Itai-itai disease
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2008-06-21T11:42:52Z
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{{nihongo|'''Itai-itai disease'''|イタイイタイ病|itai-itai byō}}, (literally: "ouch-ouch" disease) was the documented case of mass [[cadmium]] poisoning in [[Toyama Prefecture]], [[Japan]]. The cadmium poisoning caused [[Osteoporosis|softening of the bones]] and kidney failures. The name of the disease is due to the severe pain (Japanese: 痛い ''itai'') caused in the joints and the spine. The term ''itai-itai'' disease was coined by locals.<ref name="icett">ICETT Itai-itai disease (1998) http://www.icett.or.jp/lpca_jp.nsf/a21a0d8b94740fbd492567ca000d5879/b30e2e489f4b4ff1492567ca0011ff90?OpenDocument</ref> The cadmium was released in the rivers by [[mining]] companies in the mountains. The mining companies were successfully sued for the damage. Itai-itai disease is known as one of the [[Four Big Pollution Diseases of Japan]].<ref name="almeida1998">{{cite journal | author=Almeida, P and Stearns, L | title=Political opportunities and local grassroots environmental movement: The case of Minamata | journal=Social Problems | volume=45 | issue=1 | pages=37–60 | year=1998 | doi=10.1525/sp.1998.45.1.03x0156z}}</ref>
==Cause==
''Itai-itai disease'' was caused by [[cadmium poisoning]] due to mining in Toyama Prefecture. The earliest records of mining for [[gold]] in the area date back to [[710]]. Regular mining for [[silver]] started in 1589, and soon thereafter, mining for [[lead]], [[copper]], and [[zinc]] began. Increased demand for raw materials during the [[Russo-Japanese War]] and [[World War I]], as well as new mining technologies from Europe, increased the output of the mines, putting the Kamioka Mines in Toyama among the world's top mines. Production increased even more before [[World War II]]. Starting in 1910 and continuing through [[1945]], cadmium was released in significant quantities by mining operations, and the disease first appeared around 1912.<ref name="icett"/> Prior to World War II the mining, controlled by the Mitsui Mining and Smelting Co., Ltd., increased to satisfy the wartime demand. This subsequently increased the pollution of the [[Jinzu River]] and its tributaries. The river was used mainly for [[irrigation]] of rice fields, but also for drinking water, washing, fishing, and other uses by downstream populations<ref name="icett"/>.
Due to the cadmium poisoning, the fish in the river started to die, and the rice irrigated with river water did not grow well. The cadmium and other heavy metals accumulated at the bottom of the river and in the water of the river. This water was then used to irrigate the rice fields. The rice absorbed all heavy metals, especially the cadmium. The cadmium accumulated in the people eating contaminated rice.
The population complained to the Mitsui Mining and Smelting about the pollution. The company subsequently built a basin to store the mining waste water before leading it into the river. It was too little too late, and many people were already very sick. The causes of the poisoning were not well understood and, up to 1946, it was thought to be simply a regional disease or possibly a type of bacteria<ref name="icett"/>.
Medical tests started in the 1940s and 1950s, searching for the cause of the disease. Initially, it was expected to be lead poisoning due to the lead mining upstream. Only in 1955 did Dr. Hagino and his colleagues suspect cadmium as the cause of the disease.<ref name="icett"/> Toyama prefecture also started an investigation in 1961, determining that the Mitsui Mining and Smelting's Kamioka Mining Station caused the cadmium pollution and that the worst affected areas were 30 km downstream of the mine. In 1968 the Ministry of Health and Welfare issued a statement about the symptoms of ''itai-itai'' disease caused by the cadmium poisoning.<ref name="kanazawa">Itai-itai disease http://www.kanazawa-med.ac.jp/~pubhealt/cadmium2/itaiitai-e/itai01.html</ref>
The reduction of the levels of cadmium in the water supply reduced the number of new disease victims; no new victim has been recorded since 1946. While the victims with the worst symptoms came from Toyama prefecture, the government found victims in five other prefectures.
