We report the case of a 44-year-old man who has been working as a mechanic for 19 years. He presented with chronic eczema on his hands and forearms, which first appeared 3 years ago. His personal and family history was negative for skin diseases and atopy.

The patient had several eczematous and lichenificated patches with intense itching on the dorsum of the hands, flexor surface of wrists and forearms (figure 1). Previous treatments with...]]> 2012-05-04T17:09:50-07:00 info:doi/10.1136/oemed-2011-100446 hwp:master-id:oemed;oemed-2011-100446 BMJ Publishing Group Ltd 2012-06-01 PostScript 69 6 452 452 http://oem.bmj.com/cgi/content/short/69/6/452-b?rss=1 Weaver et al1 have published data on the associations between urinary cadmium and four glomerular filtration measures or N-acetyl-β-d-glucosaminidase (NAG) as a biological renal effect. Their target subjects were lead-handling workers and they concluded a paradoxical result that urinary cadmium was significantly associated with lower serum creatinine as well as higher estimated glomerular filtration rate and calculated creatinine clearance. My colleagues and I have previously reported the combined effects of low-level cadmium and lead exposure on urinary indicators including NAG and β2-microglobulin (BMG) of workers with geometric means of urinary cadmium and lead being 1.17 and 1.27 μg/g creatinine, respectively.2 In that study, we used multiple regression analysis to predict log-transformed values of urinary NAG or BMG using age, pH, log-transformed urinary cadmium and log-transformed urinary lead. As a result, log-transformed urinary cadmium was the only significant predictor variable of NAG (β=0.572; p<0.01) and log-transformed urinary...]]> 2012-05-04T17:09:50-07:00 info:doi/10.1136/oemed-2011-100515 hwp:master-id:oemed;oemed-2011-100515 BMJ Publishing Group Ltd 2012-06-01 PostScript 69 6 452 453 http://oem.bmj.com/cgi/content/short/69/6/453?rss=1 At Fukushima, many public sector workers have experienced occupational exposure to radiation. The area around the stricken nuclear power plant comprises an emergency evacuation preparation zone (radius 30 km) with an inner no-entry zone (radius 20 km) and a planned evacuation zone (‘designated zone’ hereinafter).1 The designated zone comes under the purview of the local governments of one prefecture, four cities, six towns and three villages, with a combined workforce of about 34 000 employees2 3 (figure 1). These workers perform various functions in the designated zone, such as overseeing evacuation and temporary return of residents, accompanying searches for bodies, and surveying debris. Also working in the designated zone are employees of various ministries and emergency agencies, including defence, fire and police, and their local departments. Administrative measures to protect public servants from radiation exposure are regulated by the Industrial Safety and Health Law 2012-05-04T17:09:50-07:00 info:doi/10.1136/oemed-2011-100436 hwp:master-id:oemed;oemed-2011-100436 BMJ Publishing Group Ltd 2012-06-01 PostScript 69 6 453 454 http://oem.bmj.com/cgi/content/short/69/6/454?rss=1 We thank Dr Kawada for his interest in our article entitled ‘Associations of low-level urine cadmium with kidney function in lead workers.’1 As discussed in the methods and shown in the footnotes to tables 3 and 4 in the manuscript, we adjusted for blood and tibia lead. We have presented lead analyses in this cohort in multiple past publications;2–8 so, in order to focus on the unique cadmium associations and comply with space considerations, we did not show the lead regression coefficients. Multiple linear regression was used in the analysis.

Competing interests

None.

Provenance and peer review

Not commissioned; internally peer reviewed.