Association between Minamata Disease Status and Activities of Daily Living among Inhabitants in Previously Methylmercury-Polluted Areas
Objectives: Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following th...
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Published in | Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene) Vol. 63; no. 4; pp. 699 - 710 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
Japan
The Japanese Society for Hygiene
2008
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Subjects | |
Online Access | Get full text |
ISSN | 0021-5082 1882-6482 1882-6482 |
DOI | 10.1265/jjh.63.699 |
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Abstract | Objectives: Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas. Methods: Data were collected by two-stage stratified sampling of residents 40–79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability. Results: We classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08–4.01), 3.87 (2.14–7.01), and 4.50 (2.66–7.61) for BADL and 2.41 (1.62–3.61), 3.20 (2.12–4.85) and 3.68 (2.52–5.38) in Not Yet, Recent, and Early for IADL, respectively. Conclusion: Early, Recent, and Not Yet had lower ADL grades than Normal. Moreover, the population with a low ADL grade and health-related anxieties had increased throughout the previously methylmercury-polluted areas. The issue of ill health among populations living in previously methylmercury-polluted areas should be addressed in the wider context of public and community health. |
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AbstractList | Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas.
Data were collected by two-stage stratified sampling of residents 40-79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability.
We classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08-4.01), 3.87 (2.14-7.01), and 4.50 (2.66-7.61) for BADL and 2.41 (1.62-3.61), 3.20 (2.12-4.85) and 3.68 (2.52-5.38) in Not Yet, Recent, and Early for IADL, respectively.
Early, Recent, and Not Yet had lower ADL grades than Normal. Moreover, the population with a low ADL grade and health-related anxieties had increased throughout the previously methylmercury-polluted areas. The issue of ill health among populations living in previously methylmercury-polluted areas should be addressed in the wider context of public and community health. Objectives: Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas. Methods: Data were collected by two-stage stratified sampling of residents 40–79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability. Results: We classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08–4.01), 3.87 (2.14–7.01), and 4.50 (2.66–7.61) for BADL and 2.41 (1.62–3.61), 3.20 (2.12–4.85) and 3.68 (2.52–5.38) in Not Yet, Recent, and Early for IADL, respectively. Conclusion: Early, Recent, and Not Yet had lower ADL grades than Normal. Moreover, the population with a low ADL grade and health-related anxieties had increased throughout the previously methylmercury-polluted areas. The issue of ill health among populations living in previously methylmercury-polluted areas should be addressed in the wider context of public and community health. Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas.OBJECTIVESMinamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas.Data were collected by two-stage stratified sampling of residents 40-79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability.METHODSData were collected by two-stage stratified sampling of residents 40-79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability.We classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08-4.01), 3.87 (2.14-7.01), and 4.50 (2.66-7.61) for BADL and 2.41 (1.62-3.61), 3.20 (2.12-4.85) and 3.68 (2.52-5.38) in Not Yet, Recent, and Early for IADL, respectively.RESULTSWe classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08-4.01), 3.87 (2.14-7.01), and 4.50 (2.66-7.61) for BADL and 2.41 (1.62-3.61), 3.20 (2.12-4.85) and 3.68 (2.52-5.38) in Not Yet, Recent, and Early for IADL, respectively.Early, Recent, and Not Yet had lower ADL grades than Normal. Moreover, the population with a low ADL grade and health-related anxieties had increased throughout the previously methylmercury-polluted areas. The issue of ill health among populations living in previously methylmercury-polluted areas should be addressed in the wider context of public and community health.CONCLUSIONEarly, Recent, and Not Yet had lower ADL grades than Normal. Moreover, the population with a low ADL grade and health-related anxieties had increased throughout the previously methylmercury-polluted areas. The issue of ill health among populations living in previously methylmercury-polluted areas should be addressed in the wider context of public and community health. |
