Relationship among prevalence of patients with Itai-itai disease, prevalence of abnormal urinary findings, and cadmium concentrations in rice of individual hamlets in the Jinzu River basin, Toyama prefecture of Japan

Current Situation and Causes Analysis of Cadmium Pollution in the Kakehashi River Basin

Cadmium (Cd) pollution is a public environmental problem worthy of attention. Long-term exposure to Cd may have adverse effects on human health. Our previous study showed that urinary concentration of Cd (U-Cd) in the residents decreased when Cd-polluted paddy soil was removed. However, from 2008 to 2014, the concentration of U-Cd increased. At the same time, the concentration of urinary β2-microglobulin (β2-MG), which is considered to be an early sign of cadmium-induced renal dysfunction, increased continuously. To find the cause of elevated urinary cadmium (U-Cd) in residents of cadmium-contaminated areas, we measured the concentration of cadmium in the blood (B-Cd) of 29 elderly residents (15 female and 14 male) and edible rice (R-Cd), and correlations between R-Cd, B-Cd, and U-Cd were analyzed in the formerly cadmium-polluted areas (the Kakehashi River basin). In 2016, we collected blood, urine, and rice samples from each participant. The analysis showed a significant correlation between age and B-Cd, U-Cd, and β2-MG. However, there was no significant correlation between R-Cd and U-Cd, B-Cd, or β2-MG concentrations. Although we found a slightly higher level of Cd in rice and urine than reported in 2008, we cannot be sure that it indicates an increased Cd contamination in the Kakehashi River basin because larger studies are required for such a conclusion. The increased urinary Cd concentrations in this area may be because Cd in tissues and organs returns to blood and urine as participants age, which leads to an increasing trend.

Trace elements in Foodstuffs from the Mediterranean Basin-Occurrence, Risk Assessment, Regulations, and Prevention strategies: A review

Trace elements (TEs) are chemical compounds that naturally occur in the earth's crust and in living organisms at low concentrations. Anthropogenic activities can significantly increase the level of TEs in the environment and finally enter the food chain. Toxic TEs like cadmium, lead, arsenic, and mercury have no positive role in a biological system and can cause harmful effects on human health. Ingestion of contaminated food is a typical route of TEs intake by humans. Recent data about the occurrence of TEs in food available in the Mediterranean countries are considered in this review. Analytical methods are also discussed. Furthermore, a discussion of existing international agency regulations will be given. The risk associated with the dietary intake of TEs was estimated by considering consumer exposure and threshold values such as Benchmark dose lower confidence limit and provisional tolerable weekly intake established by the European Food Safety Authority and the Joint FAO/WHO Expert Committee on Food Additives, respectively. Finally, several remediation approaches to minimize TE contamination in foodstuffs were discussed including chemical, biological, biotechnological, and nanotechnological methods. The results of this study proved the occurrence of TEs contamination at high levels in vegetables and fish from some Mediterranean countries. Lead and cadmium are more abundant in foodstuffs than other toxic trace elements. Geographical variations in TE contamination of food crops clearly appear, with a greater risk in developing countries. There is still a need for the regular monitoring of these toxic element levels in food items to ensure consumer protection.

Physiological of biochar and α-Fe2O3 nanoparticles as amendments of Cd accumulation and toxicity toward muskmelon grown in pots

BACKGROUND

Due to the severe cadmium (Cd) pollution of farmland soil, effective measures need to be taken to reduce the Cd content in agricultural products. In this study, we added α-Fe2O3 nanoparticles (NPs) and biochar into Cd-contaminated soil to investigate physiological responses of muskmelon in the whole life cycle.

RESULTS

The results showed that Cd caused adverse impacts on muskmelon (Cucumis melo) plants. For instance, the chlorophyll of muskmelon leaves in the Cd alone treatment was reduced by 8.07-32.34% in the four periods, relative to the control. The treatments with single amendment, α-Fe2O3 NPs or 1% biochar or 5% biochar, significantly reduced the soil available Cd content, but the co-exposure treatments (α-Fe2O3 NPs and biochar) had no impact on the soil available Cd content. All treatments could reduce the Cd content by 47.64-74.60% and increase the Fe content by 15.15-95.27% in fruits as compared to the Cd alone treatment. The KEGG enrichment results of different genes in different treatments indicated that single treatments could regulate genes related to anthocyanin biosynthesis, glutathione metabolism and MAPK signal transduction pathways to reduce the Cd toxicity.

CONCLUSIONS

Overall the combination of biochar and α-Fe2O3 NPs can alleviate Cd toxicity in muskmelon. The present study could provide new insights into Cd remediation in soil using α-Fe2O3 NPs and biochar as amendments.