The mines are still in operation and cadmium pollution levels remain high, although improved nutrition and medical care has reduced the occurrence of Itai-itai disease. <ref name="Mcgraw-hill"/>
==Symptoms==
One of the main effects of this painful cadmium poisoning are very weak and brittle bones. Spinal and leg pain is common, and a waddling gait often develops due to bone deformities caused by the cadmium. The pain eventually becomes debilitating, with fractures becoming more common as the bone weakens. Other complications include coughing, anemia, and kidney failure, leading to death.<ref name="Mcgraw-hill">Hamilton, J. "What is Itai-Itai disease" http://www.accessscience.com/studycenter.aspx?main=9&questionID=4978</ref>
A marked prevalence in older, postmenopausal women has been observed. The cause of this phenomenon is not fully understood, and is currently under investigation. Current research has pointed to general malnourishment, as well as poor calcium metabolism relating to the women's age and gender.<ref name="Mcgraw-hill"/> Postmenopausal Women are know to have increased risks of osteoperosis and poor calcium metabolism.
Recent animal studies have shown that cadmium poisoning alone is not enough to elicit all of the symptoms of Itai-itai disease.<ref name="Mcgraw-hill"/> These studies are pointing to damage of the mitochondria of kidney cells by cadmium as a key factor of the disease.
==Legal action==
29 plaintiffs, consisting of nine victims and 20 family members of victims, sued the Mitsui Mining and Smelting Co. in 1968 in the Toyama Prefectural court. In June 1971, the court found the Mitsui Mining and Smelting Co. guilty. Subsequently, the company appealed to the Nagoya District Court in Kanazawa, but the appeal was rejected in August 1972. The Mitsui Mining and Smelting Co. agreed to pay for the medical care of the victims; finance the monitoring of the water quality performed by the residents; and pay reparations to the victims of the disease<ref name="icett"/>.
People who consider themselves victims of ''itai-itai'' disease have to contact the Japanese [[Ministry of Health, Labour and Welfare|Ministry of Health, Labor and Welfare]] to have their claims assessed. Many victims were not satisfied with government actions and demanded a change in the official procedures. This caused the government to review the criteria for recognizing a victim legally; the government also reassessed the treatment of the disease.
A person is considered to have ''itai-itai'' disease if he or she lived in the contaminated areas, has kidney dysfunctions, softening of the bones, but no related heart problems. 184 victims have been legally recognized since 1967, of whom 54 were recognized in the period from 1980 to 2000. An additional 388 people have been identified as potential victims, those that had not been officially examined yet<ref name="icett"/>. 15 victims were still alive [[as of 1993]].
==Economic costs==
The cadmium pollution had contaminated many agricultural areas. Heavy metal pollution affected many areas in Japan, and as a result the Prevention of Soil Contamination in Agricultural Land Law of 1970 was enacted. It ordered planting to be stopped so that restoration of the soil could be enacted to areas with 1ppm of cadmium or more contamination in the soil. Surveying in Toyama Prefecture began in 1971, and by 1977 1500 hectacres along the Jinzu river were designated for soil restoration. These farmers were compensated for lost crops as well as for lost production in past years by the Mitsui Mining and Smelting, Toyama Prefecture, and the national government. [[As of 1992]], only 400 hectacres remained contaminated<ref name="icett"/>.
In 1992, the average annual health expense compensation was 743 million [[yen]]. Agricultural damage was compensated with 1.75 billion yen per year, or a total of annually 2.518 billion yen. Another 620 million yen were invested annually to reduce further pollution of the river<ref name="icett"/>.
==See also==
*[[Minamata disease]]
*[[Heavy metal poisoning]]
==Notes and References==
{{reflist}}
==External links==
*[http://www.kanazawa-med.ac.jp/~pubhealt/cadmium2/itaiitai-e/itai01.html Additional Information on Itai-Itai Disease]
*[http://www.icett.or.jp/lpca_jp.nsf/a21a0d8b94740fbd492567ca000d5879?OpenView Preventative Measures Against Water Pollution]
*[http://www.accessscience.com/studycenter.aspx?main=9&questionID=4978 What is Itai-itai disease?]
[[Category:Japanese political scandals]]
[[Category:Pollution in Japan]]
[[Category:Medical disasters]]
[[Category:Cadmium]]
[[Category:Disasters in Japan]]
[[de:Itai-Itai-Krankheit]]
[[ko:이타이이타이 병]]
[[ja:イタイイタイ病]]
[[pl:Choroba itai-itai]]
[[sv:Itai-itai]]
[[zh:痛痛病]]