Naoko Matsuda-Inoguchi

Urban population exposure to lead and cadmium in east and south-east Asia

Information is still scarce for many Asian countries on general population exposure to two potentially toxic heavy metals of lead (Pb) and cadmium (Cd). The present review on publications from this study group is intended to provide an overview of the non-occupational exposure to Pb and Cd among general populations in east and south-east Asia. During the period of 1991-1998, surveys were conducted in four cities in south-east Asia, five cities in mainland China, and two cities each in Japan and Korea. Peripheral blood, morning spot urine and 24-h food duplicate samples were collected from 20-50 non-smoking adult women in each survey site. The samples were digested by heating in the presence of mineral acids, and then analyzed by inductively-coupled plasma mass spectrometry for the metals in blood (Pb-B and Cd-B), in urine (Pb-U and Cd-U), and in food duplicate (Pb-F and Cd-F). Measures were subjected to statistical analysis with an assumption of log-normal distribution. Pb-B, Pb-U and Pb-F levels varied substantially among the 11 urban sites; GM distributed in ranges of 32-65 microg/l for Pb-B, 2.1-7.5 microg/g cr (creatinine) for Pb-U, and 7-32 microg/day for Pb-F. The same was also the case for Cd exposure parameters, the distribution ranges being 0.5-1.8 microg/l for Cd-B, 1.2-3.1 microg/g cr for Cd-U, and 5-32 microg/day for Cd-F. It appeared that the exposure to Pb and Cd was highest in Kuala Lumpur, and Tokyo + Kyoto, respectively, and lowest in Tokyo + Kyoto and in Manila. Additional surveys in Japan showed that Pb exposure was even lower in rural areas than in Tokyo + Kyoto. When compared with the values reported in the literature, Pb exposure levels among Asian populations appear to be similar to the levels in Europe and in the United States, whereas Cd exposure seems to be higher in Asia than in Europe. The contribution of the dietary route in Pb absorption was variable and was inversely related to the extent of air pollution, whereas Cd uptake was almost exclusively via the dietary route with little contribution of the respiratory route.

Cadmium exposure of women in general populations in Japan during 1991–1997 compared with 1977–1981

Objectives: The Japanese people are known to have high environmental exposure to cadmium (Cd). The present survey was initiated to elucidate possible changes in the intensity of Cd exposure to the population by comparison of the present exposure level with the situation some 15 years ago. Methods: During 1991–1997, 24-h food-duplicate samples, peripheral blood specimens and morning spot urine samples were collected from 588 non smoking women from 27 survey sites in six regions, where food-duplicate and blood samples had also been obtained during 1977–1981 from 399 women. The samples were wet-ashed (after homogenization in the case of food-duplicates), and Cd in the wet-ashed samples was analyzed by inductively-coupled plasma mass spectrometry for Cd intake via foods (Cd-F), Cd concentration in blood (Cd-B) and Cd concentration in urine (Cd-U). The Cd-F and Cd-B were compared with the Cd-F and Cd-B obtained at the same sites in the 1977–1981 survey. Results: The exposure levels during 1991–1997 were such that Cd-F, Cd-B and Cd-Ucr (Cd–U after correction for creatinine concentration) were 25.5 μg/day, 1.90 μg/l and 4.39 μg/g creatinine. Comparison with the 1977–1981 survey results (i.e., 37.5 μg/day for Cd-F and 3.47 μg/l for Cd-B) showed that there were significant reductions (by 32 and 45%) in both parameters respectively during the last 15 years. The dietary route was an almost exclusive (i.e., 99% of the sum of dietary and respiratory uptake) route of Cd uptake, of which Cd in rice (11.7 μg/day) contributed about 40% of the total dietary intake. When compared among survey sites, inter-site variation in dietary Cd intake was primarily due to differences in the intake through boiled rice. Despite the recent reduction in Cd exposure, the current exposure level for Japanese people is still higher than the levels among other rice-dependent populations in Asia as well as in other parts of the world. Comparison was made between the present findings in general populations and observations among known Cd-pollution cases in Japan. Conclusions: Dietary uptake is an almost exclusive route of Cd exposure in the general Japanese population. Boiled rice is a strong determinant of variation in dietary Cd intake. Whereas there was a substantial reduction in Cd exposure among Japanese populations in the last 15 years, the current level is still high when compared internationally.