The adverse impact of cadmium on immune function and lung host defense

Cadmium (Cd) is a transition metal, also referred to as a heavy metal, that is naturally abundant in the earth's crust. It has no known benefit to humans. It is primarily released into our environment through mining and smelting in industrial processes and enters the food chain through uptake by plants from contaminated soil and water. In humans, Cd primarily enters the body through ingestion of foods and cigarette smoke and has an extremely long resident half-life in the body compared to other transition metals. Environmental workplace exposure is also a source through inhalation, although much less common. The principal organs adversely affected by Cd following acute and chronic exposure are the kidneys, bone, vasculature and lung. Cd adversely impacts cell function through changes in gene expression and signal transduction and is recognized as a carcinogen. Despite a substantial body of mechanistic studies in cells and animal models, the overall impact of Cd on innate immune function in humans remains poorly understood. The best evidence is perhaps alteration of reactive oxygen species balance and signaling in cells that regulate innate immunity causing alteration of the inflammatory response that is postulated to contribute to chronic diseases. Epidemiologic studies support this possibility since increased tissue levels in humans are strongly associated with leading chronic diseases including chronic obstructive pulmonary disease (COPD), which will be discussed in depth. Additional studies are required to understand how chronic exposure and accumulation of this leading environmental toxicant in vital organs negatively impact innate immune function and host defense leading to chronic disease in humans.

Potential protective roles of curcumin against cadmium-induced toxicity and oxidative stress

Curcumin, used as a spice and traditional medicine in India, exerts beneficial effects against several diseases, owing to its antioxidant, analgesic, and anti-inflammatory properties. Evidence indicates that curcumin might protect against heavy metal-induced organ toxicity by targeting biological pathways involved in anti-oxidation, anti-inflammation, and anti-tumorigenesis. Curcumin has received considerable attention owing to its therapeutic properties, and the mechanisms underlying some of its actions have been recently investigated. Cadmium (Cd) is a heavy metal found in the environment and used extensively in industries. Chronic Cd exposure induces damage to bones, liver, kidneys, lungs, testes, and the immune and cardiovascular systems. Because of its long half-life, exposure to even low Cd levels might be harmful. Cd-induced toxicity involves the overproduction of reactive oxygen species (ROS), resulting in oxidative stress and damage to essential biomolecules. Dietary antioxidants, such as chelating agents, display the potential to reduce Cd accumulation and metal-induced toxicity. Curcumin scavenges ROS and inhibits oxidative damage, thus resulting in many therapeutic properties. This review aims to address the effectiveness of curcumin against Cd-induced organ toxicity and presents evidence supporting the use of curcumin as a protective antioxidant.

Cadmium, lead and mercury in the blood of psoriatic and vitiligo patients and their possible associations with dietary habits

BACKGROUND

Psoriasis and vitiligo are common, autoimmune skin diseases, their etiology is still unclear. The relationship between environmental factors including diet and various skin diseases has been studied. The general mechanism of cadmium (Cd), lead (Pb) and mercury (Hg) toxicity is through the production of reactive oxygen species which are known to play a role in etiopathogenesis of skin disorders.

OBJECTIVE

The aim of this study was to estimate the influence of dietary habits on the concentration of Cd, Pb and Hg in the peripheral blood samples of patients with psoriasis and vitiligo.

METHODS

In this case-control study, sixty patients with psoriasis, fifty patients with vitiligo and fifty eight healthy people were examined. Blood levels of Cd, Pb and Hg were determined by atomic absorption spectrometry. Food-frequency questionnaires were implemented to collect the dietary data.

RESULTS

Significant differences (p < 0.05) of Cd levels were found between women and men with psoriasis and women and men in the control group. The concentration of Pb was significantly higher among vitiligo patients (50.04 ± 26.54 μg/L) than in healthy controls (36.04 ± 27.35 μg/L). Significantly lower ratio of Se/Pb, Zn/Pb and Cu/Pb was found among psoriatic men. Significantly (p < 0.05) lower values of Se/Hg ratio were observed among vitiligo patients compared to controls.

CONCLUSIONS

The elevated levels of toxic elements could increase oxidative stress which may partly contribute to inflammation in the pathogenesis of psoriasis and vitiligo, which requires further research. Analysis of the influence of frequent consumption of food products on toxic metals concentration showed that the dietary habits have impact on the content of examined toxic metals in the blood of patients. The obtained results may be useful for composing the diet and could be helpful in prevention of psoriasis and vitiligo.

