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
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Follow-Up
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Men | Women | |||
---|---|---|---|---|
β2-MG (μg/g Cr) | β2-MG (μg/g Cr) | |||
<1000 | ≥1000 | <1000 | ≥1000 | |
Number of participants | 1191 | 192 | 1386 | 314 |
Number of deaths during the follow-up period (%) | 905 (76.0) | 184 (95.8) | 816 (58.9) | 279 (88.9) |
Total person-years of observation | 23,102 | 2142 | 4184 | 31,187 |
Mortality rate (/1000 person-years) | 39.2 | 85.9 | 26.2 | 66.7 |
Mean observed years per person | 19.4 | 11.2 | 22.5 | 13.3 |
Men, n (%) | Women, n (%) | |||
---|---|---|---|---|
β2-MG (μg/g Cr) | β2-MG (μg/g Cr) | |||
<1000 | ≥1000 | <1000 | ≥1000 | |
Malignant neoplasms | 273 (22.9) | 38 (19.8) | 193 (13.9) | 38 (12.1) |
Esophagus | 4 (0.3) | 1 (0.5) | 1 (0.1) | 3 (1.0) |
Stomach | 49 (4.1) | 8 (4.2) | 28 (2.0) | 4 (1.3) |
Colon, rectum | 31 (2.6) | 4 (2.1) | 28 (2.0) | 7 (2.2) |
Liver | 33 (2.8) | 1 (0.5) | 17 (1.2) | 0 (0.0) |
Pancreas | 25 (2.1) | 5 (2.6) | 30 (2.2) | 3 (1.0) |
Lung | 62 (5.2) | 10 (5.2) | 22 (1.6) | 7 (2.2) |
Prostate | 16 (1.3) | 1 (0.5) | 0 (0.0) | 0 (0.0) |
Breast | 0 (0.0) | 0 (0.0) | 8 (0.6) | 3 (1.0) |
Uterus | 0 (0.0) | 0 (0.0) | 2 (0.1) | 0 (0.0) |
Ovary | 0 (0.0) | 0 (0.0) | 6 (0.4) | 1 (0.3) |
Bladder | 6 (0.5) | 2 (1.0) | 3 (0.2) | 2 (0.6) |
Kidney | 4 (0.3) | 0 (0.0) | 1 (0.1) | 0 (0.0) |
Lymphatic or hematopoietic tissue | 13 (1.1) | 4 (2.1) | 16 (1.2) | 1 (0.3) |
Endocrine, nutritional, and metabolic diseases | 14 (1.2) | 2 (1.0) | 18 (1.3) | 7 (2.2) |
Diabetes | 8 (0.7) | 2 (1.0) | 12 (0.9) | 4 (1.3) |
Circulatory disease | 251 (21.1) | 68 (35.4) | 275 (19.8) | 110 (35.0) |
Cardiovascular disease | 124 (10.4) | 31 (16.1) | 141 (10.2) | 61 (19.4) |
Ischemic heart disease | 36 (3.0) | 9 (4.7) | 31 (2.2) | 14 (4.5) |
Heart failure | 66 (5.5) | 15 (7.8) | 84 (6.1) | 38 (12.1) |
Cerebrovascular disease | 113 (9.5) | 32 (16.7) | 128 (9.2) | 46 (14.6) |
Cerebral hemorrhage | 23 (1.9) | 2 (1.0) | 28 (2.0) | 7 (2.2) |
Cerebral infarction | 58 (4.9) | 7 (3.6) | 64 (4.6) | 7 (2.2) |
Subarachnoidal hemorrhage | 4 (0.3) | 0 (0.0) | 14 (1.0) | 2 (0.6) |
Diseases of the respiratory system | 162 (13.6) | 24 (12.5) | 113 (8.2) | 22 (7.0) |
Pneumonia and influenza | 96 (8.1) | 12 (6.3) | 76 (5.5) | 16 (5.1) |
Diseases of the digestive system | 33 (2.8) | 9 (4.7) | 33 (2.4) | 17 (5.4) |
Gastric and duodenal ulcer | 1 (0.1) | 3 (1.6) | 1 (0.1) | 2 (0.6) |
Ileus and intestinal obstruction | 3 (0.3) | 3 (1.6) | 5 (0.4) | 2 (0.6) |
Liver cirrhosis | 11 (0.9) | 2 (1.0) | 8 (0.6) | 3 (1.0) |
Kidney and urinary tract diseases | 22 (1.8) | 13 (6.8) | 20 (1.4) | 15 (4.8) |
