Low-level cadmium exposure in Toyama City and its surroundings in Toyama prefecture, Japan, with references to possible contribution of shellfish intake to increase urinary cadmium levels

Trace Elements in Gluten-free Pastas and Flours from Markets Located in the Las Vegas, Nevada Area

The popularity of gluten-free foods has been increasing across the United States and abroad. A significant reason for this trend involves marketing efforts targeted towards individuals seeking to avoid the consequences of celiac disease or a perceived gluten intolerance. Many gluten-free food products originate in regions of the world where irrigation with metal-contaminated waters is common. Calcium, Fe, Mg, Ti and Zn were detected at various levels across all foods products. Cadmium was detected in 96.8% of U.S. and 54.5% of Asian gluten-free foods with gluten containing foods above reported averages (216 μg kg-1 Cd); as was Co (140μg kg-1) in 48.4 % of U.S., 72.7% of Asian gluten-free foods, and 40% of the gluten containing foods; Cr was in 54.8% of the U.S., 72.5% of Asian gluten-free foods, and 100% of gluten containing food products; while Ca, Fe, Mg, Ti and Zn were greater than 10,000 μg kg-1 with Ba, Cd, Co, Mo, and Ni above reported averages. Finally, trace metals were more commonly detected in the gluten containing foods overall. It was found that trace elements were more commonly found in the gluten containing products; however, none of the higher than expected levels pose a significant health risk to consumers.

Associations between metal concentrations in whole blood and placenta previa and placenta accreta: the Japan Environment and Children's Study (JECS)

Background

Placenta previa and placenta accreta associate with high morbidity and mortality for both mothers and fetus. Metal exposure may have relationships with placenta previa and placenta accreta. This study analyzed the associations between maternal metal (cadmium [Cd], lead [Pb], mercury [Hg], selenium [Se], and manganese [Mn]) concentrations and placenta previa and placenta accreta.

Methods

We recruited 17,414 women with singleton pregnancies. Data from a self-administered questionnaire regarding the first trimester and medical records after delivery were analyzed. Maternal blood samples were collected to measure metal concentrations. The subjects were classified into four quartiles (Q1, Q2, Q3, and Q4) according to metal concentrations.

Results

The odds ratio for placenta previa was significantly higher among subjects with Q4 Cd than those with Q1 Cd. The odds ratio for placenta previa was significantly higher for subjects with Q2 Pb than those with Q1 Pb.

Conclusion

Participants with placenta previa had higher Cd concentrations. However, this study was cross-sectional and lacked important information related to Cd concentration, such as detailed smoking habits and sources of Cd intake. In addition, the subjects in this study comprised ordinary pregnant Japanese women, and it was impossible to observe the relationship between a wide range of Cd exposure and placenta previa. Therefore, epidemiological and experimental studies are warranted to verify the relationship between Cd exposure and pregnancy abnormalities.

Electronic supplementary material

The online version of this article (10.1186/s12199-019-0795-7) contains supplementary material, which is available to authorized users.

Hospital-based screening to detect patients with cadmium nephropathy in cadmium-polluted areas in Japan

BACKGROUND

In health examinations for local inhabitants in cadmium-polluted areas, only healthy people are investigated, suggesting that patients with severe cadmium nephropathy or itai-itai disease may be overlooked. Therefore, we performed hospital-based screening to detect patients with cadmium nephropathy in two core medical institutes in cadmium-polluted areas in Akita prefecture, Japan.

METHODS

Subjects for this screening were selected from patients aged 60 years or older with elevated serum creatinine levels and no definite renal diseases. We enrolled 35 subjects from a hospital in Odate city and 22 from a clinic in Kosaka town. Urinary ß₂-microglobulin and blood and urinary cadmium levels were measured.