The Role of Natural Antioxidants Against Reactive Oxygen Species Produced by Cadmium Toxicity: A Review

Cadmium (Cd) is a significant ecotoxic heavy metal that adversely affects all biological processes of humans, animals and plants. Exposure to acute and chronic Cd damages many organs in humans and animals (e.g. lung, liver, brain, kidney, and testes). In humans, the Cd concentration at birth is zero, but because the biological half-life is long (about 30 years in humans), the concentration increases with age. The industrial developments of the last century have significantly increased the use of this metal. Especially in developing countries, this consumption is higher. Oxidative stress is the imbalance between antioxidants and oxidants. Cd increases reactive oxygen species (ROS) production and causes oxidative stress. Excess cellular levels of ROS cause damage to proteins, nucleic acids, lipids, membranes and organelles. This damage has been associated with various diseases. These include cancer, hypertension, ischemia/perfusion, cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, insulin resistance, acute respiratory distress syndrome, idiopathic pulmonary fibrosis, asthma, skin diseases, chronic kidney disease, eye diseases, neurodegenerative diseases (amyotrophic lateral sclerosis, Parkinson's disease, Alzheimer's disease, and Huntington disease). Natural antioxidants are popular drugs that are used by the majority of people and have few side effects. Natural antioxidants play an important role in reducing free radicals caused by Cd toxicity. Our goal in this review is to establish the relationship between Cd and oxidative stress and to discuss the role of natural antioxidants in reducing Cd toxicity.

Associations between socioeconomic status and blood cadmium levels in Korea

OBJECTIVES

Although smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship.

METHODS

Data (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants’ dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables.

RESULTS

Participants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels.

CONCLUSIONS

In cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.

Arsenic, selenium, boron, lead, cadmium, copper, and zinc in naturally contaminated rocks: A review of their sources, modes of enrichment, mechanisms of release, and mitigation strategies

Massive and ambitious underground space development projects are being undertaken by many countries around the world to decongest megacities, improve the urban landscapes, upgrade outdated transportation networks, and expand modern railway and road systems. A number of these projects, however, reported that substantial portions of the excavated debris are oftentimes naturally contaminated with hazardous elements, which are readily released in substantial amounts once exposed to the environment. These contaminated excavation debris/spoils/mucks, loosely referred to as "naturally contaminated rocks", contain various hazardous and toxic inorganic elements like arsenic (As), selenium (Se), boron (B), and heavy metals like lead (Pb), cadmium (Cd), copper (Cu), and zinc (Zn). If left untreated, these naturally contaminated rocks could pose very serious problems not only to the surrounding ecosystem but also to people living around the construction and disposal sites. Several incidents of soil and ground/surface water contamination, for example, have been documented due to the false assumption that excavated materials are non-hazardous because they only contain background levels of environmentally regulated elements. Naturally contaminated rocks are hazardous wastes, but they still remain largely unregulated. In fact, standard leaching tests for their evaluation and classification are not yet established. In this review, we summarized all available studies in the literature about the factors and processes crucial in the enrichment, release, and migration of the most commonly encountered hazardous and toxic elements in naturally contaminated geological materials. Although our focus is on naturally contaminated rocks, analogue systems like contaminated soils, sediments, and other hazardous wastes that have been more widely studied will also be discussed. Classification schemes and leaching tests to properly identify and regulate excavated rocks that may potentially pose environmental problems will be examined. Finally, management and mitigation strategies to limit the negative effects of these hazardous wastes are introduced.

Selenium reduces cadmium uptake into rice suspension cells by regulating the expression of lignin synthesis and cadmium-related genes

Although previous studies have indicated that selenium (Se) can reduce cadmium (Cd) uptake into rice, the mechanism at the cellular level has not been reported. Here, rice suspension cells exposed to Cd treatment in the presence or absence of Se were characterized. Compared with treatment with alone, pretreatment with Se increased the proportion of live cells by 83.1%. The levels of reactive oxygen species and mitochondrial membrane potential in the Se-pretreated rice cells were decreased by 86.6% and 76.0%, respectively. In addition, non-invasive micro-test technology suggested that the mean values of Cd²⁺ influx decreased significantly in the Se-pretreated rice cells in a concentration-dependent manner. The results of inductively coupled plasma-mass spectrometry (ICP-MS) showed that 67.4%-78.8% Cd accumulated onto the cell walls of the pretreated-Se rice cells. The addition of Se increased the lignin content and thickness of the cell walls, leading to an improved mechanical force of the cell walls, as determined by atomic force microscopy (AFM). Furthermore, Se pretreatment decreased the expression of genes involved in Cd uptake (OsNramp5) and transport (OsLCT1) but activated the expression of genes involved in Cd transport into vacuoles (OsHMA3) and lignin synthesis (OsPAL, OsCoMT and Os4CL3). These results indicated that supplying Se alleviates Cd toxicity by regulating the express of lignin synthesis and Cd-related genes. The present findings provide new insights on a plausible explanation of the Se-reduced Cd uptake into rice.

