Characteristics of smoking cessation in former smokers in a rural area of Japan

Japan has a relatively high prevalence of smoking in men. Despite the importance of behavioral patterns on successful smoking cessation, only limited information is available in Japan. The present study collected data from former smokers in a rural community in Japan in order to identify health status at the time of cessation, predominant motivating factors, and the role of smoking cessation aids in individuals who successfully stopped smoking. This cross-sectional study collected data using a self-reported questionnaire from 149 randomly-selected former smokers [119 men and 30 women, aged 20-79 years] who were residents of Nanao, Ishikawa Prefecture, Japan. Of the male participants, 14.3% quit due to serious personal health problems, including cardiovascular disease, cancer, or respiratory tract disease, while 20.8% of former smokers experienced mild personal health problems or were pregnant at the time of cessation. An approximately equal number stopped smoking due to fear of illness in the absence of immediate health concerns. Compared to personal health motivations, a smaller number of male smokers quit due to anti-smoking social pressure or expense. We also observed a marked increase in former smokers who quit for these reasons in recent years. Smoking lost its appeal in 19.3% of male and 10.0% of female smokers. Approximately, 95% of quitters did not utilize health professional counseling or pharmacological therapy. Personal health concerns in former smokers in Nanao, Japan were the predominant motivation for quitting smoking, with the vast majority of former smokers achieving successful smoking cessation by themselves

Relationship between urinary cadmium and mortality in habitants of a cadmium-polluted area: a 22-year follow-up study in Japan / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies have suggested that the exposure to cadmium (Cd) increased mortalities from renal diseases, cardiovascular diseases and malignant neoplasm, including lung cancer and prostate cancer among inhabitants living in Cd-polluted areas and factory workers. This study aimed to assess the influence of environmental exposure to Cd on long term outcome of inhabitants living in an area polluted by Cd.</p><p><b>METHODS</b>A 22-year follow-up study was conducted with 3119 inhabitants (1403 men and 1716 women) living in the Cd polluted Kakehashi River basin in Japan. The subjects were divided into 4 groups according to the amount of urinary Cd level (< 3.0 µg/g creatinine (Cr), 3.0 - 4.9 µg/g Cr, 5.0 - 9.9 µg/g Cr, and ≥ 10.0 µg/g Cr). Mortality was calculated by the person-years method. Hazards ratios (HR) and 95% confidence intervals (CI) were assessed by the Cox's proportional hazard model.</p><p><b>RESULTS</b>Compared with urinary Cd < 3.0 µg/g Cr group, the HR of 5.0 - 9.9 µg/g Cr and ≥ 10.0 µg/g Cr groups were significantly increased after adjustment for age in both sexes: 1.24 (95%CI 1.01 - 1.51) and 1.48 (95%CI 1.17 - 1.90) for men; 1.64 (95%CI 1.17 - 2.28) and 1.78 (95%CI 1.27 - 2.50) for women. The most frequent cause of death was malignant neoplasm in men and cardiovascular diseases in women. The significant increase in mortality risk for cardiovascular diseases was observed in the subjects with ≥ 10 µg/g Cr in both sexes: 1.79 for men (95%CI 1.02 - 3.12) and 2.38 for women (95%CI 1.11 - 5.07). When the subjects were divided into 2 categories (< 20 µg/g Cr and ≥ 20 µg/g Cr), the HR of the urinary Cd ≥ 20 µg/g Cr group for nephritis and nephrosis were 4.82 (95%CI 1.07 - 21.61) in men and 7.92 (95%CI 1.77 - 35.33) in women, respectively. The significant increase was not observed for malignant neoplasm.</p><p><b>CONCLUSION</b>These results suggest a dose-response relationship between Cd body burden and mortality for cardiovascular diseases, cerebrovascular diseases and nephritis and nephrosis.</p>

Detection of Urinary Kidney Injury Molecule-1 in a Chronic Cadmium Exposed Population, Mae Sot District, Tak Province