RESULTS

The criteria for renal tubular dysfunction and the over-accumulation of cadmium were set as a urinary ß₂-microglobulin level higher than 10,000 μg/g cr. and a blood cadmium level higher than 6 μg/L or urinary cadmium level higher than 10 μg/g cr., respectively. Subjects who fulfilled both criteria were diagnosed with cadmium nephropathy. Six out of 57 patients (10.5% of all subjects) had cadmium nephropathy.

CONCLUSIONS

This hospital-based screening is a very effective strategy for detecting patients with cadmium nephropathy in cadmium-polluted areas, playing a complementary role in health examinations for local inhabitants.

REGISTRATION NUMBER

No. 6, date of registration: 6 June, 2010 (Akita Rosai Hospital), and No. 1117, date of registration: 26 December, 2013 (Akita University).

Association of past diseases with levels of cadmium and tubular dysfunction markers in urine of adult women in non-polluted areas in Japan

BACKGROUND AND OBJECTIVES

Whereas information has been accumulating on the association of anemia and other diseases with cadmium (Cd) burden, histories of past diseases of the examinees are often not taken in account when the results of health examination are evaluated for cadmium exposure-related health effects on general populations. The present study was initiated to examine the possible association of previous diseases with Cd exposure parameters, taking advantage of compiled data on adult women.

METHODS

Data were cited from previous publications of this research group on Cd, α1-microglobulin (α1-MG), β2-microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG) and urine density makers (i.e., creatinine and specific gravity) in the urine of more than 17,000 adult women in non-polluted areas in Japan. Information on previous disease history together with age and smoking habits was obtained by self-administered questionnaires, and 13,031 never-smoking women were selected for the present analyses. To compare the cases with disease history, control cases were randomly selected after stratification by 5 years of age at a ratio of one case to three controls from those with no disease history; summation for all age strata made up the control groups for the disease group in concern. The random sampling to set up control groups was repeated three times in total. The difference between the disease group and control groups was considered valid in cases the difference was statistically significant (p ≦ 0.05), in all three cases after correction (or non-correction) for urine density, and the same results were obtained when compared with the three different control groups.

RESULTS

In the anemia group, Cd-U was higher over corresponding three control groups, although none of α1-MG-U, β2-MG-U or NAG-U showed significant changes. In the diabetes mellitus group, NAG-U was higher than in the controls, but such differences were not observed in Cd-U or β2-MG-U. The elevation in α1-MG-U was not reproducible. In the case of the hypertension group, the elevations in Cd-U, α1-MG-U, and β2-MG-U were observed, but changes in NAG-U could not be confirmed. In the analysis of dose-response relationship, the diabetes mellitus group showed increases in the slope for β2-MG-U and in the intercept for NAG-U. No changes in dose-response relationship were observed in other disease groups as compared with the corresponding control groups.

CONCLUSIONS

Care should be taken in evaluating Cd-related health examination results for those with history of diseases such as hypertension, anemia and diabetes mellitus in particular.

Variation in benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) among general Japanese populations with no anthropogenic exposure to cadmium

BACKGROUND

The use of benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) have been gaining popularity not only in experimental studies but also in epidemiological studies including those on toxicology of cadmium (Cd), a ubiquitous hazardous element in the environment. However, the reproducibility of BMD and BMDL values has seldom been examined.

OBJECTIVES

This study was initiated to determine whether consistent BMD and BMDL values are obtained for similar non-exposed populations, i.e., the populations with no anthropogenic exposure to Cd in a single nation of Japan.

METHODS

Cd (an exposure marker), α(1)-microglobulin (α(1)-MG), β(2)-microglobulin (β(2)-MG) and N-acetyl-β-D-glucosaminidase (NAG) (three effect markers of tubular dysfunction) levels in the urine of adult Japanese women from five previous publications of this study group were examined. Overall, data were available for 17,375 cases (in 16 prefectures) regarding Cd, α(1)-MG and β(2)-MG, and 6,409 cases (in ten prefectures) regarding NAG. The data were used to calculate BMD and BMDL values taking advantage of the hybrid approach (Budtz-Jǿrgensen et al. in Biometrics 57:698-706, 2001). It was possible to calculate BMD and BMDL values for α(1)-MG and β(2)-MG for all of the 16 prefectures with 17,375 cases, whereas the values for NAG were successfully calculated for nine prefectures with 5,843 cases.

