Cadmium poisoning

Japanese: カドミウム中毒 - カドミウムちゅうどく（英語表記）Cadmium poisoning
Cadmium poisoning

What kind of addiction is it?

Cadmium is zinc ( Aen ) or lead ( Accent ) It is a metal obtained as a by-product in the refining of metals such as copper, and has been widely used in recent years. As a result, it causes environmental pollution from mines and waste, which in turn causes contamination of water and agricultural products.

In the past, itai-itai disease occurred in the Jinzu River basin in Toyama Prefecture, and the main cause was believed to be long-term ingestion of cadmium.

How symptoms manifest

Acute poisoning through oral ingestion may cause nausea, vomiting, abdominal pain, and diarrhea, but recovery will occur quickly.

In chronic poisoning, however, the kidneys are affected. Proximal tubule ( Gold and silver coins ) Epithelial cells are damaged, and proteinuria, aminoaciduria, and glycosuria are observed. In addition, calcium is lost, Osteomalacia ( Tips and tricks ) also occurs.

Testing and diagnosis

The earliest observation is detection of β2- microglobulin (normally reabsorbed in the proximal tubules) in a urine test.

According to the "Environmental Health Criteria" (one of the activities of the International Program on Chemical Safety) by the World Health Organization (WHO) and others, it is said that an increase in low molecular weight proteins in the urine can be observed when 140 to 260 μg of cadmium are ingested every day for a long period of time, or a total amount of cadmium of 2,000 mg or more is ingested.

Treatment methods

For acute poisoning due to oral ingestion, gastric lavage and administration of chelating agents such as EDTA (1g per day) are performed. Chelation therapy cannot be used for chronic poisoning. First, stop consuming food and water that contains cadmium.

Food Standards and Standards

The Food Sanitation Act requires that the cadmium concentration in rice grains (brown rice) must be less than 1.0 ppm. In addition, rice grains with cadmium concentrations between 0.4 ppm and 1.0 ppm are not to be distributed for consumption. The International Food Standards have set the cadmium concentration in polished rice at 0.4 ppm or less, as proposed by Japan, and Japan is scheduled to revise the standard to the same level.

The standards for raw water used to manufacture soft drinks and mineral water and the tap water quality standards stipulate that cadmium levels must be below 0.01 mg/L. The raw water standards for mineral water will be abolished and the same standards will be provisionally set as raw material standards (product standards).

Tamio Yoneya

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな中毒か

　カドミウムは、亜鉛(あえん)や鉛(なまり)などを精錬した際の副産物として得られる金属で、近年、広く応用されています。そのため、鉱山や廃棄物による環境汚染によって、水や農産物の汚染を引き起こします。

　過去に、富山県神通川流域においてイタイイタイ病が発生しましたが、カドミウムの長期摂取が主な原因とされています。

症状の現れ方

　経口摂取によって急性中毒が起こると、吐き気・嘔吐、腹痛、下痢が現れますが、すみやかに回復します。

　一方、慢性中毒の場合は腎臓が侵されます。近位尿細管(きんいにょうさいかん)上皮細胞が障害を受け、蛋白尿、アミノ酸尿、糖尿がみられます。また、カルシウムが失われるので、骨軟化症(こつなんかしょう)も起きます。

検査と診断

　尿検査によるβ2­ミクログロブリン（通常は近位尿細管で再吸収される）の検出が、最も早期に観察されます。

　WHO（世界保健機関）などによる「環境保健クライテリア」（国際化学物質安全性計画の活動のひとつ）によると、長期間毎日140～260㎍のカドミウム、または総量として2000㎎以上のカドミウムを摂取すると、尿中低分子蛋白の増加が観察されるといわれています。

治療の方法

　経口摂取による急性中毒では、胃洗浄やEDTA（1日に1g）などのキレート薬の投与が行われます。慢性中毒に対しては、キレート療法は行えません。まず、カドミウムを含む食品や水の摂取をやめることです。

食品の規格基準

　食品衛生法では、米粒（玄米）中のカドミウム濃度は1.0ppm未満とされています。また、0.4ppm以上1.0ppm未満の米粒は、食用として流通しないように措置されています。国際食品規格で精米中のカドミウム濃度が日本が提案した0.4ppm以下と決まりましたが、日本でも同水準に改正される予定です。

　清涼飲料水やミネラルウォーター類を製造する原水の基準および水道水質基準では、カドミウムは0.01㎎／ℓ以下とされています。なお、ミネラルウォーター類の原水基準は削除され、同じ基準が生分規格（製品基準）として、暫定的に設定される予定です。

米谷　民雄

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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