Author | TAMURA, Kenji SUNG, Woncheol MARUYAMA, Sadami KAWAKITA, Minoru TANAKA, Shiro Group, Shiranui Study USHIJIMA, Kayo TANAKA, Mika MUKAI, Yoshito |
Author_xml | – sequence: 1 fullname: USHIJIMA, Kayo organization: Department of Public Health, Fukuoka University School of Medicine – sequence: 1 fullname: TANAKA, Mika organization: Department of Nursing, School of Medicine, Fukuoka University – sequence: 1 fullname: TAMURA, Kenji organization: Integrated Health Risk Assessment Section, Environmental Health Sciences Division National Institute for Environmental Studies – sequence: 1 fullname: MUKAI, Yoshito organization: Department of Nursing, Faculty of Health Science, Kumamoto Health Science University – sequence: 1 fullname: Group, Shiranui Study – sequence: 1 fullname: KAWAKITA, Minoru organization: Center for Research Training and Guidance in Educational Practice, Aichi University of Education – sequence: 1 fullname: MARUYAMA, Sadami organization: School of Literature, Kumamoto University – sequence: 1 fullname: SUNG, Woncheol organization: School of Sociology, Chukyo University – sequence: 1 fullname: TANAKA, Shiro organization: Department of Biostatistics, School of Health Sciences and Nursing, University of Tokyo |
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References_xml | – reference: (2) Berkman LF, Kawachi I. A historical framework for social epidemiology. In: Berkman LF, Kawachi I eds. Social Epidemiology. New York: Oxford University Press, 2000:3-12. – reference: (17) Kinjo Y, Higashi H, Nakano A, Sakamoto M, Sakaki R. Profile of subjective complaints and activities of daily living among current patients with Minamata disease after 3 decades. Environ Res. 1993;63:241-251. – reference: (21) 新開省二,藤田幸司,藤原佳典,熊谷 修,天野秀紀,吉田裕人,竇 貴旺.地域高齢者におけるタイプ別閉じこもりの予後 2年後の研究.日本公衆衛生雑誌2005; 52:627-638. – reference: (15) 古谷野亘,柴田 博,芳賀 博,須山靖男.地域老人における日常生活動作能力―その変化と死亡率への影響.日本公衆衛生雑誌1984;31:637-641. – reference: (9) Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-186. – reference: (22) 山川正信,上島弘嗣,岡山 明,喜多義邦,辻橋幹恵,三上房江,佐藤美由紀,西田厚子,畑野相子,宮田克子.訪問悉皆調査による在宅高齢者のADL(日常生活動作能力)の実態.日本公衆衛生雑誌1994;41:987-996. – reference: (25) 原田正純.16年後の水俣病の臨床的・疫学的研究.神経進歩1972;16:870-880. – reference: (5) Minkler M, Fuller-Thomson E, Guralnik JM. Gradient of disability across the socioeconomic spectrum in the Unitied States. N Engl J Med. 2006;355:695-703. – reference: (12) Fillenbaum GG. Screening the elderly. A brief instrumental activities of daily living measure. J Am Geriatr Soc. 1985; 33:698-706. – reference: (4) Geronimus AT, Bound J, Waidmann TA. Poverty, time, and place: variation in excess mortality across selected US populations, 1980-1990. J Epidemiol Community Health. 1999; 53:325-334. – reference: (28) Fukuda Y, Ushijima K, Kitano T, Sakamoto M, Futatsuka M. An analysis of subjective complaints in a population living in a methylmercury-polluted area. Environ Res. 1999; 81: 100-107. – reference: (23) 那須郁夫,斎藤安彦.全国高齢者における健康状態別余命の推計,とくに咀嚼能力との関連について.日本公衆衛生雑誌2006;53:411-423. – reference: (18) 牛島佳代,北野隆雄,二塚 信.水俣病認定患者の健康と生活の実態に関する調査研究.日本衛生学雑誌2003; 58:395-400. – reference: (10) Fillenbaum GG, Smyer MA. The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. J Gerontol. 1981;36:428-434. – reference: (13) 芳賀 博,柴田 博,松崎俊久,安村誠司.地域老人の日常生活動作能力に関する追跡的研究.民族衛生1988; 54:217-233. – reference: (27) 立津政順,村山英一,原田正純,宮川太平.後天性水俣病の後遺症―発病後平均4 1/2年と7 7/12年における症状とその変動―.神経進歩1969;13:76-83. – reference: (35) Marmot MG. Improvement of Social environment to improve health. Lancet. 1998;351:57-60. – reference: (24) 橋本修二,岡本和士,前田 清,佐々木隆一郎,青木信雄,豊嶋英明,加藤孝之,岡田 博.地域高齢者の生命予後に影響する日常生活上の諸因子についての検討 3年6カ月の追跡調査.日本公衆衛生雑誌1986; 33: 741-748. – reference: (8) Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: A Standardized measure of biological and psychosocial function. JAMA. 1963;21:914-919. – reference: (30) Tamashiro H, Akagi H, Arakaki M, Futatsuka M, Roht LH. Causes of death in Minamata disease: analysis of death certificates. Int Arch Occup Environ Health. 