The Relationship between the Urinary Cadmium Concentration and Cause-Specific Mortality in Subjects without Severe Renal Damage: A 35-Year Follow-Up Study in a Cadmium-Polluted Area of Japan

Masaru Sakurai, Yasushi Suwazono, Muneko Nishijo, Kazuhiro Nogawa, Yuuka Watanabe, Kazuka Yoneda, Masao Ishizaki, Yuko Morikawa, Teruhiko Kido and Hideaki Nakagawa
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Masaru Sakurai: Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan
Yasushi Suwazono: Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Muneko Nishijo: Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa 920-0293, Japan
Kazuhiro Nogawa: Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Yuuka Watanabe: Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Kazuka Yoneda: Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan
Masao Ishizaki: Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan
Yuko Morikawa: School of Nursing, Kanazawa Medical University, Ishikawa 920-0293, Japan
Teruhiko Kido: School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa 920-0942, Japan
Hideaki Nakagawa: Department of Social and Environmental Medicine, Kanazawa Medical University, Ishikawa 920-0293, Japan

IJERPH, 2021, vol. 18, issue 15, 1-16

Abstract: We evaluated the association between urinary cadmium concentration (uCd, ?g/g Cr) and risk of cause-specific mortality according to urinary ?2-microglobulin (MG) concentration. Participants were 1383 male and 1700 female inhabitants of the Cd-polluted Kakehashi River basin. The uCd and ?2-MG were evaluated in a survey in 1981–1982, where those participants were followed-up over 35 years later. Among the participants with a urinary ?2-MG < 1000, the hazard ratios (HRs) (95% confidence interval) for mortality were significantly higher in those with a uCd of ?10.0 compared with <5.0 for cardiovascular disease [HR 1.92 (1.08–3.40) for men, 1.71 (1.07–2.71) for women], pneumonia or influenza [2.10 (1.10–4.00) for men, 2.22 (1.17–4.19) for women], and digestive diseases [for men; 3.81 (1.49–9.74)]. The uCd was significantly associated with mortality from heart failure in women and digestive diseases in men, after adjustment for other causes of death using the Fine and Gray competing risk regression model. For participants with a urinary ?2-MG of ?1000, no significant association was observed between uCd and any major cause of death. In the absence of kidney damage, Cd may increase the risk of death from cardiovascular disease, pneumonia, and digestive diseases.

Keywords: urinary cadmium; renal tubular dysfunction; mortality; cohort study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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