Renal disease | 0 (0.0) | 2 (1.0) | 2 (0.1) | 2 (0.6) |
Renal failure | 16 (1.3) | 9 (4.7) | 12 (0.9) | 12 (3.8) |
Senility | 39 (3.3) | 14 (7.3) | 71 (5.1) | 44 (14.0) |
External causes of mortality | 53 (4.4) | 6 (3.1) | 37 (2.7) | 9 (2.9) |
Toxic effects of cadmium | 1 (0.1) | 0 (0.0) | 2 (0.1) | 0 (0.0) |
β2-MG: β2-microglobulin. |
Urinary Cd Concentration (μg/g Cr) | p for Trend | ||||
---|---|---|---|---|---|
<5.0 | 5.0–9.9 | ≥10.0 | |||
Men | |||||
All-cause mortality | n | 550 | 292 | 63 | |
Mortality rate (/1000 PY) | 37.9 | 41.1 | 42.8 | ||
HR (95%CI) | 1.00 (reference) | 1.08 (0.94–1.24) | 1.23 (0.95–1.60) | 0.092 | |
Malignant neoplasm | n | 171 | 88 | 14 | |
Mortality rate (/1000 PY) | 11.8 | 12.4 | 9.5 | ||
HR (95%CI) | 1.00 (reference) | 1.06 (0.82–1.37) | 0.87 (0.51–1.51) | 0.95 | |
RR (95%CI) | 1.00 (reference) | 1.00 (0.78–1.30) | 0.70 (0.41–1.20) | 0.37 | |
Stomach | n | 27 | 20 | 2 | |
Mortality rate (/1000 PY) | 1.9 | 2.8 | 1.4 | ||
HR (95%CI) | 1.00 (reference) | 1.53 (0.86–2.73) | 0.78 (0.19–3.27) | 0.47 | |
RR (95%CI) | 1.00 (reference) | 1.45 (0.82–2.58) | 0.66 (0.16–2.74) | 0.64 | |
Colon, rectum | n | 21 | 7 | 3 | |
Mortality rate (/1000 PY) | 1.4 | 0.99 | 2.0 | ||
HR (95%CI) | 1.00 (reference) | 0.66 (0.28–1.54) | 1.43 (0.43–1.48) | 0.85 | |
RR (95%CI) | 1.00 (reference) | 0.65 (0.28–1.51) | 1.29 (0.39–4.28) | 0.78 | |
Liver | n | 22 | 10 | 1 | |
Mortality rate (/1000 PY) | 1.5 | 1.4 | 0.68 | ||
HR (95%CI) | 1.00 (reference) | 0.96 (0.45–2.02) | 0.49 (0.07–3.65) | 0.58 | |
RR (95%CI) | 1.00 (reference) | 0.90 (0.43–1.90) | 0.41 (0.06–3.02) | 0.40 | |
Pancreas | n | 17 | 6 | 2 | |
Mortality rate (/1000 PY) | 1.2 | 0.84 | 1.4 | ||
HR (95%CI) | 1.00 (reference) | 0.73 (0.29–1.86) | 1.31 (0.30–5.70) | 0.86 | |
RR (95%CI) | 1.00 (reference) | 0.68 (0.27–1.73) | 1.07 (0.25–4.65) | 0.69 | |
Lung | n | 34 | 27 | 1 | |
Mortality rate (/1000 PY) | 2.3 | 3.8 | 0.68 | ||
HR (95%CI) | 1.00 (reference) | 1.61 (0.97–2.67) | 0.31 (0.04–2.28) | 0.62 | |
RR (95%CI) | 1.00 (reference) | 1.57 (0.95–2.61) | 0.26 (0.04–1.89) | 0.81 | |
Prostate | n | 13 | 3 | 0 | |
Mortality rate (/1000 PY) | 0.90 | 0.42 | 0 | ||
HR (95%CI) | 1.00 (reference) | 0.49 (0.14–1.73) | - | 0.42 | |
RR (95%CI) | 1.00 (reference) | 0.45 (0.13–1.57) | 0.08 | ||
Lymphatic or hematopoietic tissue | n | 9 | 3 | 1 | |
Mortality rate (/1000 PY) | 0.62 | 0.42 | 0.68 | ||
HR (95%CI) | 1.00 (reference) | 0.65 (0.18–2.42) | 1.19 (0.15–9.41) | 0.77 | |
RR (95%CI) | 1.00 (reference) | 0.64 (0.17–2.36) | 0.99 (0.13–7.88) | 0.70 | |
Women | |||||
All-cause mortality | n | 228 | 404 | 184 | |
Mortality rate (/1000 PY) | 25.1 | 26.7 | 26.4 | ||
HR (95%CI) | 1.00 (reference) | 1.19 (1.01–1.40) | 1.22 (1.00–1.49) | 0.035 | |
