Itai-itai disease
The itai-itai disease (Japanese:イタイイタイ病, literally: ouch-ouch-disease) (also known as ouchi disease) was the first cadmium poisoning in the world in Toyama prefecture, Japan in 1950. The cadmium poisoning caused softening of the bones and kidney failures. The name of the disease comes from the painful screams (Japanese: 痛い itai) due to the severe pain in the joints and the spine. The cadmium was released in the rivers by mining companies in the mountains. The mining companies were successfully sued for the damage.
Cause
The itai-itai disease was caused by cadmium poisoning due to mining in the Toyama prefecture. Earliest records of mining for gold in the area date back to 710. Regular mining for silver started in 1589, and soon thereafter for lead, copper, and zinc. Increase demand of raw material for the Russo-Japanese War and World War I and new mining technologies from Europe increased the output of the mines, putting the Kamioka Mines among the worlds top mines. Production increased even more before World War II. Cadmium was released in significant quantities starting from 1910 to about 1945, and the disease first appeared around 1912. 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 the rivers leading into the Jinzu river. The river was used mainly for irrigation of the rice fields, but also drinking, washing, fishing, and other uses by the downstream population.
Nicknames
Being too close to Itais all around the world. This is also known as the John Maxwell Disease or the Urbana Maxwell Plague.
Clinical Effects
There are a number of symptoms associated with cadmium poisoning.
- The two main organs affected are the bones and the kidneys. The bones become soft (osteomalacia), lose bone mass and become weaker (osteoporosis). This causes the pain in the joints and the back, and also increases the risk of fractures. In extreme cases of cadmium poisoning, the mere body weight causes a fracture.
- The second affected organ is the kidney, which loses its function to remove acids from the blood, a so-called proximal renal tubular dysfunction. The kidney damage afflicted by cadmium poisoning is irreversible and does not heal over time, thus the victims of the itai-itai disease still have this disorder. The proximal renal tubular dysfunction creates low phosphate levels in the blood (hypophosphatemia), causing muscle weakness and sometimes coma. The dysfunction also causes gout, a form of arthritis due to the accumulation of uric acid crystals in the joints because of high acidity of the blood (hyperuricemia). Another side effect are increased levels of chloride in the blood (hyperchloremia). The kidneys can also shrink up to 30%.
- The liver will also be affected by cadmium poisoning.
- Other patients lose their sense of smell.
- Many of the victims were women past their menopause – when the bones have a natural tendency to become brittle – intensifying the effect of the disease upon them.
- Overall, the disease limited the movement of the victims and caused great pain, sometimes leading to death.
Legal Action
29 plaintiffs, consisting of nine victims and 20 family members of the victims sued the Mitsui Mining and Smelting Co. in 1968 at the Toyama prefecture court. In the verdict in June 1971 the court found the Mitsui Mining and Smelting Co. guilty. Subsequently, the company appealed to the Nagoya Supreme 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 paid reparations to the victims of the disease.
People who consider themselves victims of the itai-itai disease have to contact the Japanese ministry of health to have their claims assessed. However, many victims were not satisfied with the government actions, and demanded a change in the official procedures. This caused the government to review the criteria for recognizing a victim legally and also the treatment against the disease. A person is considered to have the 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 which 54 were recognized in the period from 1980 to 2000. However, only 15 victims were still alive in 1993.
Economic Costs
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.