{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:40:29Z","timestamp":1783431629815,"version":"3.54.6"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T00:00:00Z","timestamp":1579824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Chronic heavy metal exposure and the health hazards that ensue are important public-health problems. We highlight the occurrence of hypophosphataemic osteomalacia due to chronic cadmium exposure in the silver industry in India. Three silversmiths presented similarly with clinical, biochemical and radiological evidence of hypophosphataemic osteomalacia. Considering their occupation, their blood samples were screened for heavy metals and were found to have toxic levels of cadmium. They were initiated on neutral phosphate and calcitriol. On follow-up, they reported significant reduction in severity of symptoms. It is essential to maintain a high index of suspicion in diagnosing this condition. A thorough knowledge of the occupational background of patients, as well as ambient conditions at the workplace is of utmost importance in contemplating the possibility of such rare occurrences. Moreover, regulatory agencies and policy makers ought to survey the silver industry and ensure that the metals used are within permissible safe limits of exposure.<\/jats:p>","DOI":"10.1093\/occmed\/kqaa001","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T20:09:22Z","timestamp":1579291762000},"page":"207-210","source":"Crossref","is-referenced-by-count":7,"title":["Hypophosphataemic osteomalacia due to cadmium exposure in the silver industry"],"prefix":"10.1093","volume":"70","author":[{"given":"J","family":"Paul","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K E","family":"Cherian","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T V","family":"Paul","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"2020052710595353500_CIT0001","doi-asserted-by":"crossref","first-page":"29592","DOI":"10.3390\/ijms161226183","article-title":"Heavy metals and human health: mechanistic insight into toxicity and counter defense system of antioxidants","volume":"16","author":"Jan","year":"2015","journal-title":"Int J Mol Sci"},{"key":"2020052710595353500_CIT0002","doi-asserted-by":"crossref","first-page":"60","DOI":"10.2478\/intox-2014-0009","article-title":"Toxicity, mechanism and health effects of some heavy metals","volume":"7","author":"Jaishankar","year":"2014","journal-title":"Interdiscip Toxicol"},{"key":"2020052710595353500_CIT0003","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/BF03161007","article-title":"Cadmium exposure: health hazards of silver cottage industry in developing countries","volume":"2","author":"Sethi","year":"2006","journal-title":"J Med Toxicol"},{"key":"2020052710595353500_CIT0004","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1265\/jjh.67.455","article-title":"[Itai-itai disease: cadmium-induced renal tubular osteomalacia]","volume":"67","author":"Aoshima","year":"2012","journal-title":"Nihon Eiseigaku Zasshi"},{"key":"2020052710595353500_CIT0005","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.taap.2009.04.020","article-title":"Current status of cadmium as an environmental health problem","volume":"238","author":"J\u00e4rup","year":"2009","journal-title":"Toxicol Appl Pharmacol"},{"key":"2020052710595353500_CIT0006","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s11883-013-0356-2","article-title":"Cadmium exposure and clinical cardiovascular disease: a systematic review","volume":"15","author":"Tellez-Plaza","year":"2013","journal-title":"Curr Atheroscler Rep"},{"key":"2020052710595353500_CIT0007","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1289\/ehp.8763","article-title":"Cadmium-induced effects on bone in a population-based study of women","volume":"114","author":"Akesson","year":"2006","journal-title":"Environ Health Perspect"},{"key":"2020052710595353500_CIT0008","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s12011-011-9256-x","article-title":"Cadmium stimulates the osteoclastic differentiation of RAW264.7 cells in presence of osteoblasts","volume":"146","author":"Chen","year":"2012","journal-title":"Biol Trace Elem Res"},{"key":"2020052710595353500_CIT0009","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.etap.2009.04.010","article-title":"Effects of cadmium on osteoblasts and osteoclasts in vitro","volume":"28","author":"Chen","year":"2009","journal-title":"Environ Toxicol Pharmacol"},{"key":"2020052710595353500_CIT0010","first-page":"7","article-title":"Cadmium: a possible etiological factor in peripheral polyneuropathy","volume":"20","author":"Viaene","year":"1999","journal-title":"Neurotoxicology"},{"key":"2020052710595353500_CIT0011","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.bbapap.2016.09.008","article-title":"Nickel impact on human health: An intrinsic disorder perspective","volume":"1864","author":"Zambelli","year":"2016","journal-title":"Biochim Biophys Acta"},{"key":"2020052710595353500_CIT0012","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0142-9612(97)00149-X","article-title":"In vitro biomineralization by osteoblast-like cells. 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