to be introduced "as soon as possible," stating that it was the only way to prevent the metal from finding its way into agricultural soils and from there into the food chain.
Cadmium is also emitted during waste incineration and battery recycling. Tobacco is another source of exposure to cadmium.
What risks are associated with cadmium exposure?
Cadmium exposure can cause or increase the risk of developing lung cancer.
It is also suspected of causing pancreatic, bladder, prostate and breast cancers.
It is a mutagen, meaning that it can permanently change genetic material, and can also cause reproductive problems.
“In the event of prolonged exposure, even at low oral doses, mainly through diet, cadmium causes kidney damage, which may eventually lead to kidney failure and bone fragility, increasing the risk of osteoporosis and fractures,” states ANSES.
“Other adverse effects have also been identified, particularly on neurodevelopment and the cardiovascular system.”
The recent report confirms that long-term adverse effects linked to increased cadmium consumption are “likely to impact a growing proportion of the population if no measures are put in place to reduce exposure.”