Cadmium and lead contents in rice and other cereal products in Japan in 1998-2000.

Cereals, especially rice, are a major source of cadmium (Cd) intake for general Japanese populations. In 1998-2000, rice (polished), bread (loaf), noodle and (wheat) flour samples (4113 samples in total) were collected in 63 cities all over Japan, and analyzed for Cd by inductively-coupled plasma mass spectrometry. Another pollutant element of lead (Pb) was determined in parallel. The grand geometric mean for Cd in polished raw (uncooked) rice was 50 ng/g, whereas it was 19 ng/g for flour. The value for Pb was 2-3 ng/g in rice and flour. Calculation for daily Cd intake via rice, taking advantage of the present findings on Cd contents in rice and wheat together with administrative area-specific daily consumptions of rice and wheat showed that Cd via rice is much more than Cd via wheat and that Cd via rice is highest in an area alongside the sea of Japan among the whole country, the observation being in agreement with the results from a previous food duplicate-based field survey.

Possible effects of environmental cadmium exposure on kidney function in the Japanese general population.

Objectives: To examine whether the current level of environmental exposure to cadmium (Cd) is associated with kidney dysfunction among general populations in Japan. Methods: A nationwide survey was conducted in Japan from 1991 to 1997 at 30 survey sites (with no known environmental heavy metal pollution), by the collection of 24-h food-duplicate samples, peripheral blood specimens and morning spot urine samples. In practice, 607 non-smoking adult women provided these samples. After being wet-ashed, the samples were analyzed for Cd in food duplicates (Cd-F), in blood (Cd-B) and urine (Cd-U) by inductively-coupled plasma mass spectrometry (ICP-MS). Urine samples were also analyzed for α1-microglobulin (α1-MG), β2-microglobulin (β2-MG) and retinol-binding protein (RBP), creatinine (cr) and specific gravity. Possible tubular dysfunction in association with Cd exposure was examined by simple, multiple and logistic regression analyses, and comparison among three different Cd-dose groups. To minimize the confounding effects of aging, 367 women from 41 to 60 years old were selected and subjected to the same statistical analyses. Results: The analysis of a whole population of 607 women showed that α1-MG and possibly β2-MG increased as a function of Cd-F, Cd-B and Cd-U. When the analysis was repeated with the selected population of 367 women aged 41–60, the Cd dose-dependent changes in α1-MG and β2-MG became less evident. The distribution of the selected population with α1-MG above two low cut-off values of >4.9 and >8.4 mg/g cr or with β2-MG above the lowest cut-off value of >400 μg/g cr, was biased toward the group with higher Cd-Ucr, but such bias was not significant for both α1-MG and β2-MG when higher cut-off values were employed. No bias was detected with RBP. Logistic regression analysis with α1-MG, β2-MG and RBP (with cut-off values given above) in combination with age, Cd-F, Cd-B and Cd-Ucr gave essentially the same results. Conclusions: The evidence for kidney dysfunction was of borderline significance in the present study population for which geometric mean Cd-F, Cd-B and Cd-U were 24.7 μg/day, 1.76 μg/l, and 3.94 μg/g cr, respectively. The findings might suggest at the same time that the safety margin is small for the Japanese general population regarding environmental Cd exposure.

Non-occupational lead and cadmium exposure of adult women in Bangkok, Thailand

This survey was conducted to examine the extent of the exposure of Bangkok citizens to lead (Pb) and cadmium (Cd), and to evaluate the role of rice as the source of these heavy metals. In practice, 52 non-smoking adult women in an institution in the vicinity of Bangkok, volunteered to offer blood, spot urine, boiled rice and 24-h total food duplicate samples. Samples were wet-ashed, and then analyzed for Pb and Cd by ICP-MS. Geometric means for the levels in blood (Pb-B and Cd-B) and urine (Pb-U and Cd-U as corrected for creatinine concentration), and also for dietary intake (Pb-F and Cd-F) were 32.3 micrograms/l for Pb-B, 0.41 microgram/l for Cd-B, 2.06 micrograms/g creatinine for Pb-U, 1.40 micrograms/g creatinine for Cd-U, 15.1 micrograms/day for Pb-F and 7.1 micrograms/day for Cd-F. Rice contributed 30% and 4% of dietary Cd and Pb burden, respectively. When compared with the counterpart values obtained in four neighboring cities in southeast Asia (i.e. Nanning, Tainan, Manila, and Kuala Lumpur), dietary Pb burden of the women in Bangkok was middle in the order among the values for the five cities. Pb level in the blood was the lowest of the levels among the five cities and Pb in urine was also among the low group. This apparent discrepancy in the order between Pb-B (i.e. the fifth) and Pb-F (the third) might be attributable to recent reduction of Pb levels in the atmosphere in Bangkok. Regarding Cd exposure, Cd levels in blood and urine as well as dietary Cd burden of Bangkok women were either the lowest or the next lowest among those in the five cities.

