Sir, the recent publication on cadmium related health effects is very interesting (Swaddiwudhipong et al., 2011). Swaddiwudhipong et al. concluded that ‘‘in persons with prolonged excessive cadmium exposure, toxic health effects may progress even after exposure reduction (Swaddiwudhipong et al., 2011)’’. I have some concerns on this work. First, the laboratory investigations in this works require information on reliability and quality control. Second, it seems that this work is a salami publication to a previous publication in J. Med. Assoc. Thailand (Swaddiwudhipong et al., 2010). It seems that Swaddiwudhipong et al. might have selection bias in recruitment of subjects, which is a subset of a larger sample in the previous report (Swaddiwudhipong et al., 2010), into this work. Finally, the health effects in this study might be or might not be directly relating to cadmium exposure. Other confounding underlying diseases can be the causes of abnormalities. In a previous report by Swaddiwudhipong’s team, it is already confirmed that the