Phytosiderophores determine thresholds for iron and zinc accumulation in biofortified rice endosperm while inhibiting the accumulation of cadmium

Nicotianamine (NA) and 2'-deoxymugenic acid (DMA) are metal-chelating ligands that promote the accumulation of metals in rice endosperm, but it is unclear how these phytosiderophores regulate the levels of different metals and limit their accumulation. In this study, transgenic rice plants producing high levels of NA and DMA accumulated up to 4-fold more iron (Fe) and 2-fold more zinc (Zn) in the endosperm compared with wild-type plants. The distribution of Fe and Zn in vegetative tissues suggested that both metals are sequestered as a buffering mechanism to avoid overloading the seeds. The buffering mechanism involves the modulation of genes encoding metal transporters in the roots and aboveground vegetative tissues. As well as accumulating more Fe and Zn, the endosperm of the transgenic plants accumulated less cadmium (Cd), suggesting that higher levels of Fe and Zn competitively inhibit Cd accumulation. Our data show that although there is a strict upper limit for Fe (~22.5 µg g-1 dry weight) and Zn (~84 µg g-1 dry weight) accumulation in the endosperm, the careful selection of strategies to increase endosperm loading with essential minerals can also limit the accumulation of toxic metals such as Cd, thus further increasing the nutritional value of rice.

Cadmium-induced toxicity is rescued by curcumin: A review

Cadmium (Cd) is one of the most common environmental and occupational heavy metals with extended distribution. Exposure to Cd may be associated with several deleterious consequences on the liver, bones, kidneys, lungs, testes, brain, immunological, and cardiovascular systems. Overproduction of reactive oxygen species (ROS) as the main mechanism behind its toxicity causes oxidative stress and subsequent damages to lipids, proteins, and DNA. Therefore, antioxidants along with chelating agents have shown promising outcomes against Cd-induced toxicity. Curcumin with various beneficial effects and medical efficacy has been evaluated for its inhibitory activities against biological impairments caused by Cd. Thus, this article is intended to address the effectiveness of curcumin against toxicity following Cd entry. Curcumin can afford to attenuate lipid peroxidation, glutathione depletion, alterations in antioxidant enzyme, and so forth through scavenging and chelating activities or Nrf2/Keap1/ARE pathway induction. © 2017 BioFactors, 43(5):645-661, 2017.

Toxicity of cadmium and its health risks from leafy vegetable consumption

Cadmium (Cd) is a highly toxic heavy metal and has spread widely in the environment in recent decades. This review summarizes current knowledge about Cd contamination of leafy vegetables, its toxicity, exposure, health risks, and approaches to reducing its toxicity in humans. Leafy vegetable consumption has been identified as a dominant exposure pathway of Cd in the human body. An overview of Cd pollution in leafy vegetables as well as the main sources of Cd is given. Notable estimated daily intakes and health risks of Cd exposure through vegetable consumption for humans are revealed in occupational exposure areas and even in some reference areas. Vegetable consumption is one of the most significant sources of exposure to Cd, particularly in occupational exposure regions. Therefore, numerous approaches have been developed to minimize the accumulation of Cd in leafy vegetables, among which the breeding of Cd pollution-safe cultivars is one of the most effective tools. Furthermore, dietary supplements from leafy vegetables perform positive roles in alleviating Cd toxicity in humans with regard to the effects of essential mineral elements, vitamins and phytochemicals taken into the human body via leafy vegetable consumption.

Cadmium chloride treatment of rats significantly impairs membrane integrity of mesenchymal stem cells via electrolyte imbalance and lipid peroxidation, a possible explanation of Cd related osteoporosis

OBJECTIVES

Bone marrow mesenchymal stem cells (MSCs) play an important role in bone health. Cadmium causes osteoporosis, but the exact mechanisms of its effect on MSCs are not known.

MATERIALS AND METHODS

Rats were treated with cadmium chloride (40 mg/l) in drinking water for six weeks, and then the biochemical and morphological studies on MSCs were carried out as a cellular backup for osteoblasts. Viability and proliferation properties of the cells were evaluated using MTT assay, trypan blue, population doubling number, and colony forming assay. Morphology of the cells and biochemical parameters including activity of metabolic (ALP, AST, and ALT) and antioxidant enzymes (SOD, CAT, and POX) as well as the MDA level (as an indication of lipid peroxidation) were investigated. In addition, intracellular calcium, potassium, and sodium content were estimated. Data was analyzed statistically and P<0.05 was taken as the level of significance.

RESULTS

The results showed a significant reduction in viability and proliferation ability of extracted cells when compared to the controls. In addition, it was revealed that the cadmium treatment of rats caused a significant reduction in nuclear diameter and cytoplasm area. Also, there was significant increase in (ALT) and (AST) activity and intracellular calcium and potassium content but no change was observed with sodium content and ALP activity. The results showed [a] significant reduction in the antioxidant enzyme activity and increases in the MDA level.

CONCLUSION

Based on the present study, reduction of viability and proliferation ability of MSCs might be a causative factor of osteoporosis in industrial areas.

