Itai-itai disease: Renal tubular osteomalacia induced by environmental exposure to cadmiumhistorical review and perspectives

Cadmium (Cd) is one of the most toxic elements encountered in industry and contaminated environments. In Japan, environmental exposure to Cd and its effects on human health have been significant issues since the first outbreak of itai-itai disease, which is the most severe stage of chronic Cd poisoning, in the Cd-polluted Jinzu River basin of Toyama. In this region, the soil replacement of polluted rice paddy fields, which was an intervention program, was continuously conducted from 1980 until it was completed in 2012. As a result, the Cd content in rice has markedly decreased. However, Cd nephropathy is still prevalent, progressive and irreversible among the inhabitants of the Jinzu River basin, and new occurrences of itai-itai disease are found even today.