BACKGROUND: As research progresses, there is a growing body of evidence indicating that urinary metallothionein (MT) levels may be elevated in individuals exposed to cadmium (Cd). This study aimed to investigate the potential association between urinary MT levels and causes of mortality among residents of the Kakehashi River Basin who have been exposed to Cd. METHOD: The study involved a total of 1,398 men and 1,731 women were conducted between 1981 and 1982, with follow-up until November 2016. The study employed the Cox proportional-hazards model to examine the association between higher urinary MT concentrations and the risk of all-cause or cause-specific mortality within the population. Furthermore, the Fine and Gray competing risks regression model was used to evaluate the links between specific causes of death. RESULTS: The findings revealed that elevated urinary MT concentrations were linked to increased all-cause mortality and higher mortality rates from renal and urinary tract diseases across all participants. Specifically, in men, higher urinary MT levels were associated with elevated all-cause mortality, while in women, increased concentrations were linked to higher mortality from endocrine, nutritional, and metabolic diseases, as well as cardiovascular diseases. Even after adjusting for competing risks, higher urinary MT concentrations were associated with tumor-related mortality in men and continued to be associated with cardiovascular disease mortality in women. CONCLUSIONS In conclusion, the results suggest that women may face a greater risk of adverse health effects due to prolonged exposure to Cd. Urinary MT levels could potentially serve as a biomarker for mortality from these diseases in populations chronically exposed to Cd.
Humans ; Male ; Female ; Cadmium/urine* ; Japan/epidemiology* ; Metallothionein/metabolism* ; Middle Aged ; Cause of Death ; Adult ; Follow-Up Studies ; Aged ; Environmental Exposure/analysis* ; Proportional Hazards Models

  In our hospital the palliative care committee has been held once a month since 2000. In 2007, a total of 1,583 cancer patients were admitted to our hospital orreceived medical care at home. The average length of hospital stay was 24 days. Of the total number of patients, 88.4% was informed that they had cancer. In the latter half of the year it increased to 92.6% because the palliative caretakers gave doctors accurate information on patients' psychology and social background. In October 2007 a questionnaire survey was conducted on those who visited our palliative care section on the occasion of the hospital festival. A total of 46 responded to our survey about the knowledge of palliative care, physician's precise explanation about the illness, image of opioids, desirable place of death and so on. Twenty-eight respondents (60.9%) did not know anything about palliative care. Forty-four (95.7%) wanted precise explanation of cancer. Thirty-four (73.9%) said they had had a night image of opioids after reading the panel. Twenty-eight (60.9%) responded they would rather stay at home until death. We should give healthy people more information about palliative care and opioids.