Malignant neoplasm | n | 58 | 93 | 42 | |
Mortality rate (/1000 PY) | 6.4 | 6.1 | 6.0 | ||
HR (95%CI) | 1.00 (reference) | 0.97 (0.70–1.35) | 0.97 (0.65–1.45) | 0.89 | |
RR (95%CI) | 1.00 (reference) | 0.91 (0.66–1.27) | 0.90 (0.61–1.35) | 0.61 | |
Stomach | n | 9 | 11 | 8 | |
Mortality rate (/1000 PY) | 0.99 | 0.73 | 1.15 | ||
HR (95%CI) | 1.00 (reference) | 0.75 (0.31–1.80) | 1.19 (0.46–3.09) | 0.64 | |
RR (95%CI) | 1.00 (reference) | 0.70 (0.29–1.70) | 1.14 (0.44–2.92) | 0.79 | |
Colon, rectum | n | 8 | 15 | 5 | |
Mortality rate (/1000 PY) | 0.88 | 0.99 | 0.72 | ||
HR (95%CI) | 1.00 (reference) | 1.16 (0.49–2.75) | 0.87 (0.28–2.68) | 0.87 | |
RR (95%CI) | 1.00 (reference) | 1.09 (0.46–2.58) | 0.80 (0.26–2.45) | 0.73 | |
Liver | n | 5 | 10 | 2 | |
Mortality rate (/1000 PY) | 0.55 | 0.66 | 0.29 | ||
HR (95%CI) | 1.00 (reference) | 1.20 (0.41–3.51) | 0.53 (0.10–2.75) | 0.55 | |
RR (95%CI) | 1.00 (reference) | 1.14 (0.39–3.33) | 0.50 (0.10–2.57) | 0.43 | |
Pancreas | n | 9 | 13 | 8 | |
Mortality rate (/1000 PY) | 0.99 | 0.86 | 1.15 | ||
HR (95%CI) | 1.00 (reference) | 0.87 (0.37–2.04) | 1.19 (0.46–3.08) | 0.76 | |
RR (95%CI) | 1.00 (reference) | 0.83 (0.36–1.95) | 1.14 (0.44–2.96) | 0.83 | |
Lung | n | 7 | 12 | 3 | |
Mortality rate (/1000 PY) | 0.77 | 0.79 | 0.43 | ||
HR (95%CI) | 1.00 (reference) | 1.11 (0.44–2.85) | 0.62 (0.16–2.43) | 0.58 | |
RR (95%CI) | 1.00 (reference) | 1.00 (0.39–2.53) | 0.56 (0.14–2.22) | 0.43 | |
Lymphatic or hematopoietic tissue | n | 5 | 7 | 4 | |
Mortality rate (/1000 PY) | 0.55 | 0.46 | 0.57 | ||
HR (95%CI) | 1.00 (reference) | 0.85 (0.27–2.67) | 1.05 (0.28–3.93) | 0.97 | |
RR (95%CI) | 1.00 (reference) | 0.81 (0.26–2.56) | 1.03 (0.28–3.81) | 1.00 |
Urinary Cd Concentration (μg/g Cr) | p for Trend | ||||
---|---|---|---|---|---|
<5.0 | 5.0–9.9 | ≥10.0 | |||
Men | |||||
Circulatory disease | n | 158 | 74 | 19 | |
Mortality rate (/1000 PY) | 10.9 | 10.4 | 12.9 | ||
HR (95%CI) | 1.00 (reference) | 0.94 (0.71–1.24) | 1.29 (0.80–2.09) | 0.67 | |
RR (95%CI) | 1.00 (reference) | 0.86 (0.65–1.15) | 1.11 (0.68–1.82) | 0.73 | |
Cardiovascular disease | n | 77 | 33 | 14 | |
Mortality rate (/1000 PY) | 5.3 | 4.6 | 9.5 | ||
HR (95%CI) | 1.00 (reference) | 0.85 (0.56–1.28) | 1.92 (1.08–3.40) | 0.29 | |
RR (95%CI) | 1.00 (reference) | 0.79 (0.52–1.20) | 1.72 (0.96–3.10) | 0.56 | |
Ischemic heart disease | n | 20 | 11 | 5 | |
Mortality rate (/1000 PY) | 1.4 | 1.5 | 3.4 | ||
HR (95%CI) | 1.00 (reference) | 1.11 (0.53–2.31) | 2.64 (0.99–7.04) | 0.13 | |
RR (95%CI) | 1.00 (reference) | 1.06 (0.51–2.21) | 2.27 (0.84–6.05) | 0.24 | |
Heart failure | n | 42 | 19 | 5 | |
Mortality rate (/1000 PY) | 2.9 | 2.7 | 3.4 | ||