Interactive effects of cadmium and Microcystis aeruginosa (cyanobacterium) on the growth, antioxidative responses and accumulation of cadmium and microcystins in rice seedlings

Cadmium pollution and harmful cyanobacterial blooms are two prominent environmental problems. The interactive effects of cadmium(II) and harmful cyanobacteria on rice seedlings remain unknown. In order to elucidate this issue, the interactive effects of cadmium(II) and Microcystis aeruginosa FACHB905 on the growth and antioxidant responses of rice seedling were investigated in this study, as well as the accumulation of cadmium(II) and microcystins. The results showed that the growth of rice seedlings was inhibited by cadmium(II) stress but promoted by inoculation of M. aeruginosa FACHB905. cadmium(II) stress induced oxidative damage on rice seedlings. Inoculation of M. aeruginosa FACHB905 alleviated the toxicity of cadmium(II) on rice seedlings. The accumulation of cadmium(II) in rice seedlings was decreased by M. aeruginosa FACHB905, but the translocation of cadmium(II) from root to shoot was increased by this cyanobacterium. The accumulation of microcystins in rice seedlings was decreased by cadmium(II). Results presented in this study indicated that cadmium(II) and M. aeruginosa had antagonistic toxicity on rice seedlings. The findings of this study throw new light on evaluation of ecological- and public health-risks for the co-contamination of cadmium(II) and harmful cyanobacteria.

Recommended Rice Intake Levels Based on Average Daily Dose and Urinary Excretion of Cadmium in a Cadmium-Contaminated Area of Northwestern Thailand

This study was performed to investigate the dose-response relationship between average daily cadmium dose (ADCD) from rice and the occurrence of urinary cadmium (U-Cd) in individuals eating that rice. This was a retrospective cohort designed to compare populations from two areas with different levels of cadmium contamination. Five-hundred and sixty-seven participants aged 18 years or older were interviewed to estimate their rice intake, and were assessed for U-Cd. The sources of consumed rice were sampled for cadmium measurement, from which the ADCD was estimated. Binary logistic regression was used to examine the association between ADCD and U-Cd (cut-off point at 2 μg/g creatinine), and a correlation between them was established. The lowest estimate was ADCD = 0.5 μg/kg bw/day [odds ratio (OR) = 1.71; with a 95% confidence interval (CI) 1.02–2.87]. For comparison, the relationship in the contaminated area is expressed by ADCD = 0.7 μg/kg bw/day, OR = 1.84; [95 % CI, 1.06–3.19], while no relationship was found in the non-contaminated area, meaning that the highest level at which this relationship does not exist is ADCD = 0.6 μg/kg bw/day [95% CI, 0.99–2.95]. Rice, as a main staple food, is the most likely source of dietary cadmium. Abstaining from or limiting rice consumption, therefore, will increase the likelihood of maintaining U-Cd within the normal range. As the recommended maximum ADCD is not to exceed 0.6 μg/kg bw/day, the consumption of rice grown in cadmium-contaminated areas should not be more than 246.8 g/day. However, the exclusion of many edible plants grown in the contaminated area from the analysis might result in an estimated ADCD that does not reflect the true level of cadmium exposure among local people.

Phytoremediation of cadmium improved with the high production of endogenous phenolics and free proline contents in Parthenium hysterophorus plant treated exogenously with plant growth regulator and chelating agent

Pot experiments were conducted to evaluate the effects of gibberellic acid (GA3) and ethylenediaminetetraacetic acid (EDTA) on growth parameters, cadmium (Cd) phytoextraction, total phenolics, free proline and chlorophyll content of Parthenium hysterophorus plant grown in Cd-contaminated (100 mg/kg) soil. GA3 was applied as foliar spray (10(-2), 10(-4) and 10(-6) M) while EDTA (40 mg/kg soil) was added to soil as single and in split doses. Results showed decrease in growth parameters due to Cd stress but P. hysterophorus plant demonstrated Cd hyperaccumulator potential based on bioconcentration factor (BCF). Lower concentration of GA3 (10(-6) M) showed highest significant increase in the growth parameters while Cd concentration, accumulation (1.97 ± 0.11 mg/DBM) and bioconcentration (9.75 ± 0.34) was significantly higher in the treatment T11 (GA3 10(-2) + split doses of EDTA). Cadmium significantly increased the root free proline while total phenolic concentration was significantly high in all parts of the plant. Chlorophyll contents were significantly reduced by Cd. GA3 showed significant increase in phenolic and chlorophyll contents in plant. Cadmium accumulation in plant tissues showed positive correlation with free proline (R (2) = 0.527, R (2) = 0.630) and total phenolics (R (2) = 0.554, R (2) = 0.723) in roots and leaves, respectively. Cd contents negatively correlated with biomass, chlorophyll and total water contents. Proline and phenolic contents showed positive correlation with dry biomass of plant. These findings suggest further investigation to study the role of endogenous phenolics and proline in heavy metal phytoremediation.

