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Cadmium (Cd) is an environmental pollutant. Long-term exposure to Cd may lead adverse health effects in humans. Our epidemiological studies showed that urinary Cd (U-Cd) concentrations increased from 2008 to 2014, although they were reduced from 1986 until 2008. This aim of this study was to elucidate the long-term effects of the changing trend of cadmium exposure levels (U-Cd) on residents' renal function within 30 years after Cd-exposure ceased. In 2016, urine samples were collected from each participant by visiting 20 elderly Japanese (9 female and 11 male) living in the Kakehashi river basin; a previously Cd-polluted area in Ishikawa, Japan. The geometric means of the β2-microglobulin (β2-MG) and urinary Cd (U-Cd) continued increase to 2014 until 2016. Furthermore, Cd concentration and β2-MG in urine were still higher than those in the non-polluted areas in Japan. Significant correlations were found among age, U-Cd and β2-MG, and these were clearer in females than in males. In summary, we propose that three decades after Cd-exposure ceased, age has been more strongly associated with β2-MG than Cd body burden. Moreover, renal tubular dysfunction is irreversible and worsens after exposure to Cd, with females being more sensitive to exposure.

This follow-up study was conducted over 30 years in a cadmium-polluted area of Japan. Urinary cadmium (U-Cd) concentration decreased by nearly half from 1986 to 2008 in men and women. However, it increased from 2008 to 2014 and maintained similar levels in 2016. Because renal atrophy may induce an increase in U-Cd, kidney volumes were determined using magnetic resonance imaging (MRI) scans in 2018. Based on the MRI results, we divided the participants into two groups, namely the normal group (n = 6, three men and three women) and the lesion group (n = 6, three men and three women). The level of urinary N-acetyl-β-d-glucosaminidase/creatinine (U-NAG/Cr) in the lesion group was significantly higher than in the normal group. The level of serum alkaline phosphatase (Al-P) was positively associated with U-Cd. Age and renal cortex volumes showed significantly negative associations. However, U-Cd and renal cortex and kidney volumes showed no significant associations. These results suggest that U-NAG and serum Al-P were sensitive biomarkers to reflect renal tubular dysfunction and bone damage caused by cadmium poisoning. Individuals chronically exposed to Cd should be observed carefully, due to the increased effect of aging on renal cortex volumes.

The absorption of cadmium (Cd) may lead to Cd-related diseases such as renal tubular dysfunction and bone disease, and it is known to take around 10-30 years to reduce Cd concentrations to half their original levels. Urinary β2 -microglobulin (β2 -MG), N-acetyl-β-D-glucosaminidase (NAG), protein, glucose and albumin were used as indicators of renal dysfunction caused by Cd exposure. Our previous study found that urinary Cd concentrations had increased recently and that age was more strongly associated with urinary β2 -MG concentration than recent Cd body burden. Therefore, the purpose of the present study was to investigate the effect of aging on Cd concentrations and renal dysfunction. The Cd, β2 -MG, NAG, protein, glucose and albumin concentrations in the urine of 40 Japanese subjects (20 females and 20 males) environmentally exposed to Cd were collected. They lived in the Kakehashi River basin and were divided into three age categories: 50-69, 70-79 and 80-99 years. Significant differences in urinary Cd and β2 -MG concentrations were found among age groups, with urinary Cd levels tending to increase with age in both sexes. No significant correlations were found between urinary Cd and any indicators of renal dysfunction. The correlation between age, Cd and indicators of renal dysfunction was observed more clearly in females than in males. Age is more strongly correlated with indicators of renal dysfunction than Cd body burden. Copyright © 2017 John Wiley & Sons, Ltd.

OBJECTIVES This study aimed to clarify workplace recognition regarding working continuation of employees with early onset dementia. METHODS An anonymous self-administrated questionnaire was emailed to a prefecture consisting of 1,293 workplaces with 50 or more employees. Survey items assessed demographics, workplace regulations supporting employees, coworker acceptance of employees with early onset dementia, and recognition and dealing with employees with early onset dementia. The possibility of employees with early onset dementia continuing work was compared for demographics, workplace regulations supporting employees, and cooperation in the workplace. RESULTS Responses were received from 375 workplaces, and 273 valid responses were analyzed. In total, 133 workplaces (48.7%) answered that there was a high possibility of continuing employment for employees with early onset dementia and 135 workplaces (49.5%) were aware of early onset dementia. Less than 10% of workplaces reported examination of managing employees with early onset dementia, implementation/planning of training and information dissemination to managers or employees. Factors related to the possibility of continuing employment were number of employees (< 100, p = .015, odds ratio = 2.02), workplace regulations supporting employees with early onset dementia (p = .011, odds ratio = 2.22), and workplace coordination with occupational health staff (p = .004, odds ratio = 2.16). CONCLUSIONS There is a general need for training and information regarding early onset dementia in the workplace. For smaller companies, external advice and support in providing systems suitable to each workplace is necessary.