HR (95%CI) | 1.00 (reference) | 0.86 (0.50–1.48) | 1.20 (0.47–3.04) | 0.94 | |
RR (95%CI) | 1.00 (reference) | 0.82 (0.48–1.44) | 1.07 (0.42–2.72) | 0.76 | |
Cerebrovascular disease | n | 73 | 35 | 5 | |
Mortality rate (/1000 PY) | 5.0 | 4.9 | 3.4 | ||
HR (95%CI) | 1.00 (reference) | 0.98 (0.65–1.47) | 0.75 (0.30–1.86) | 0.63 | |
RR (95%CI) | 1.00 (reference) | 0.90 (0.60–1.36) | 0.59 (0.24–1.46) | 0.26 | |
Cerebral hemorrhage | n | 13 | 10 | 0 | |
Mortality rate (/1000 PY) | 0.90 | 1.4 | 0 | ||
HR (95%CI) | 1.00 (reference) | 1.51 (0.66–3.44) | - | 0.95 | |
RR (95%CI) | 1.00 (reference) | 1.46 (0.64–3.36) | - | 0.81 | |
Cerebral infarction | n | 42 | 14 | 2 | |
Mortality rate (/1000 PY) | 2.9 | 2.0 | 1.4 | ||
HR (95%CI) | 1.00 (reference) | 0.77 (0.42–1.41) | 0.63 (0.15–2.60) | 0.31 | |
RR (95%CI) | 1.00 (reference) | 0.63 (0.34–1.16) | 0.42 (0.10–1.73) | 0.07 | |
Subarachnoidal hemorrhage | n | 2 | 2 | 0 | |
Mortality rate (/1000 PY) | 0.14 | 0.28 | 0 | ||
HR (95%CI) | - | - | - | ||
RR (95%CI) | |||||
Women | |||||
Circulatory disease | n | 75 | 138 | 62 | |
Mortality rate (/1000 PY) | 8.3 | 9.1 | 8.9 | ||
HR (95%CI) | 1.00 (reference) | 1.30 (0.98–1.73) | 1.33 (0.94–1.86) | 0.08 | |
RR (95%CI) | 1.00 (reference) | 1.17 (0.87–1.57) | 1.20 (0.85–1.71) | 0.28 | |
Cardiovascular disease | n | 37 | 67 | 37 | |
Mortality rate (/1000 PY) | 4.1 | 4.4 | 5.3 | ||
HR (95%CI) | 1.00 (reference) | 1.36 (0.90–2.05) | 1.71 (1.07–2.71) | 0.02 | |
RR (95%CI) | 1.00 (reference) | 1.13 (0.74–1.71) | 1.46 (0.91–2.35) | 0.13 | |
Ischemic heart disease | n | 10 | 15 | 6 | |
Mortality rate (/1000 PY) | 1.10 | 0.99 | 0.86 | ||
HR (95%CI) | 1.00 (reference) | 1.07 (0.48–2.40) | 0.97 (0.35–2.70) | 0.98 | |
RR (95%CI) | 1.00 (reference) | 0.91 (0.41–2.05) | 0.85 (0.31–2.34) | 0.75 | |
Heart failure | n | 20 | 38 | 26 | |
Mortality rate (/1000 PY) | 2.2 | 2.5 | 3.7 | ||
HR (95%CI) | 1.00 (reference) | 1.53 (0.88–2.66) | 2.37 (1.31–4.30) | 0.004 | |
RR (95%CI) | 1.00 (reference) | 1.17 (0.67–2.05) | 1.94 (1.06–3.54) | 0.038 | |
Cerebrovascular disease | n | 34 | 69 | 25 | |
Mortality rate (/1000 PY) | 3.7 | 4.6 | 3.6 | ||
HR (95%CI) | 1.00 (reference) | 1.36 (0.90–2.07) | 1.11 (0.66–1.87) | 0.57 | |
RR (95%CI) | 1.00 (reference) | 1.23 (0.81–1.85) | 1.00 (0.60–1.67) | 0.89 | |
Cerebral hemorrhage | n | 6 | 20 | 2 | |
Mortality rate (/1000 PY) | 0.66 | 1.32 | 0.29 | ||
HR (95%CI) | 1.00 (reference) | 2.05 (0.82–5.11) | 0.46 (0.09–2.26) | 0.64 | |
RR (95%CI) | 1.00 (reference) | 1.98 (0.79–4.94) | 0.44 (0.09–2.18) | 0.47 | |
Cerebral infarction | n | 23 | 28 | 13 | |
Mortality rate (/1000 PY) | 2.5 | 1.8 | 1.9 | ||
HR (95%CI) | 1.00 (reference) | 0.87 (0.50–1.53) | 0.92 (0.46–1.84) | 0.77 | |