RESULTS

The application gave BMD values of 1.92, 2.46 and 2.32 μg Cd/g cr for α(1)-MG, β(2)-MG and NAG, respectively, and BMDL values of 1.83, 2.32 and 2.09 μg Cd/g cr. Large inter-prefectural variations were observed in the BMD and BMDL; there was about fourfold difference both in BMD and in BMDL calculated for α(1)-MG and β(2)-MG in 16 prefectures, and the variation was greater (i.e., by about sevenfold) in BMD and BMDL for NAG in nine prefectures. A survey of relevant literature revealed variation in BMD and BMDL values of similar folds as observed in the present analyses in five studies of Japanese populations. Multiple regression analyses taking BMD or BMDL as a dependent variable and age, CR concentration and Cd concentration as independent variables showed both BMD and BMDL were significantly influenced by Cd concentration in cases of α(1)-MG and β(2)-MG, whereas BMD and BMDL for NAG was by CR.

CONCLUSIONS

Even when the analysis was conducted in a single nation, both BMD and BMDL for the Cd effect markers varied by ca. fourfold when examining α(1)-MG or β(2)-MG and the values varied by ca. sevenfold for NAG among Cd-non-exposed populations. The most influential factors in the study population may include urine density and Cd levels in the urine.

Low cadmium levels in urine of residents in two prefectures where cadmium levels in locally harvested brown rice are higher than in other prefectures in Japan

Recent publications in Japan suggest that Cd in river beds and locally harvested rice tend to be higher in seven prefectures in the north-eastern part on the coast of the Sea of Japan (the high-Cd zone). The present study was initiated to investigate the current level of exposure to Cd and possible health effects among local populations in the zone. Thus, levels of Cd and three tubular dysfunction markers [i.e., α(1)-MG, β(2)-MG, and N-acetyl-β-D-glucosaminidase (NAG)] were examined in urine of local residents (700 and 704 adult women, respectively) in two prefectures (prefecture 1 and prefecture 7), which were located in the north-east (prefecture 1) and south-west ends (prefecture 7) of the high-Cd zone. Urinary Cd levels [e.g., 0.99 and 0.78 μg/l as geometric mean (GM) for observed (non-corrected) values, respectively] in prefecture 1 and prefecture 7 were comparable to the levels in other parts of Japan (All Japan-A; 0.99 μg/l). Correspondingly, GM values for α(1)-MG (2.29 and 1.99 mg/l vs. 2.17 mg/l for All Japan-A) and for β(2)-MG (87 and 80 μg/l vs. 99 μg/l for All Japan-A) were not elevated, and NAG also stayed unchanged (2.89 and 2.87 units/l for prefecture 1 and prefecture 7, respectively). Evaluation in combination with the findings in other five prefectures in the zone suggests that Cd exposure is equal to the national average both in prefecture 1 and in prefecture 7, whereas Cd exposure appeared to be elevated in the central part of the zone. The observation appears to be on line with geographical location of the two prefectures that they are on the two ends of the zone of high natural Cd background.

Associations of low-level urine cadmium with kidney function in lead workers

OBJECTIVES

Low-level cadmium exposure, resulting in, for example, urinary cadmium <2.0 μg/g creatinine, is widespread; recent data suggest nephrotoxicity even at these low levels. Few studies have examined the impact of low-level cadmium exposure in workers who are occupationally exposed to other nephrotoxicants such as lead.

METHODS

We evaluated associations of urine cadmium, a measure of cumulative dose, with four glomerular filtration measures and N-acetyl-β-D-glucosaminidase (NAG) in lead workers. Recent and cumulative lead doses were assessed via blood and tibia lead, respectively.

