Cadmium can cause acute and chronic illness in humans. The evidence for inclusion of Cd among the elements known to be human carcinogens is insufficient. There is scientifically recognized agreement that renal tubular damage and pulmonary emphysema are the two cardinal pathological lesions associated with excessive Cd exposure. Renal tubular damage is the chronic effect attributed to environmental Cd exposure for the nonoccupationally exposed population. For the nonoccupationally exposed population the primary routes of Cd exposure are through food and tobacco smoke. Most persons are in an approximate Cd balance and tend to accrete Cd until approximately age 50, after which a negative balance ensues.