RR (95%CI) | 1.00 (reference) | 0.70 (0.40–1.21) | 0.73 (0.37–1.45) | 0.33 | |
Subarachnoidal hemorrhage | n | 2 | 8 | 4 | |
Mortality rate (/1000 PY) | 0.22 | 0.53 | 0.57 | ||
HR (95%CI) | 1.00 (reference) | 2.34 (0.54–11.0) | 2.56 (0.47–14.0) | 0.28 | |
RR (95%CI) | 1.00 (reference) | 2.38 (0.50–11.2) | 2.59 (0.47–14.2) | 0.23 |
Urinary Cadmium Concentration (μg/g Cr) | p for Trend | ||||
---|---|---|---|---|---|
<5.0 | 5.0–9.9 | ≥10.0 | |||
Men | |||||
Endocrine, nutritional, and metabolic diseases | n | 8 | 6 | 0 | |
Mortality rate (/1000 PY) | 0.55 | 0.84 | 0 | ||
HR (95%CI) | 1.00 (reference) | 1.53 (0.53–4.41) | - | 0.98 | |
RR (95%CI) | 1.00 (reference) | 1.50 (0.52–4.32) | - | 0.89 | |
Diseases of the respiratory system | n | 95 | 53 | 14 | |
Mortality rate (/1000 PY) | 6.5 | 7.5 | 9.5 | ||
HR (95%CI) | 1.00 (reference) | 1.14 (0.81–1.59) | 1.63 (0.93–2.85) | 0.11 | |
RR (95%CI) | 1.00 (reference) | 1.08 (0.77–1.52) | 1.36 (0.77–2.42) | 0.32 | |
Pneumonia and influenza | n | 59 | 26 | 11 | |
Mortality rate (/1000 PY) | 4.1 | 3.7 | 7.5 | ||
HR (95%CI) | 1.00 (reference) | 0.92 (0.58–1.46) | 2.10 (1.10–4.00) | 0.19 | |
RR (95%CI) | 1.00 (reference) | 0.83 (0.52–1.33) | 1.73 (0.90–3.31) | 0.51 | |
Diseases of the digestive system | n | 16 | 11 | 6 | |
Mortality rate (/1000 PY) | 1.1 | 1.5 | 4.1 | ||
HR (95%CI) | 1.00 (reference) | 1.40 (0.65–3.03) | 3.81 (1.49–9.74) | 0.014 | |
RR (95%CI) | 1.00 (reference) | 1.37 (0.63–2.96) | 3.52 (1.39–8.95) | 0.028 | |
Liver cirrhosis | n | 5 | 5 | 1 | |
Mortality rate (/1000 PY) | 0.34 | 0.70 | 0.68 | ||
HR (95%CI) | 1.00 (reference) | 2.05 (0.59–7.09) | 1.91 (0.22–16.3) | 0.68 | |
RR (95%CI) | 1.00 (reference) | 2.04 (0.60–6.95) | 1.87 (0.22–15.9) | 0.25 | |
Kidney and urinary tract diseases | n | 14 | 6 | 2 | |
Mortality rate (/1000 PY) | 0.96 | 0.84 | 1.36 | ||
HR (95%CI) | 1.00 (reference) | 0.83 (0.32–2.17) | 1.67 (0.38–7.39) | 0.81 | |
RR (95%CI) | 1.00 (reference) | 0.80 (0.31–2.10) | 1.27 (0.29–5.56) | 0.96 | |
Senility | n | 20 | 17 | 2 | |
Mortality rate (/1000 PY) | 1.4 | 2.4 | 1.4 | ||
HR (95%CI) | 1.00 (reference) | 1.64 (0.85–3.16) | 1.17 (0.27–5.05) | 0.27 | |
RR (95%CI) | 1.00 (reference) | 1.60 (0.83–3.08) | 0.88 (0.20–3.80) | 0.40 | |
External causes of mortality | n | 31 | 18 | 4 | |
Mortality rate (/1000 PY) | 2.1 | 2.5 | 2.7 | ||
HR (95%CI) | 1.00 (reference) | 1.19 (0.67–2.13) | 1.33 (0.47–3.77) | 0.47 | |
RR (95%CI) | 1.00 (reference) | 1.14 (0.64–2.04) | 1.19 (0.41–3.39) | 0.62 | |
Women | |||||
Endocrine, nutritional, and metabolic diseases | n | 2 | 12 | 4 | |
Mortality rate (/1000 PY) | 0.22 | 0.79 | 0.57 | ||
HR (95%CI) | 1.00 (reference) | 3.72 (0.83–16.7) | 2.79 (0.51–15.3) | 0.25 | |