RESULTS

In 712 lead workers, mean (SD) blood and tibia lead values, urine cadmium values and estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation were 23.1 (14.1) μg/dl, 26.6 (28.9) μg Pb/g bone mineral, 1.15 (0.66) μg/g creatinine and 97.4 (19.2) ml/min/1.73 m(2), respectively. After adjustment for age, sex, body mass index, urine creatinine, smoking, alcohol, education, annual income, diastolic blood pressure, current or former lead worker job status, new or returning study participant, and blood and tibia lead, higher ln-urine cadmium was associated with higher calculated creatinine clearance, eGFR (β = 8.7 ml/min/1.73 m(2); 95% CI 5.4 to 12.1) and ln-NAG but lower serum creatinine.

CONCLUSIONS

Potential explanations for these results include a normal physiological response in which urine cadmium levels reflect renal filtration, the impact of adjustment for urine dilution with creatinine in models of kidney outcomes, and cadmium-related hyperfiltration.

Effects of variations in cadmium and lead levels in river sediments on local foods and body burden of local residents in non-polluted areas in Japan

This study was initiated to examine if variations in the concentrations of cadmium (Cd) and lead (Pb) in water environment may affect metal levels in local foods and body burden of local residents in non-polluted areas in Japan. Two nationwide databases have been made available on concentrations of Cd in locally harvested brown rice and of Cd and Pb in sediments in local river beds. These data were combined with published data on metal concentrations in polished rice, food duplicates, and blood and urine from the residents. Cd in river sediments correlated significantly with those in brown rice, food duplicates, blood, and urine. Cd in food duplicates correlated with Cd in rice. In contrast, Pb concentrations in the river sediments either did not correlate or correlated only weakly with Pb in biological materials or food duplicates. Possible implication of the different behavior between Cd and Pb regarding the intensity of correlation was discussed with reference to the different routes of exposure to the elements. In conclusions, the Cd body burden on local residents in Japan is significantly influenced by Cd levels in water in the general environment, whereas water-borne Pb did not show clear correlation with the Pb body burden.

Dietary exposure and risk assessment of mercury from the Korean total diet study

As a national project, obtaining information on the amount of heavy metal exposure of individuals through food intake is an important basic parameter for risk assessment. This study was conducted to evaluate dietary exposure levels and various risks from mercury (Hg) in Korean foods. In total, 342 samples comprising 114 food items were collected and then cooked prior to analysis. As found by Hg analysis, the mean content of metal in the fish and shellfish group was highest among the 15 Korean food groups. The total daily amount of Hg intake from typical Korean foods was 2.40 microg/person/d. The daily amount (microg/person/d) of Hg intake from each food group was 0.155 in grains and cereals, 0.008 potatoes and starch, 0.005 sugars and sweets, 0.0093 pulses, 0.0018 nuts and seeds, 0.203 vegetables, 0.027 fruits, 0.021 meats and poultry, 0.004 eggs, 1.826 fish and shellfish, 0.022 seaweed, 0.043 milk and dairy products, 0.008 oils and fats, 0.042 beverages, and 0.023 seasonings. The fish and shellfish group contributed most to total dietary intake at 76%. For risk assessment, probable daily intake (PDI) was calculated and compared with provisional tolerable weekly intake (PTWI) of the Joint FAO/WHO Expert Committee on Food Additives (JECFA). The level of Hg intake through fish and shellfish of 0.001 mg/kg body weight bw/wk corresponded to 4.54% of the PTWI value of 0.005 mg/kg bw/wk, the safety standard for JECFA. The level of Hg intake through selected foods from the Food list for Koreans was 0.001 mg/kg bw/wk, corresponding to 5.95% of PTWI value. Therefore, overall intake was at levels below the recommended JECFA levels. The relative gender Hg hazard from Korean foods was 6.26% and 5.5% for males and females, respectively. The relative age Hg hazard from Korean foods was, 8.9% in those 3-6 yr old, 6.7% in those 7-12 yr old, 5.2% in those 13-19 yr old, 5.9% in those 20-29 yr old, 6.3% in those 30-49 yr old, 5.6% in those ages 50-64 yr, and 3.7% in the group of those over 65 yr of age. Relative regional Hg hazard from Korean foods was 6.3% in urban versus 5.5% in rural areas. Thus, the amount of Hg intake through consumption of Korean foods was found to be at a relatively safe level. These data may be thus used to establish safety standards for fish and shellfish consumption.

