Nishijo Muneko, Nakagawa Hideaki, Suwazono Yasushi, Nogawa Kazuhiro, Sakurai Masaru, Ishizaki Masao, Kido Teruhiko
Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan.
Health Evaluation Center, Kanazawa Medical University Hospital, Uchinada, Ishikawa 920-0293, Japan.
Toxics. 2018 Apr 6;6(2):23. doi: 10.3390/toxics6020023.
After 26 years, we followed up 7348 participants in a 1979-1984 health screening survey in the Jinzu River basin, the heaviest cadmium-polluted area in Japan. We assessed the associations of cadmium exposure levels and mortality from cancer and renal damage, indicated by records of proteinuria and glucosuria in the original survey. Mortality risks (hazard ratios) were analyzed using the Cox proportional hazards model, stratified by sex, after adjusting for age, smoking status, and hypertension, as indicated in the original survey records. In men, the adjusted hazard ratio for mortality from lung cancer was significantly lower in individuals residing in an area of historically high cadmium exposure and in subjects with a historical record of proteinuria, glucosuria, and glucoproteinuria. The risk of mortality from prostate cancer was borderline higher in cadmium-exposed men. In women, historical cadmium exposure was not associated with an increased risk of mortality from malignant neoplasms, but the adjusted hazard ratios for death from total malignant neoplasms or from renal and uterine cancers were significantly higher in exposed subjects with a historical record of proteinuria, glucosuria, and glucoproteinuria. These findings suggest that women residing in cadmium-polluted areas who exhibit markers of renal damage may be at risk of dying of cancer.
26年后，我们对日本镉污染最严重地区——荏原河流域1979 - 1984年健康筛查调查中的7348名参与者进行了随访。我们评估了镉暴露水平与癌症死亡率以及肾脏损害（通过原始调查中的蛋白尿和糖尿记录来表明）之间的关联。按照原始调查记录所示，在对年龄、吸烟状况和高血压进行调整后，使用Cox比例风险模型按性别分层分析死亡风险（风险比）。在男性中，居住在镉暴露历史较高地区以及有蛋白尿、糖尿和糖蛋白尿历史记录的个体，肺癌死亡的调整后风险比显著较低。镉暴露男性患前列腺癌的死亡风险略高。在女性中，镉暴露历史与恶性肿瘤死亡风险增加无关，但在有蛋白尿、糖尿和糖蛋白尿历史记录的暴露受试者中，总恶性肿瘤或肾癌和子宫癌死亡的调整后风险比显著更高。这些发现表明，居住在镉污染地区且有肾脏损害标志物的女性可能有死于癌症的风险。