RR (95%CI) | 1.00 (reference) | 3.46 (0.78–15.4) | 2.58 (0.47–14.2) | 0.20 | |
Diseases of the respiratory system | n | 35 | 50 | 28 | |
Mortality rate (/1000 PY) | 3.9 | 3.3 | 4.0 | ||
HR (95%CI) | 1.00 (reference) | 1.06 (0.68–1.65) | 1.37 (0.83–2.27) | 0.24 | |
RR (95%CI) | 1.00 (reference) | 0.82 (0.53–1.27) | 1.08 (0.65–1.78) | 0.87 | |
Pneumonia and influenza | n | 18 | 36 | 22 | |
Mortality rate (/1000 PY) | 2.0 | 2.4 | 3.2 | ||
HR (95%CI) | 1.00 (reference) | 1.55 (0.87–2.77) | 2.22 (1.17–4.19) | 0.014 | |
RR (95%CI) | 1.00 (reference) | 1.17 (0.66–2.05) | 1.68 (0.90–3.13) | 0.11 | |
Diseases of the digestive system | n | 9 | 13 | 11 | |
Mortality rate (/1000 PY) | 0.99 | 0.86 | 1.6 | ||
HR (95%CI) | 1.00 (reference) | 1.02 (0.43–2.41) | 1.95 (0.80–4.74) | 0.15 | |
RR (95%CI) | 1.00 (reference) | 0.87 (0.37–2.03) | 1.71 (0.71–4.10) | 0.28 | |
Liver cirrhosis | n | 2 | 3 | 3 | |
Mortality rate (/1000 PY) | 0.22 | 0.20 | 0.43 | ||
HR (95%CI) | - | - | - | ||
RR (95%CI) | |||||
Kidney and urinary tract diseases | n | 4 | 12 | 4 | |
Mortality rate (/1000 PY) | 0.44 | 0.79 | 0.57 | ||
HR (95%CI) | 1.00 (reference) | 2.07 (0.66–6.52) | 1.56 (0.38–6.33) | 0.49 | |
RR (95%CI) | 1.00 (reference) | 1.75 (0.56–5.44) | 1.33 (0.33–5.41) | 0.61 | |
Senility | n | 22 | 38 | 11 | |
Mortality rate (/1000 PY) | 2.4 | 2.5 | 1.6 | ||
HR (95%CI) | 1.00 (reference) | 1.38 (0.80–2.36) | 0.93 (0.45–1.95) | 0.93 | |
RR (95%CI) | 1.00 (reference) | 1.04 (0.61–1.77) | 0.70 (0.33–1.45) | 0.38 | |
External causes of mortality | n | 7 | 17 | 13 | |
Mortality rate (/1000 PY) | 0.77 | 1.1 | 1.9 | ||
HR (95%CI) | 1.00 (reference) | 1.47 (0.61–3.56) | 2.51 (1.00–6.30) | 0.044 | |
RR (95%CI) | 1.00 (reference) | 1.41 (0.59–3.40) | 2.44 (0.97–6.16) | 0.057 |
Urinary Cd Concentration (μg/g Cr) | p for Trend | ||||
---|---|---|---|---|---|
<5.0 | 5.0–9.9 | ≥10.0 | |||
Men | |||||
Malignant neoplasms | n | 7 | 14 | 17 | |
Mortality rate (/1000 PY) | 12.7 | 18.8 | 20.1 | ||
HR (95%CI) | 1.00 (reference) | 1.22 (0.48–3.10) | 1.30 (0.53–3.17) | 0.58 | |
RR (95%CI) | 1.00 (reference) | 1.34 (0.56–3.21) | 1.55 (0.66–3.64) | 0.31 | |
Endocrine, nutritional, and metabolic diseases | n | 0 | 2 | 0 | |
Mortality rate (/1000 PY) | 0 | 2.7 | 0 | ||
Circulatory disease | n | 19 | 23 | 26 | |
Mortality rate (/1000 PY) | 34.6 | 30.9 | 30.7 | ||
HR (95%CI) | 1.00 (reference) | 0.66 (0.36–1.23) | 0.74 (0.41–1.34) | 0.40 | |
RR (95%CI) | 1.00 (reference) | 0.61 (0.32–1.15) | 0.72 (0.40–1.32) | 0.40 | |
Cardiovascular disease | n | 10 | 7 | 14 | |
Mortality rate (/1000 PY) | 18.2 | 9.4 | 16.5 | ||
HR (95%CI) | 1.00 (reference) | 0.37 (0.14–0.99) | 0.71 (0.31–1.62) | 0.62 | |
RR (95%CI) | 1.00 (reference) | 0.36 (0.13–0.98) | 0.79 (0.35–1.78) | 0.82 | |