Cadmium (Cd) has been found as an environmental pollutant in Mae Sot district, Tak province. Contaminated Cd in water and rice causes high risk of renal dysfunction among the inhabitants. In order to investigate the effect of Cd induced renal dysfunction, a kidney injury molecule-1 (KIM-1), a recently discovered biomarker for an early detection of renal tubular dysfunction, was measured using an enzyme linked immunosorbent assay (ELISA). Polyclonal goat anti-KIM-1, horseradish peroxidase labeled streptavidin and its specific substrate were used in the in-house ELISA technique. The method was validated and used to quantitate KIM-1 in the urine of 700 Mae Sot inhabitants in comparison to two conventional renal biomarkers; N-acetyl-β-D-glucosaminidase (NAG) and β2-microglobulin (β2 -MG). The results showed that KIM-1 standard concentrations provided good linearity (r=0.998) with limit of detection and quantitation at the concentrations of 33.20 pg/ml and 110.68 pg/ml, respectively. The coefficient variation (CV) for inter-day and intra-day precisions for 3 levels of KIM-1 (200, 800 and 3,000 pg/ml) were at 0.8, 1.2, and 2.1% CV and 0.7, 2.4, and 6.7% CV, respectively. The accuracy of the assay was found with 89-101% recovery. The average ± SD of the KIM-1 concentrations in urine samples of 700 Mae Sot inhabitants were at 1,347±1,290 pg/gCr, ranged between 61-15,330 pg/gCr. Using Spearman’s rho analysis, a strong positive correlation between KIM-1 and Cd concentrations (r=0.234, P \< 0.001) was found. The Cd was also correlated well with the NAG (r=0.263, P \< 0.001) and β2-MG (r=0.179, P \< 0.001). Prevalence of high excretion of renal biomarkers was shown in dose response relationship to Cd concentrations. This finding demonstrated that KIM-1 was a sensitive biomarker for detection of renal dysfunction in population with high Cd exposure.

Effects of maternal dioxin exposure on newborn size at birth among Japanese mother-infant pairs

<p><b>OBJECTIVE</b>Maternal exposure to dioxins [polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (DFs)] during pregnancy is known to affect infant growth and neurodevelopment in humans and animals. The aim of this study was to investigate the relationship between newborn size and the concentration of dioxin isomers in breast milk and to subsequently evaluate the potential toxicity of each dioxin isomer among mothers living in sea coast areas who are at a high risk of contamination due to a high consumption of fish.</p><p><b>METHODS</b>A total of 75 milk samples were obtained within 1 month of delivery from Japanese mothers living in the coastal areas of the Japan Sea. The relationships between the levels of seven dioxins and ten furan isomers in maternal breast milk, measured by high-resolution-gas chromatography/mass spectrometry, and the birth size of newborns, which is related to fetal growth, were investigated after adjustment for confounding factors.</p><p><b>RESULTS</b>The concentrations of 1,2,3,6,7,8-HxCDD (hexachlorodibenzo-p-dioxin), 2,3,4,7,8-PeCDF (pentachlorodibenzofuran), 2,3,4,6,7,8-HxCDF, and three dioxin toxic equivalent (TEQ) levels (PCDDs-TEQ, PCDFs-TEQ, and total-TEQ) in maternal breast milk were inversely correlated to newborn length even after adjustment for gestational weeks, infant sex, and maternal age and height. These isomers were abundant among the 17 isomers tested and reflected the TEQ levels. Only 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD), the most toxic isomer, was negatively correlated with newborn head circumference, even after adjustment for gestational weeks, infant birth weight, and other confounding factors.</p><p><b>CONCLUSIONS</b>Based on our results, fetal growth may be influenced by maternal total exposure to dioxins, but only exposure to 2,3,7,8-TCDD would appear to possibly affect fetal head size during pregnancy.</p>