Cadmium toxicity and treatment

Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium. Detoxification of cadmium with EDTA and other chelators is possible and has been shown to be therapeutically beneficial in humans and animals when done using established protocols.

Association of elevated urinary cadmium with urinary stone, hypercalciuria and renal tubular dysfunction in the population of cadmium-contaminated area

Excessive urinary calcium is the major risk of renal tubular dysfunction and urinary stone formation. We examined the association of elevated urinary cadmium with urinary stones and chronic kidney disease (CKD) in 1,085 study residents of 13 cadmium-contaminated villages. Elevated urinary cadmium was significantly correlated with urinary stone and CKD. Elevated urinary cadmium appeared to increase risk of urinary stone and CKD; ORs and 95 % CIs were 2.73 (1.16, 6.42) and 3.73 (2.50, 5.57) after adjusting for other co-variables. This study revealed that elevated urinary stone and CKD induced by cadmium might increase the risk of urinary stone and CKD.

Association of lifetime cadmium intake or drinking Jinzu River water with the occurrence of renal tubular dysfunction

This study was performed to clarify whether lifetime cadmium (Cd) intake (LCd) calculated from consumption of Cd-polluted rice and other foods, or drinking and/or cooking with Jinzu River water is associated with the occurrence of renal tubular dysfunction and to estimate the threshold level of LCd using a benchmark dose procedure. From participants in the 1967 and 1968 health examinations, the 2607 subjects (1430 men and 1177 women) who were aged 50 years or more, and who had either resided in the current hamlet since birth or moved there from a nonpolluted area and resided for a total of 30 years or longer were chosen as the target population. Based on a multiple logistic regression analysis performed for abnormal urinary findings (proteinuria, glucosuria, or proteinuria with glucosuria) using LCd as the explanatory variable with or without consideration of use of the river water for drinking and/or cooking, it was inferred that both factors of LCd and use of the river water influenced the occurrence of renal tubular dysfunction, with LCd appearing to exert a greater impact compared to drinking/cooking with the river water. Moreover, the threshold values of LCd for proteinuria with glucosuria were estimated to be 2.91 g in men and 1.79 g in women, without adjustment for use of the river water. After adjustment for its use, the values of proteinuria were calculated to be 0.93 g in women. When assuming user/nonuser status of the river water, the threshold level was calculated as 0.75/0.93 g in women. The difference of 0.18 g was interpreted as representing the influence of drinking/cooking with the river water.

Influence of consumption of cadmium-polluted rice or Jinzu River water on occurrence of renal tubular dysfunction and/or Itai-itai disease

The aim of this study was to clarify whether consumption of cadmium (Cd)-polluted rice or Jinzu River water exerted any influence on the occurrence of renal tubular dysfunction and/or Itai-itai disease. From the participants of health examinations conducted in 1967 and 1968, 3,078 subjects who had resided for >30 years in the present hamlet and were aged >50 years were selected as the target population and were divided according to their residence in 55 hamlets. In a multiple regression analysis, the regression coefficients between rice-Cd concentration and prevalence of abnormal urinary findings (proteinuria, glucosuria, or proteinuria with glucosuria) or patients with Itai-itai disease were statistically significant between both sexes. The correlation between the prevalence of users of Jinzu River water and the occurrence of glucosuria in men as well as abnormal urinary findings in women was not statistically significant. We surmise that eating Cd-polluted rice and drinking and/or cooking with Jinzu River water influenced the occurrence of Itai-itai disease. The occurrence of renal tubular dysfunction is likely to have also been influenced by both factors, with eating Cd-polluted rice having a greater impact on the occurrence of renal tubular dysfunction as compared to drinking and/or cooking with Jinzu River water.

Influence of drinking and/or cooking with Jinzu River water on the development of Itai-itai disease

This study was undertaken to estimate the amount of cadmium (Cd) exposure needed for the development of Itai-itai disease and the influence of using Jinzu River water for drinking and/or cooking on its development. The subjects comprised 38 Itai-itai disease patients admitted both for questionnaire survey and medical testing. The period when the patients started to perceive leg/back pain was defined as 'mild disease onset' and that when they experienced the most severe manifestations such as ambulatory disturbance as 'severe disease onset'. In a comparison of non-users/users of river water, mean age and lifetime Cd intake (LCd) estimated from the daily consumption of rice and other foods at the onset of mild or severe disease showed smaller values in the users than non-users. LCd in non-users/users of river water for drinking and/or cooking were estimated as 3.46-3.60 g/2.58-2.63 g at mild disease onset and 4.24-4.44 g/3.50-3.54 g at severe disease onset. A portion of the differences in LCd in non-users/users is attributable to the influence of Cd consumption from the use of river water, although it was suggested that LCd estimated from eating Cd-polluted rice exerted a greater influence on the development of Itai-itai disease than drinking and/or cooking with Cd-polluted river water.