Heart failure | n | 4 | 4 | 7 | |
Mortality rate (/1000 PY) | 7.3 | 5.4 | 8.3 | ||
HR (95%CI) | 1.00 (reference) | 0.48 (0.12–1.95) | 0.87 (0.25–3.02) | 0.99 | |
RR (95%CI) | 1.00 (reference) | 0.51 (0.13–2.01) | 1.00 (0.29–3.43) | 0.85 | |
Cerebrovascular disease | n | 9 | 12 | 11 | |
Mortality rate (/1000 PY) | 16.4 | 16.1 | 13.0 | ||
HR (95%CI) | 1.00 (reference) | 0.74 (0.31–1.77) | 0.66 (0.27–1.60) | 0.38 | |
RR (95%CI) | 1.00 (reference) | 0.73 (0.30–1.76) | 0.69 (0.28–1.67) | 0.45 | |
Diseases of the respiratory system | n | 5 | 8 | 11 | |
Mortality rate (/1000 PY) | 9.1 | 10.7 | 13.0 | ||
HR (95%CI) | 1.00 (reference) | 0.99 (0.31–3.13) | 1.25 (0.43–3.65) | 0.63 | |
RR (95%CI) | 1.00 (reference) | 1.02 (0.30–3.43) | 1.38 (0.46–4.17) | 0.52 | |
Pneumonia and influenza | n | 2 | 3 | 7 | |
Mortality rate (/1000 PY) | 3.6 | 4.0 | 8.3 | ||
HR (95%CI) | 1.00 (reference) | 0.87 (0.14–5.30) | 1.90 (0.39–9.27) | 0.30 | |
RR (95%CI) | 1.00 (reference) | 0.99 (0.14–6.98) | 2.26 (0.43–11.7) | 0.25 | |
Diseases of the digestive system | n | 1 | 6 | 2 | |
Mortality rate (/1000 PY) | 1.8 | 8.1 | 2.4 | ||
Kidney and urinary tract diseases | n | 2 | 7 | 4 | |
Mortality rate (/1000 PY) | 3.6 | 9.4 | 4.7 | ||
HR (95%CI) | 1.00 (reference) | 2.00 (0.41–9.83) | 1.02 (0.19–5.68) | 0.84 | |
RR (95%CI) | 1.00 (reference) | 2.41 (0.48–12.2) | 1.24 (0.23–6.64) | 1.00 | |
Senility | n | 3 | 6 | 5 | |
Mortality rate (/1000 PY) | 5.5 | 8.1 | 5.9 | ||
HR (95%CI) | 1.00 (reference) | 0.68 (0.16–2.91) | 0.87 (0.20–3.83) | 0.94 | |
RR (95%CI) | 1.00 (reference) | 0.73 (0.20–2.69) | 0.90 (0.22–3.59) | 0.96 | |
Women | |||||
Malignant neoplasms | n | 1 | 11 | 26 | |
Mortality rate (/1000 PY) | 4.4 | 8.4 | 9.8 | ||
HR (95%CI) | 1.00 (reference) | 1.94 (0.25–15.1) | 2.25 (0.30–16.9) | 0.42 | |
RR (95%CI) | 1.00 (reference) | 2.46 (0.32–19.2) | 2.91 (0.38–22.3) | 0.29 | |
Endocrine, nutritional, and metabolic diseases | n | 0 | 2 | 5 | |
Mortality rate (/1000 PY) | 0 | 1.5 | 1.9 | ||
Circulatory disease | n | 9 | 44 | 57 | |
Mortality rate (/1000 PY) | 39.8 | 33.6 | 21.5 | ||
HR (95%CI) | 1.00 (reference) | 1.02 (0.50–2.10) | 0.75 (0.37–1.53) | 0.16 | |
RR (95%CI) | 1.00 (reference) | 1.10 (0.52–2.29) | 0.74 (0.36–1.52) | 0.083 | |
Cardiovascular disease | n | 4 | 26 | 31 | |
Mortality rate (/1000 PY) | 17.7 | 19.9 | 11.7 | ||
HR (95%CI) | 1.00 (reference) | 1.28 (0.44–3.68) | 0.86 (0.30–2.46) | 0.27 | |
RR (95%CI) | 1.00 (reference) | 1.55 (0.54–4.44) | 0.96 (0.34–2.70) | 0.23 | |
Heart failure | n | 2 | 17 | 19 | |
Mortality rate (/1000 PY) | 8.8 | 13.0 | 7.2 | ||
HR (95%CI) | 1.00 (reference) | 1.76 (0.40–7.65) | 1.16 (0.27–5.01) | 0.52 | |
RR (95%CI) | 1.00 (reference) | 2.09 (0.50–8.78) | 1.28 (0.30–5.34) | 0.47 | |
