A Three-Decade Overview of Cadmium and Lead in Placentas of Postpartum Women: A Review of Evidence from Croatia (1990s–2019)

Toxic heavy metals, including cadmium (Cd) and lead (Pb), can build up in placental tissue or pass through the placental barrier, potentially harming fetal development. Therefore, the placenta can serve as a useful tool for assessing prenatal exposure to these harmful substances. Over the past several decades, Croatia has implemented a range of environmental and public health measures aimed at reducing exposure to Cd and Pb, including ratification of the World Health Organization Framework Convention on Tobacco Control (FCTC), ban on smoking in public places, intensified health education campaigns, and the complete phase-out of leaded gasoline in 2006. As a result, smoking prevalence among women and Pb levels in ambient air have declined substantially. This study reviews and analyzes existing literature on Cd and Pb levels in placental tissue of women in Zagreb, Croatia, in order to evaluate the effectiveness of these health and environmental policies and to identify persistent or emerging risks associated with toxic metal exposure during pregnancy by comparing placental Cd and Pb levels between smokers and nonsmokers across several time periods.