Experimental studies on the bone metabolism of male rats chronically exposed to cadmium intoxication using dual-energy X-ray absorptiometry

Cadmium (Cd) has been identified as the etiologic agent of itai-itai disease. The purpose of this study was to investigate whether chronic Cd exposure affects bone metabolism in a male rat model and to estimate the bone mineral density (BMD) differences in lumbar and femoral bone because of Cd exposure. Six-week-old male Hos Donryu rats were used in this experiment. Cadmium was administered at a dose of 200 ppm to rats in the diet to produce experimental chronic Cd poisoning. Bone mineral density was measured using dual-energy X-ray absorptiometry (DEXA) with a high-resolution scan collimator (0.25 mm diameter) (Hologic QDR-2000). The Cd content in renal tissue reached a critical concentration of 128.42 ± 14.38 μg/g 10 months after the administration of the element (Table 3). The average blood urea nitrogen (BUN) value was increased throughout the period of the experiment, and the serum creatinine value of the experimental group showed an increase after 2 months of Cd administration (0.46 ± 0.09 mg/dL). The concentration of urinary calcium changed in the experimental group after exposure to Cd for 12 months (15.4 ± 0.13 mg/dL). DEXA showed a greater reduction in the bone mineral density of the 5th vertebral body (L5) in rats that had ingested Cd for 4 months (0.359 ± 0.013 g/cm2) than in control rats (0.372 ± 0.012 g/cm2, P < 0.01). On the contrary, the difference in bone mineral content between rats ingesting Cd for 6–8 months and control rats was not significant. However, significant reductions in bone mineral content were again noted in rats that had ingested Cd for 12 months (0.339 ± 0.023 g/cm2) compared with the control group (0.385 ± 0.012 g/cm2, P < 0.01). The bone mineral density of the right femoral bone in control rats was 0.328 ± 0.018 g/cm2 and that in experimental rats was 0.306 ± 0.012 g/cm2, and a meaningful difference was recognized ( P < 0.05). Histological examination of the rats exposed to Cd for 12 months showed that the 5th lumbar vertebral body (L5) exhibited osteomalacia. The results of our studies show that Cd stimulated a loss of bone mineral at an early stage to a great extent in male rats. In the examination of male rats, bone injury and renal functional disorder were encountered simultaneously. This study suggested that osteomalacia was induced by a direct action of Cd on the bone through abnormal calcium homeostasis at an early stage in male rats.

Association of urinary cadmium and myocardial infarction

We conducted a cross-sectional analysis of individuals 45-79 years old in the National Health and Nutrition Examination Survey III (1988-1994) (NHANES III). Myocardial infarction was determined by electrocardiogram (ECG). Our sample included 4912 participants, which when weighted represented 52,234,055 Americans. We performed adjusted logistic regressions with the Framingham risk score, pack-years of smoking, race-ethnicity, and family history of heart attack, and diabetes as covariates. Urinary cadmium >or= 0.88 microg/g creatinine had an odds ratio of 1.86 (95% CI 1.26-2.75) compared to urinary cadmium <0.43 microg/g creatinine. This result supports the hypothesis that cadmium is associated with coronary heart disease. When logistic regressions were done by gender, women, but not men, showed a significant association of urinary cadmium with myocardial infarction. Women with urinary cadmium >or= 0.88 microg/g creatinine had an odds ratio of 1.80 (95% CI 1.06-3.04) compared to urinary cadmium <0.43 microg/g creatinine. When the analysis was restricted to never smokers (N=2187) urinary cadmium >or= 0.88 microg/g creatinine had an odds ratio of 1.85 (95% CI 1.10-3.14) compared to urinary cadmium <0.43 microg/g creatinine.

Investigation of renal damage among residents in the cadmium-polluted Jinzu River basin, based on health examinations in 1967 and 1968

The purpose of this study was to investigate the prevalence of renal disorders in the Jinzu River basin in Toyama Prefecture, Japan where Itai-itai disease was endemic, based on the results of epidemiological studies performed in 1967 and 1968. Furthermore, was there a regional accumulation of the prevalence of abnormal urinary findings in that area? Early morning urine samples were collected from 13 183 subjects (6155 men, 7028 women) who then responded to questionnaires about lifestyle and health. The subject participation rate was 90%. Our findings showed that subjects living in the area of the Jinzu River basin have significantly higher prevalence of abnormal urinary findings compared to subjects living in neighboring river basins and these geographical distributions demonstrated a definite regional accumulation in those areas. The findings of this study verified the regional accumulation of renal disorders in the Jinzu River basin and indicate an association of the occurrence of renal disorders with the water from the Jinzu River.