Cerebrovascular disease | n | 5 | 18 | 23 | |
Mortality rate (/1000 PY) | 22.1 | 13.8 | 8.7 | ||
HR (95%CI) | 1.00 (reference) | 0.81 (0.30–2.18) | 0.59 (0.22–1.55) | 0.19 | |
RR (95%CI) | 1.00 (reference) | 0.81 (0.29–2.24) | 0.57 (0.21–1.53) | 0.16 | |
Diseases of the respiratory system | n | 4 | 5 | 13 | |
Mortality rate (/1000 PY) | 17.7 | 3.8 | 4.9 | ||
HR (95%CI) | 1.00 (reference) | 0.24 (0.07–0.92) | 0.34 (0.11–1.07) | 0.30 | |
RR (95%CI) | 1.00 (reference) | 0.26 (0.07–1.00) | 0.37 (0.11–1.20) | 0.42 | |
Pneumonia and influenza | n | 3 | 4 | 9 | |
Mortality rate (/1000 PY) | 13.3 | 3.1 | 3.4 | ||
HR (95%CI) | 1.00 (reference) | 0.28 (0.06–1.28) | 0.34 (0.09–1.31) | 0.31 | |
RR (95%CI) | 1.00 (reference) | 0.29 (0.07–1.28) | 0.36 (0.10–1.37) | 0.41 | |
Diseases of the digestive system | n | 2 | 7 | 8 | |
Mortality rate (/1000 PY) | 8.8 | 5.3 | 3.0 | ||
HR (95%CI) | 1.00 (reference) | 0.69 (0.14–3.36) | 0.47 (0.10–2.21) | 0.28 | |
RR (95%CI) | 1.00 (reference) | 0.81 (0.17–3.90) | 0.50 (0.11–2.42) | 0.26 | |
Kidney and urinary tract diseases | n | 0 | 4 | 11 | |
Mortality rate (/1000 PY) | 0 | 3.1 | 4.2 | ||
Senility | n | 6 | 11 | 27 | |
Mortality rate (/1000 PY) | 26.5 | 8.4 | 10.2 | ||
HR (95%CI) | 1.00 (reference) | 0.42 (0.15–1.13) | 0.56 (0.23–1.37) | 0.62 | |
RR (95%CI) | 1.00 (reference) | 0.36 (0.13–1.03) | 0.64 (0.26–1.58) | 0.90 |
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Sakurai, M.; Suwazono, Y.; Nishijo, M.; Nogawa, K.; Watanabe, Y.; Yoneda, K.; Ishizaki, M.; Morikawa, Y.; Kido, T.; Nakagawa, H. 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. Int. J. Environ. Res. Public Health 2021, 18, 7747. https://doi.org/10.3390/ijerph18157747
Sakurai M, Suwazono Y, Nishijo M, Nogawa K, Watanabe Y, Yoneda K, Ishizaki M, Morikawa Y, Kido T, Nakagawa H. 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. International Journal of Environmental Research and Public Health. 2021; 18(15):7747. https://doi.org/10.3390/ijerph18157747
Chicago/Turabian StyleSakurai, Masaru, Yasushi Suwazono, Muneko Nishijo, Kazuhiro Nogawa, Yuuka Watanabe, Kazuka Yoneda, Masao Ishizaki, Yuko Morikawa, Teruhiko Kido, and Hideaki Nakagawa. 2021. "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" International Journal of Environmental Research and Public Health 18, no. 15: 7747. https://doi.org/10.3390/ijerph18157747
APA StyleSakurai, M., Suwazono, Y., Nishijo, M., Nogawa, K., Watanabe, Y., Yoneda, K., Ishizaki, M., Morikawa, Y., Kido, T., & Nakagawa, H. (2021). 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. International Journal of Environmental Research and Public Health, 18(15), 7747. https://doi.org/10.3390/ijerph18157747