1984;54:135-146. – reference: (7) Ushijima K, Kitano T, Shono M, Oka T, Miyake Y, Moriyama M, Futatsuka M. Social factors associated with psychological distress among inhabitants in a methyl-mercury polluted area in rural Japan. Environ Sci. 2004; 11:151-162. – reference: (11) George LK, Fillenbaum GG. OARS methodology. A decade of experience in geriatric assessment. J Am Geriatr Soc. 1985;33:607-615. – reference: (1) 成 元哲,牛島佳代,川北 稔,丸山定巳,「不知火海研究プロジェクト」.なぜ今,大量の水俣病認定申請者なのか?公衆衛生2006;70:124-127. – reference: (20) Futatsuka M, Kitano T, Shono M, Nagano M, Wakamiya J, Miyamoto K, Ushijima K, Inaoka T, Fukuda Y, Nakagawa M, Arimura K, Osame M. Long-term follow-up study of health status in population living in methylmercury-polluted area. Environ Sci. 2005;12:239-282. – reference: (32) Kawachi I, Kennedy BP, Lochner K, Prothrow-Smith D. Social Capital, income inequality, and mortality. Am J Public Health. 1997;87:1491-1498. – reference: (6) Rose G, Marmot MG. Social class and coronary heart disease. Br Heart J. 1981;45:13-19. – reference: (19) 劉 暁潔,坂本峰至,加藤たけ子,岡元美和子,有村公良.胎児性水俣病患者の現在のActivity of Daily Living(ADL) 実態と15年前との比較およびコミュニケーション障害に関する研究.日本衛生学雑誌2007; 62:905-910. – reference: (29) 玉城英彦,新垣幹男,赤木洋勝,二塚 信,比嘉恵子.水俣病認定患者の死因と生存率について.日本公衆衛生雑誌1983;30:403-412. – reference: (31) 川北 稔,成 元哲,牛島佳代,丸山定巳,「不知火海研究プロジェクト」.申請を遅らせた住民の「水俣病」イメージ.公衆衛生2006;70:288-291. – reference: (33) Christakis NA, Allison PD. Mortality after the Hospitalization of a Spouse. N Engl J Med. 2006;354:719-730. – reference: (26) 徳臣晴比古.水俣病の臨床,水俣病―有機水銀中毒に関する研究.熊本大学医学部水俣病研究班編,1966. – reference: (16) 金城芳秀,東 博文,中野篤浩,坂本峰至,二塚 信,前田和甫.水俣病患者の健康状態調査研究―ADLおよび自覚症状を中心として―.民族衛生1991;57:142-153. – reference: (14) 藤田利治,籏野脩一.地域老人の日常生活動作の障害とその関連要因.日本公衆衛生雑誌1989;36:76-87. – reference: (34) Balfour JL, Kaplan GA. Neighborhood environment and loss of physical function in older adults: evidence from the Alameda County Study. Am J Epidemiol. 2002;15:507-515. – reference: (3) 堤 明純,職業階層と健康.川上憲人,小林廉毅,橋本英樹編,社会格差と健康:社会疫学からのアプローチ.東京:東京大学出版会,2006:81-101. – ident: 2 – ident: 11 doi: 10.1111/j.1532-5415.1985.tb06317.x – volume: 52 start-page: 627 issn: 0546-1766 issue: 7 year: 2005 ident: 21 – ident: 8 doi: 10.1001/jama.1963.03060120024016 – ident: 28 doi: 10.1006/enrs.1999.3970 – ident: 32 doi: 10.2105/AJPH.87.9.1491 – ident: 35 doi: 10.1016/S0140-6736(97)08084-7 – ident: 5 doi: 10.1056/NEJMsa044316 – ident: 9 doi: 10.1093/geront/9.3_Part_1.179 – ident: 6 doi: 10.1136/hrt.45.1.13 – ident: 10 doi: 10.1093/geronj/36.4.428 – ident: 19 doi: 10.1265/jjh.62.905 – volume: 41 start-page: 987 issn: 0546-1766 issue: 10 year: 1994 ident: 22 – ident: 27 doi: 10.1111/j.1748-1716.1969.tb04541.x – volume: 70 start-page: 288 issn: 0368-5187 issue: 4 year: 2006 ident: 31 – volume: 57 start-page: 142 issn: 0368-9395 issue: 4 year: 1991 ident: 16 doi: 10.3861/jshhe.57.142 – ident: 4 doi: 10.1136/jech.53.6.325 – ident: 7 – ident: 17 doi: 10.1006/enrs.1993.1144 – volume: 33 start-page: 741 issn: 0546-1766 issue: 12 year: 1986 ident: 24 – ident: 20 – ident: 26 – ident: 3 – volume: 58 start-page: 395 issn: 0021-5082 issue: 3 year: 2003 ident: 18 doi: 10.1265/jjh.58.395 – ident: 12 doi: 10.1111/j.1532-5415.1985.tb01779.x – ident: 1 – ident: 34 – volume: 54 start-page: 217 issn: 0368-9395 issue: 5 year: 1988 ident: 13 doi: 10.3861/jshhe.54.217 – ident: 33 doi: 10.1056/NEJMsa050196 – volume: 53 start-page: 411 issn: 0546-1766 issue: 6 year: 2006 ident: 23 – volume: 31 start-page: 637 issn: 0546-1766 issue: 12 year: 1984 ident: 15 – volume: 36 start-page: 76 issn: 0546-1766 issue: 2 year: 1989 ident: 14 – ident: 30 doi: 10.1007/BF00378516 – ident: 25 – volume: 30 start-page: 403 issn: 0546-1766 issue: 9 year: 1983 ident: 29 |
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Snippet | Objectives: Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish... Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have... |
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SubjectTerms | Activities of Daily Living ADL: Activities of Daily Living Adult Aged Female Health Status Humans Japan Male Mercury Poisoning, Nervous System - complications Mercury Poisoning, Nervous System - epidemiology Mercury Poisoning, Nervous System - etiology Methylmercury Compounds - poisoning Middle Aged Minamata Disease status proportions of MD compensation recipient Surveys and Questionnaires |
Title | Association between Minamata Disease Status and Activities of Daily Living among Inhabitants in Previously Methylmercury-Polluted Areas |
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