Background lead and cadmium exposure of adult women in Xian City and two farming villages in Shaanxi Province, China.

The objectives of the present study are: (a) to clarify the current levels of environmental exposure to lead (Pb) and cadmium (Cd) in Shaanxi Province in China in comparison with levels in other parts of mainland China; (b) to examine if there is any urban-rural difference in Pb and Cd exposure; and (c) to quantify the role of cereals as the dietary source of environmental exposure to these metals. For this purpose, triplet surveys on lead and cadmium exposure were conducted in the provincial capital of Xian and two farming villages A and B in Shaanxi Province, China in 1997. The grand geometric mean for lead (Pb) intake via foods (Pb-F), Pb in blood (Pb-B) and Pb in urine as corrected for creatinine concentration (Pb-Ucr) were 30 micrograms/day, 33 micrograms/l and 5 micrograms/g creatinine, respectively, with significant differences among the survey sites, e.g. Pb-B being higher in Xian (43 micrograms/l) than in the two villages (38 and 22 micrograms/l). The counterpart values for cadmium (Cd) intake via foods (Cd-F), Cd in blood (Cd-B) and Cd in urine (Cd-Ucr) were 6.1 micrograms/day, 0.46 microgram/l and 2.8 micrograms/g creatinine, respectively, with no substantial inter-survey site difference. Thus, it was possible to conclude that, from comparison with the values reported in 1990s literature, the exposure of Shaanxi people to Pb and Cd is no higher than, and even possibly lower than, the levels reported for people in other parts of mainland China. The exposure to Cd was almost exclusively from foods, whereas the exposure to air-borne Pb was large enough in Xian to explain higher Pb-B and Pb-Ucr than the level in Village B despite lower Pb-F in Xian than in Village B. Cereals (wheat, rice, maize and foxtail millet) contributed 26 and 84% of dietary Pb and Cd intake, respectively.

Exposure of women in general populations to lead via food and air in East and Southeast Asia

BACKGROUND Despite increasing public concern of the possible health effects of lead (Pb) on general populations, reports on Pb levels in blood (Pb-B) and urine (Pb-B), as well as Pb intake via foods (Pb-F) for many Asian countries are scarce. The present study was initiated to elucidate the extent of non-occupational Pb exposure among general populations in East and Southeast Asia. METHODS In 1991-1997, peripheral blood, morning spot urine and 24-hour food duplicate samples were collected from 20 to 50 non-smoking adult women in each of four cities in Southeast Asia and five cities in Mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively coupled plasma mass spectrometry for Pb-B, Pb-U and Pb-F. Measures after logarithmic conversion were subjected to ANOVA and regression analysis. RESULTS Geometric mean values in cities in East and Southeast Asia were in ranges of 32-65 microg/L for Pb-B, 2.1-7.5 microg/g cr for Pb-Ucr, and 7-32 microg/day for Pb-F. The values for a combination of two cities of Tokyo and Kyoto, Japan (38 microg/L for Pb-B and 9.3 microg/day for Pb-F) appeared to be lower than the values for other Asian cities, and the values for all Japan (thus including both urban and rural areas) were even lower (19 microg/L for Pb-B and 7.7 microg/day for Pb-F). Comparison of Pb uptake via respiratory and dietary routes showed that Pb via dietary route accounted for 15% of the total in Manila where Pb in air was high (ca. 650 ng/m(3)), whereas it was 54% in Tokyo+Kyoto where Pb in air was low (ca. 75 ng/m(3)). CONCLUSIONS When compared internationally, Pb-F and Pb-B in Asia in general are similar to or somewhat higher than the levels in Europe and USA, whereas the levels in Japan are probably lower than the two latter areas. In Asia, Pb-F accounted for 15-54% of all Pb sources, the percentage being variable depending on local conditions especially Pb in atmospheric air.

