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Toyama Prefecture, Japan
Documented by D. Hagino, reopened private practice
at conclusion of World War II (1946)
"itai itai byo" — "ouch ouch" disease
endemic to the area for several years
~"rheumatic disease" described by Nagasawa et al. 1947
empirical relationship with contaminated water in Jintsu River
drained Kamiska mine (Pb, Zn, Cd)
crop damage from acid mine drainage
"De Re Metallica" -George Agricola. 1556. pg 8. copy.
Clinical Symptoms-diagnostic cases
~5,000 people with recognizable symptoms
primarily post menopausal women with multiple births (Ca2+ metabolism remobilization)
symptoms:
lumbar pains & leg myalgia
pressure on bones causing pain
waddling gait from bone deformation
Sequence
symptoms persist for several years
mild trauma — unable to walk
bed ridden — clinical conditions progress rapidly
multiple fractures resulting from slight trauma, such as coughing
skeletal deformities with marked decrease in body height
hypochromic anemia – workers with chronic Cd poisoning.
Autopsies
[Cd] livers ~50X [Cd] livers in US, UK, & Sweden (not occupationally exposed)
Diagnosis
Estimated daily intake ~600 µg/day
Estimated annual intake ~200 mg/year
Renal tubular dysfunction @ 200 ppm (wet weight)
(possible?) Bone loss by interference with Zn during bone formation
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