Objective: The effects of cadmium (Cd) on birth weight have been discussed in the scientific literature. However, investigations on the effects of maternal body burden of Cd on the next generation during pregnancy and lactation have been limited. The relation between maternal exposure to Cd and pregnancy outcome or Cd in breast milk in Japanese mothers was investigated. Methods: Cd concentrations in urine and colostrum milk samples of 57 mothers were measured by atomic absorption spectrophotometery. The relations between maternal urinary Cd and infant growth, gestational age at birth, and Cd in breast milk were investigated. Results: The rate of perterm deliveries of mothers with higher urinary Cd (>2 nmol/mmol creatinine (Cr)) was higher than that of mothers with lower urinary Cd (<2 nmol/mmol Cr). The gestational age was significantly correlated with urinary Cd even after adjustment for maternal age. The height and weight of newborn infants of mothers with higher urinary Cd were significantly lower than those of the newborn infants of mothers with lower urinary Cd, but these decreases were ascribed to early delivery induced by Cd. The Cd in breast milk of mothers with higher urinary Cd was significantly higher than that of mothers with lower urinary Cd. A significant positive correlation was found between maternal urinary Cd and Cd in breast milk. Conclusion: Maternal exposure to Cd seems to increase early delivery, which leads to a lower birth weight. Also, the Cd is transferred in part to the next generation through breast milk after birth.

Objectives:To clarify the causes of death of residents with renal tubular dysfunction induced by cadmium (Cd) in the environment.Methods:A 15 year follow up study was performed with the inhabitants living in the Cd polluted Kakehashi River basin in Japan. Standardised mortality ratios (SMRs) for causes of death, classified by ICD-9, were computed using the person-years method to investigate the excess mortality of subjects with urinary β2-MG (microglobulin) ⩾1000 μg/gCr. Mortality risk analysis was performed using Cox’s proportional model to compare mortality between subjects with urinary β2-MG ⩾1000 and <1000 μg/gCr, and to investigate the relationship between the degree of urinary β2-MG and mortality.Results:Excess mortality due to heart failure and cerebral infarction in both sexes, and nephritis and nephrosis in men, was observed among subjects with urinary β2-MG ⩾1000 μg/gCr. Significant increases in mortality risk for cerebral infarction in men and for malignant neoplasms in women with urinary β2-MG ⩾1000 μg/gCr were observed during the first five year observation period. For nephritis and nephrosis, the mortality risks for men and women with urinary β2-MG ⩾1000 μg/gCr significantly increased over the 15 year observation period. The mortality risks for heart failure and cerebral infarction increased in proportion to the increased urinary β2-MG in both sexes. Increased mortality risks for nephritis and nephrosis were identified in the subjects with urinary β2-MG ⩾10000 μg/gCr in both sexes.Conclusion:Renal tubular dysfunction induced by Cd affected the causes of death, and mortality for heart failure, cerebral infarction, and nephritis and nephrosis was increased among inhabitants living in a Cd polluted area in Japan. In women, cancer mortality may have been increased while Cd pollution was ongoing.

Background and Purpose-Evidence of an inverse relationship between serum high-density lipoprotein cholesterol (HDL-C) and the risk of stroke is sparse in Asians and in women. The purpose of this investigation was to examine the relationship in a long-term cohort study of Japanese men and women among whom stroke occurrence is higher than in Western countries. Methods-A prospective cohort study was performed involving 4989 participants (1523 men, 3466 women) 35 to 79 years of age at baseline with Ϸ10 years of follow-up in a rural area of Japan. End points included all stroke incidence and ischemic stroke incidence. Results-During follow-up, 132 participants developed stroke, including 81 ischemic stroke cases. Age-adjusted incidence rates per 10 000 person-years for all stroke in subjects with low HDL-C (Ͻ30 mg/dL [0.78 mmol/L]) were 103.4 in men and 49.3 in women, which were remarkably higher than in subjects with high HDL-C (Ն60 mg/dL [1.56 mmol/L]) (26.4 in men and 15.5 in women). A similar relationship was observed for ischemic stroke. Multivariate-adjusted relative risks for all stroke incidence and ischemic stroke incidence were 2.89 (95% CI, 1.35 to 6.20) and 2.92 (95% CI, 1.17 to 7.32), respectively, for low versus high HDL-C participants. The relationships were independent of sex, age, body mass index, blood pressure, serum total cholesterol, alcohol consumption, and smoking. Conclusions-This 10-year follow-up study of Japanese men and women demonstrated that lower HDL-C levels were related significantly and independently to increased risk of all stroke incidence and ischemic stroke incidence.