Gender differences in the disposition and toxicity of metals

There is increasing evidence that health effects of toxic metals differ in prevalence or are manifested differently in men and women. However, the database is small. The present work aims at evaluating gender differences in the health effects of cadmium, nickel, lead, mercury and arsenic. There is a markedly higher prevalence of nickel-induced allergy and hand eczema in women compared to men, mainly due to differences in exposure. Cadmium retention is generally higher in women than in men, and the severe cadmium-induced Itai-itai disease was mainly a woman's disease. Gender differences in susceptibility at lower exposure are uncertain, but recent data indicate that cadmium has estrogenic effects and affect female offspring. Men generally have higher blood lead levels than women. Lead accumulates in bone and increased endogenous lead exposure has been demonstrated during periods of increased bone turnover, particularly in women in pregnancy and menopause. Lead and mercury, in the form of mercury vapor and methylmercury, are easily transferred from the pregnant women to the fetus. Recent data indicate that boys are more susceptible to neurotoxic effects of lead and methylmercury following exposure early in life, while experimental data suggest that females are more susceptible to immunotoxic effects of lead. Certain gender differences in the biotransformation of arsenic by methylation have been reported, and men seem to be more affected by arsenic-related skin effect than women. Experimental studies indicate major gender differences in arsenic-induced cancer. Obviously, research on gender-related differences in health effects caused by metals needs considerable more focus in the future.

Monitoring of cadmium toxicity in a Thai population with high-level environmental exposure

This study evaluated the utility of single and combined measurements of cadmium toxicity markers for surveillance purposes, using a sample of 224 individuals, 30-87 years of age, who were residents of cadmium polluted area in Mae Sot District, Tak Province, Thailand. Urinary cadmium levels excreted by them ranged between 1 and 58 microg/g creatinine with geometric mean of 8.2 microg/g creatinine which was 16-fold greater than the average for the general Thai population of 0.5 microg/g creatinine. The urinary markers evaluated were total protein, albumin, N-acetyl-beta-D-glucosaminidase (NAG), lysozyme, beta2-microglobulin (beta2-MG) and alpha1-microglobulin (alpha1-MG). Among these markers, only NAG showed a positive correlation with urinary cadmium in both male and female subjects with and without disease (r=0.43-0.71). Further, the prevalence rates for urinary NAG above 8 units/g creatinine (NAG-uria) increased with exposure levels in a dose dependent manner (p=0.05) among subjects with disease. In contrast, however, increased prevalence of beta2-MG above 0.4 mg/g creatinine (beta2-MG-uria) was associated with cadmium above 5 microg/g creatinine only in those without disease (POR=10.6 and 7.8 for 6-10 and >10 microg/g creatinine). Prevalence rates for abnormal excretion of all other markers, except albumin, were markedly increased among those having beta2-MG-uria with and without disease (chi2-test, p<or=0.001-0.02). Thus, urinary beta2-MG and NAG should be used together with urinary cadmium in the monitoring of renal toxicity in a population exposed to high-level cadmium coupled with high prevalence of chronic diseases.

Cadmium exposure aggravates mortality more in women than in men

This study aimed to examine whether the mortality associated with exposure to cadmium (Cd) differs between the sexes. Target subjects were 14,604 (6,944 men, 7,660 women) from a list of all residents in the Jinzu River basin in 1967 and 1968. Trend of proportion of the population aged 70 years and older was significantly higher in women in the following decreasing order: non-Jinzu River basin, a region receiving a mixed water supply, and the Jinzu River basin. Sex ratios (proportions of population of men to that of women) in those aged 70 years and older became significantly higher in the same order. This tendency was compatible with the geographical distribution of the prevalence of abnormal urinary findings and Cd concentration in rice which was grown and consumed in the area. This study revealed that Cd exposure aggravates mortality more in women than in men.

Estimation of cumulative cadmium intake causing Itai-itai disease

This study was undertaken to estimate the amount of cadmium (Cd) exposure needed for the development of Itai-itai disease. The investigated subjects comprised 82 Itai-itai disease patients and 11 persons requiring observation who were admitted in 1977 and 1978 for medical testing. With the period when the Itai-itai disease patients started to perceive leg/back pain defined as the 'mild disease onset', and the period when they experienced the most severe manifestations such as ambulatory disturbance and bone fractures defined as 'severe disease onset'. Relative cumulative person number distribution according to life time cadmium intake (LCD) at mild disease onset, severe disease onset, and time of death was depicted as an sigmoid curve and the establishment of probit regression lines was demonstrated between them. LCD at the time when mild disease onset and severe disease onset were recognized in half of the Itai-itai disease patients was 3.1 and 3.8 g, respectively. Furthermore, LCD at the time when mild disease onset and severe disease onset were recognized in 5% of the Itai-itai disease patients was calculated to be 2.6 and 3.3 g, respectively. The present results clarify that Itai-itai disease, the most severe stage of chronic Cd poisoning, occurs at levels of Cd consumption amounting to approximately three-fold of those currently seen in Japan.