The biological half-life of cadmium (Cd) is as long as 10-30 years. Exposure to this element induces renal tubular dysfunction, which is considered irreversible. β2 -microglobulin (β2 -MG) is a low-molecular-weight protein, and urinary β2 -MG is one of the most useful and critical indicators for the early detection of renal tubular dysfunction. However, very little research has been published concerning the long-term observation of Cd-induced adverse health effects. As such, this follow-up study was conducted for 28 years to clarify the relationship between the concentration of Cd and β2 -MG in the urine of 28 inhabitants (14 male and 14 female) living in the Kakehashi River basin, Ishikawa prefecture (Japan), previously one of the most highly Cd-polluted regions in this country. All subjects were over 60 years old in 2014 and participated in all six health examinations conducted over 28 years (1986-2014). Urine was collected at the appropriate time and kept frozen to analyze urinary Cd and β2 -MG concentrations. The urinary Cd concentration was found to decrease by nearly half between 1986 and 2008 in both male and female subjects, whereas it increased significantly from 2008 to 2014 in males. In contrast, urinary β2 -MG concentrations tended to increase over the 28-year study period in both sexes. Urinary Cd and β2 -MG concentrations in females were significantly higher than those in males in this Cd-polluted region. Age is more strongly associated with urinary β2 -MG concentration than recent Cd body burden. Copyright © 2016 John Wiley & Sons, Ltd.

Additional file 2. Foot-care practice in intervention and control groups.

The absorption of cadmium (Cd) may lead to Cd-related diseases such as renal tubular dysfunction and bone disease, and it is known to take around 10-30 years to reduce Cd concentrations to half their original levels. Urinary β

Aim To measure illuminance in the home lives of elderly people to clarify the current state of affairs and concurrently investigate quantification methods for this purpose. Methods Illuminance and the physical and mental health of 24 elderly people living, with some assistance, in their homes in a prefecture in the Hokuriku region were studied over 3 days. Illuminance was quantified in accordance with the rotation of the earth, with day and night defined according to times of sunrise/sunset. Daytime mean illuminance and mean time exposed to seven levels of illuminance between 50 and 1000 lx during the day were calculated. Physical and mental health were assessed through interviews using the Instrumental Activities of Daily Living Scale, the Short-Form 36-Item Health Survey version 2, the Philadelphia Geriatric Center Morale Scale and the Geriatric Depression Scale-Short Form. Analysis of the correlation between illuminance and scores on mental and physical health was carried out. Results The mean score for daytime illuminance was 687 lx. The mean time for daytime exposure to light above 400 lx was 59 min. A significant positive correlation was found between daytime mean illuminance, time exposed to light over 400 lx and life satisfaction. A significant negative correlation was found between time exposed to light over 400 lx and depression scores. Conclusions Findings uncovered for the first time the actual illumination experienced by frail elderly individuals living at home in Japan. The quantification of illuminance is important, because research has shown a relationship between mental health and illuminance exposure. Geriatr Gerontol Int 2013; 13: 798–806.

We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

We measured the illuminance exposure for 3 days in winter of a convenience sample of 44 elderly people certified as requiring support in Japan's Hokuriku region. We calculated the illuminance ratio per minute during activity and while in bed and analyzed the relationship between illuminance, subjective sleep quality, and psychosomatic health. There was a significant negative correlation between illuminance and 15-item Geriatric Depression Scale scores. Multiple regression analysis indicated that depression scores were significantly related to age, level of required support, and illuminance. The findings suggest that environments without light and dark cycles increase depression scores in frail elderly people.

To measure illuminance in the home lives of elderly people to clarify the current state of affairs and concurrently investigate quantification methods for this purpose.Illuminance and the physical and mental health of 24 elderly people living, with some assistance, in their homes in a prefecture in the Hokuriku region were studied over 3 days. Illuminance was quantified in accordance with the rotation of the earth, with day and night defined according to times of sunrise/sunset. Daytime mean illuminance and mean time exposed to seven levels of illuminance between 50 and 1000 lx during the day were calculated. Physical and mental health were assessed through interviews using the Instrumental Activities of Daily Living Scale, the Short-Form 36-Item Health Survey version 2, the Philadelphia Geriatric Center Morale Scale and the Geriatric Depression Scale-Short Form. Analysis of the correlation between illuminance and scores on mental and physical health was carried out.The mean score for daytime illuminance was 687 lx. The mean time for daytime exposure to light above 400 lx was 59 min. A significant positive correlation was found between daytime mean illuminance, time exposed to light over 400 lx and life satisfaction. A significant negative correlation was found between time exposed to light over 400 lx and depression scores.Findings uncovered for the first time the actual illumination experienced by frail elderly individuals living at home in Japan. The quantification of illuminance is important, because research has shown a relationship between mental health and illuminance exposure.