Prolonged consumption of rice containing elevated cadmium (Cd) levels is a significant health issue particularly in subsistence communities that are dependent on rice produced on-farm. This situation is further exacerbated in areas of known non-ferrous mineralization adjacent to rice-based agricultural systems where the opportunity for contamination of rice and its eventual entry into the food chain is high. In the current study, an assessment of the degree of soil Cd and Zn contamination and associated rice grain Cd contamination downstream of an actively mined zone of Zn mineralization in western Thailand was undertaken. Total soil Cd and Zn concentrations in the rice-based agricultural system investigated ranged from 0.5 to 284 mg kg(-1) and 100 to 8036 mg kg(-1), respectively. Further, the results indicate that the contamination is associated with suspended sediment transported to fields via the irrigation supply. Consequently, the spatial distribution of Cd and Zn is directly related to a field's proximity to primary outlets from in-field irrigation channels and inter-field irrigation flows with 60-100% of the Cd and Zn loading associated with the first three fields in irrigation sequence. Rice grain Cd concentrations in the 524 fields sampled, ranged from 0.05 to 7.7 mg kg(-1). Over 90% of the rice grain samples collected contained Cd at concentrations exceeding the Codex Committee on Food Additives and Contaminants (CCFAC) draft Maximum Permissible Level for rice grain of 0.2 mg Cd kg(-1). In addition, as a function of demographic group, estimated Weekly Intake (WI) values ranged from 20 to 82 mug Cd per kg Body. This poses a significant public health risk to local communities. The results of this study suggest that an irrigation sequence-based field classification technique in combination with strategic soil and rice grain sampling and the estimation of WI values via rice intake alone may be a useful decision support tool to rapidly evaluate potential public health risks in irrigated rice-based agricultural systems receiving Cd contaminated irrigation water. In addition, the proposed technique will facilitate the cost effective strategic targeting of detailed epidemiological studies thus focusing resources to specific 'high risk' areas.