Biological variations in cadmium, alpha 1-microglobulin, beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase in adult women in a non-polluted area

OBJECTIVES

This study was initiated to investigate the extents of biological variations in cadmium and three common tubular dysfunction marker levels in blood and urine through repeated sampling.

METHODS

A 12-month survey and a 10-week survey were conducted in an area with no known cadmium pollution. In the 12-month survey, five adult women offered urine samples once every month and blood samples once in every season, respectively. In the 10-week survey, 17 adult women gave urine samples once every week. Blood and urine samples were analyzed for cadmium (Cd-B and Cd-U) by graphite-furnace atomic absorption spectrometry, and urine samples were analyzed also for alpha 1-microglobulin (alpha 1-MG-U), beta 2-microglobulin (beta 2-MG-U) and N-acetyl-beta-D-glucosaminidase (NAG-U) by conventional methods, all under strict quality control. The results were subjected to statistical analysis to examine the extents of biological variations through-out the study periods.

RESULTS

Variations in geometric means (GMs) for Cd-B, Cd-U, alpha 1-MG-U, beta 2-MG-U, and NAG-U were all small; the ratio of the largest GM over the lowest GM was 1.1 for Cd-B, 2 for Cd-U and 2 to 3 for alpha 1-MG-U, beta 2-MG-U, and NAG-U in the 12-month survey, and 1.7 at largest for all parameters in the 10-week survey. The within-subject variations during the 12-month or 10-week periods were however large, i.e., more than 4-5-fold difference between the smallest and the largest values obtained for the same subject. Effects of the correction for urine density to reduce the variations were limited. In contrast, within-subject variation in Cd-B was small with a ratio of 1.3.

CONCLUSIONS

Variations in GM values for Cd-U, alpha 1-MG-U, beta 2-MG-U, and NAG-U at different time of sampling are small so that single measurement would be acceptable as far as the evaluation on a group basis is the study objective. Within-subject variations are wide however, the ratio of the largest value over the smallest value being 4-5 or more, irrespective of correction for urine density. Therefore, care should be practiced when evaluation on an individual basis is intended. Very low within-subject variation in Cd-B may suggest the advantage of Cd-B over Cd-U for individual evaluation among general populations if blood sampling is accepted.

Changes in tubular dysfunction marker levels in parallel with the levels of copper, rather than cadmium, in urine of middle-aged women in non-polluted areas

OBJECTIVE

This study was initiated to investigate if and to what extent the elevations in urinary alpha(1)- and beta(2)-microglobulins (alpha(1)-MG and beta(2)-MG, respectively) are specific to Cd nephro-toxicity.

METHODS

Stored urine samples, collected from 1,000 adult women in 11 prefectures all over Japan, were analysed for eight elements (Ca, Cd, Co, Cu, Mg, Mn, Ni and Zn), alpha(1)-MG, beta(2)-MG, creatinine (CR) and specific gravity (SG); the data were cited from previous publications. The levels of eight elements and two MGs were expressed as observed and after correction for CR or SG (1.016). Age, CR and SG distributed normally, whereas two MGs and eight elements distributed log-normally. The 1,000 cases were classified into quartiles (i.e., 250 cases/group) of the lowest to the highest values (Groups A to D) for each element.