Background exposure of general women populations in Japan to cadmium in the environment and possible health effects

1. The surveys were conducted in 1990s on 470 non-smoking adult women [with no specific exposure to cadmium (Cd)] in 22 sites in six regions in Japan. 2. It was found that the dietary Cd intake (as a grand geometric mean) was 25.9 microg/day, the Cd level in blood was 2.1 microg/l, and Cd level in urine was 2.1 microg/g creat. 3. Cd in rice contributed about 30% of total dietary Cd intake. 4. There was a substantial reduction in Cd burden when compared with observation in 1980s. 5. Effects on kidney functions were essentially negative when evaluated in terms of beta2-microglobulin (beta2-MG), but might be positive when alpha1-microglobulin (alpha1-MG) was evaluated; further studies are apparently necessary. 6. No effects on liver functions were detected.

Correlation between concentration in urine and in blood of cadmium and lead among women in Asia

The objectives of the present study are to examine if there exists a quantitative relationship between lead in urine (Pb-U) and that in blood (Pb-B), and also between cadmium in urine (Cd-U) and that in blood (Cd-B) among the general populations who are environmentally (and not occupationally) exposed to these elements at various levels. For this purpose, peripheral blood and morning spot urine samples were collected in 1991-1998 from approximately 50 non-smoking adult women each in four cities in south-east Asia and five cities in mainland China, and two cities each in Japan and Korea. The samples were wet-ashed and then analyzed by inductively-coupled plasma mass spectrometry for Pb-B, Cd-B, Pb-U and Cd-U. Measured values were subjected to analysis to detect possible correlation between the pairs of parameters. A significant correlation between Pb-B and Pb-U was observed when the intensity of Pb exposure (as expressed by Pb-B) was relatively high so that the correlation was significant in all cases studied when Pb-B level was, e.g. 50 microg/l or above. It was also observed that the correlation between Cd-B and Cd-U was significant when Cd-B was, e.g. > 1 microg/l. Thus, it is possible to deduce that, in environmental health, Pb-B and Cd-U levels can be estimated on a group basis from Pb-U and Cd-B, respectively, when Pb and Cd exposure levels are relatively high, e.g. with Pb-B and Cd-B of > 50 microg/l and > 1 microg/l.

Estimates of mineral intakes using food composition tables vs measures by inductively-coupled plasma mass spectrometry: Part 1. calcium, phosphorus and iron

Objectives: To examine the accuracy of food composition table (FCT)-based estimation of dietary nutrient element intake in reference to the instrumental measurement by inductively-coupled plasma mass spectrometry (ICP-MS).Design: Cross-sectional study.Setting: Communities.Subjects: 884 adult non-smoking women in 23 study sites in 6 areas in Asia (i.e. China (Mainland), China (Taiwan), Korea, Japan, Malaysia and the Philippines.Methods: 24-hour food duplicate samples foods offered by the women were subjected (1) to the estimation of daily dietary intake of calcium (Ca), phosphorus (P) and iron (Fe), using 6 types of national FCTs one for each area, and (2) to ICP-MS analysis for the measurement of the same elements.Results: Comparison of the estimated values (E) with corresponding measured values (M) in terms of the mean (E)/(M) ratio for each area showed that the ratio was various among the 6 areas studied. Ca showed smallest deviation (69 to 165%) from the agreement (100%), which was followed by P (113 to 306%), whereas Fe showed the largest deviation (124 to 368%).Conclusions: Caution should be exercised in using FCTs for estimation of dietary Fe intake. The wide variation was not due to the use of the FCT established for each area, because the inter-study site variation within one area was as large as the inter-area variation.Sponsorship: Dai-ichi Mutual Life Insurance, Japan; Iijima Memorial Foundation for the Promotion of Food Science and Technology, Japan; the Ministry of Education, Science, Sports and Culture and the Ministry of Health and Welfare, the Government of Japan.