No abstract

No abstract

No abstract

Dioxin levels in the breast milk of mothers residing near a contaminated former airbase in Vietnam remain much higher than in unsprayed areas, suggesting high perinatal dioxin exposure for their infants. The present study investigated the association of perinatal dioxin exposure with autistic traits in 153 3-year-old children living in a contaminated area in Vietnam. The children were followed up from birth using the neurodevelopmental battery Bayley-III. The high-2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposed groups (⩾3.5 pg per g fat) showed significantly higher Autism Spectrum Rating Scale (ASRS) scores for both boys and girls than the mild-TCDD exposed groups, without differences in neurodevelopmental scores. In contrast, the high total dioxin-exposed group, indicated by polychlorinated dibenzo-p-dioxins/furans (PCDDs/Fs)-the toxic equivalents (TEQ) levels ⩾ 17.9 pg-TEQ per g fat, had significantly lower neurodevelopmental scores than the mild-exposed group in boys, but there was no difference in the ASRS scores. The present study demonstrates a specific impact of perinatal TCDD on autistic traits in childhood, which is different from the neurotoxicity of total dioxins (PCDDs/Fs).

Background and Purpose-Stroke mortality in Japan has significantly declined during recent decades. To determine the cause of this decrease, we studied the trends in stroke incidence and case fatality within 28 days after stroke in a rural area in Japan. Methods-We used a population-based registry during 1977-1991 in Oyabe, a rural area in the central part of Japan. The average population aged 25 years and older numbered 32 859 persons. Changes in age-standardized stroke incidence rate were calculated and compared between the 3 periods 1977-1981, 1982-1986, and 1987-1991. The 28-day case fatality rate was evaluated and also compared between the 3 periods by onset year. Results-The total number of strokes was 2068. The age-standardized incidence rate of all strokes decreased during the 15-year period, from 605 to 417 per 100 000 in men and from 476 to 329 per 100 000 in women. A marked decline was found during 1977-1986 but was not apparent during 1987-1991. Moreover, there was an increase in the group aged 75 years and older. The 28-day case fatality rates for all strokes improved from 18.0% to 14.2% in men and from 26.8% to 19.1% in women during the observation period. Conclusions-These data indicate that declines in the stroke incidence and the 28-day case fatality have been associated with a marked decrease in stroke-related mortality in Japan. (Stroke. 2000;31:1583-1587.) Key Words: epidemiology Ⅲ incidence Ⅲ Japan Ⅲ stroke outcome S troke is one of the major causes of death and disability in most developed countries. 1 Stroke mortality in Japan had been higher than that in other developed countries 1,2 but has significantly declined during recent decades, and by 1990 stroke-related deaths were only 40% of those of 1965. 3 Measurement of community trends in incidence and case fatality is necessary to determine whether mortality is falling because there are fewer events occurring or because survival after the event has improved. No nationwide study of stroke incidence in Japan is available. By some studies of model districts, a decline in stroke incidence was reported. 4 -8 However, information about secular trends in incidence and case fatality is still inadequate. Additionally, few studies have been conducted on the survival rate of stroke patients in a whole population in Japan.The purpose of our study was to reveal the trends of stroke incidence and survival rate from the data of a communitybased stroke registry in a rural area in Japan. This area is a valuable one in which a population-based registry system of stroke was established and has been maintained for a relatively long period. Subjects and MethodsWe used a population-based registry in the jurisdiction of the Oyabe Public Health Center and determined the trend in stroke incidence during 1977-1991 and acute fatal rate within 28 days after stroke. The jurisdiction of Oyabe Public Health Center is a semirural area located in Toyama prefecture, in the central part of Japan. It comprises the city of Oyabe and the town of Fukuoka and has an area of 19...