RESULTS

alpha(1)-MG and beta(2)-MG increased as a function of Ca, Cd and Cu when corrected for CR, and the two MGs increased in parallel only with Cd and Cu after SG correction. Prevalence of alpha(1)-MG-uria (cut-off values; 5.3 and 6.5 mg/g cr or l) and beta(2)-MG-uria (cut-off values; 300 and 400 microg/g cr or l) was elevated with increasing Ca, Cd and Cu when corrected for CR, but only with Cd and Cu when corrected for SG. Multiple regression analysis of 353 cases of 50-59 year-old women with the eight element levels as independent variables and one of the two MGs as a dependent variable showed that Cu was the most influential element, and both Cd and Zn were less influential.

CONCLUSIONS

Urinary levels of alpha(1)-MG and beta(2)-MG among women with no environmental Cd exposure correlated more closely with Cu levels than Cd levels in urine. The observation suggests that sub-clinical elevation in alpha(1)-MG and beta(2)-MG is not always attributable to nephro-toxicity of Cd, and that consideration on possible effects of other elements such as Cu is necessary.

Reference values for cobalt, copper, manganese, and nickel in urine among women of the general population in Japan

OBJECTIVE

The present study was initiated to establish the reference levels of Co, Cu, Mn, and Ni in urine of women in the general Japanese population.

METHODS

Stored urine samples were subjected to the analysis. The samples were collected from 1,000 adult women all over Japan, who had no occupational exposure to these elements. Co, Cu, Mn, and Ni in urine were analyzed by graphite furnace atomic absorption spectrometry. The concentrations were distributed log-normally, and were presented in terms of geometric mean (GM) and geometric standard deviation, as observed or after correction for creatinine concentration or a specific gravity of urine of 1.016.

RESULTS

The GM values of observed levels (i.e., with no correction for urine density) and of the levels after correction for creatinine (cr) concentration (values in parenthesis) were 0.68 g/l (0.60 microg/g cr) for Co, 13.4 g/l (11.8 g/g cr) for Cu, 0.14 microg/l (0.12 g/g cr) for Mn and 2.1 g/l (1.8 g/g cr) for Ni. There was a life-long age-dependent increase in Cu. Mn levels reached the maximum at 60 to 69 years of ages. In contrast, age-dependency was not substantial in Co and Ni.

CONCLUSIONS

Comparison with values reported in literatures for other areas showed that Co and Ni levels in urine of Japanese women are higher than, Cu level is comparable with, and Mn level is lower than others. The reasons for high Co and Ni levels deserve further study.

Correlation among cadmium levels in river sediment, in rice, in daily foods and in urine of residents in 11 prefectures in Japan

OBJECTIVE

The objective of this study is to examine if overall correlation exists among cadmium levels (Cd) in the general environment, dietary Cd intake, and Cd body burden of local residents.

METHODS

Eleven prefectures in Japan were selected as the areas where large-scale data on Cd levels in urine of adult women (40-49 and 50-59 years of age, respectively) were available to calculate geometric mean (GM) values for each of the prefecture. Other data were cited from published or previously established databases on Cd in the sediments of river bottoms (as a representative of Cd in the environment), Cd in rice for local consumption, and Cd in daily food duplicate samples collected from local women populations, and calculated for GM values for the prefectures. The GM values were subjected to correlation matrix and regression analysis.

RESULTS

Marginally significant (P < 0.10) correlation was detected between Cd in sediment and Cd in rice. Furthermore, correlation of Cd in sediment was significant with Cd in total foods (P < 0.05) and possibly with Cd in urine (P < 0.05-0.10). Importance of data on Cd in rice paddy soil as a missing link is discussed.

CONCLUSIONS

Correlation was demonstrated in the flow of Cd transport from the environment (expressed as Cd contents in river sediments) to humans (in terms of Cd in urine) among general populations in Japan.