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Lead is a toxic metal abundant in the environment . Consumption of food contaminated at low levels of lead, especially by small children and pregnant women, raises a health concern . Duplicated food portions and drinking water were collected over 3 days from 88 children and 87 pregnant women in Shimotsuke, Tochigi, Japan . Participants were recruited in this study between January 2014 and October 2015 . Dust was also collected from their homes . Lead concentrations were measured and consequent oral lead exposure levels were estimated for this population at high risk to environmental toxicants . Lead concentrations of peripheral and cord blood, taken from children and pregnant women, and were also analyzed . Lead concentrations in food, drinking water, and house dust were low in general . Oral lead exposure to lead was higher for children (Mean ± SEM; 5 .21 ± 0 .30 μg/kg BW/week) than in pregnant women (1 .47 ± 0 .13 μg/kg BW/week) . Food and house dust were main sources of lead contamination, but the contribution of house dust widely varied . Means ± SEM of peripheral and cord blood lead concentrations were 0 .69 ± 0 .04 μg/dL and 0 .54 ± 0 .05 μg/dL, respectively for pregnant women and 1 .30 ± 0 .07 μg/dL (peripheral only) in children . We detect no correlation between smoking situations and blood lead concentration in pregnant women . We conclude that oral lead exposure levels for Japanese children and pregnant women were generally low, with higher concentrations and exposure for children than for pregnant women . More efforts are necessary to clarify the sources of lead contamination and reduce lead exposure of the population at high risk even in Japan . Lead is a highly toxic heavy metal ubiquitous in the environment, and found at trace levels in food, soil, water, house dust, and air [1] . Lead toxicity affects to almost all organs and organ systems, and it is known that the nervous system is the most vulnerable especially in developing fetuses and children [2, 3] . Developing fetuses and small children are more sensitive to environmental contaminants than adults [4, 5], and adverse effects due to exposure to lead of wide range concentration are concerning . Prohibition of usage of leaded gasoline in the 1980s resulted in a remarkable decrease of environmental lead in Japan . It has been reported that concentrations of lead in blood of adults and children have been declining [6] . Acute exposure to lead is rare and sporadic at present in Japan; however, concerns about low-level chronic exposure to lead are rapidly growing . Until 2012 in the USA, children were considered as having a blood lead “level of concern” if the blood lead concentration was found to be higher than 10 μg/dL [7] . However, blood lead at concentrations below 5 μg/dL is a causal risk factor for diminished intellectual and academic abilities, higher rates of neurobehavioral disorders such as hyperactivity and attention deficits, and lower birth weight in children [8,9,10,11,12] . The US Centers for Disease Control and Prevention (CDC) stated that no safe threshold for blood lead level [13] . It has been suggested that no threshold of blood lead level for impact on children’s IQ cannot be found [9, 14], and it is now recommended that exposure to lead should be reduced to “as less as possible” [13] . Children are exposed to lead more often by hand-mouth behavior from time spent on dusty floors . Absorption of lead from the gastrointestinal tract is more efficient for children than that for adults [15] . In a pregnant woman, lead can cross the placenta to the fetus and can affect the developing prenatal fetus [16, 17] . Adverse effects of prenatal exposure to lead of developing fetus through the placenta by maternal circulatory system have already been reported [18,19,20,21,22,23] . Decreasing lead exposure for pregnant women and children is still needed; therefore, monitoring of lead exposure level of these populat
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| June 16, 2021 | Families
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It’s amazing how two little lines popping up on a stick can produce such a range of conflicting emotions in a person. Hopefully, that range tends more toward elation rather than the shock-filled-terror end of the scale. Whatever the scenario, there is sure to be a healthy dose of fear in the mix somewhere.
For expats living in Japan, aside from the realization that you are expecting, that fear may be compounded even further by having to figure out prenatal care, doctors, official registration and the like. I can relate. Not to worry, Savvy Tokyo is here to help! After you’ve done your little happy dance, a few fist pumps and taken some deep calming breaths—read of the following tips.
If you suspect you may be pregnant, you’ll be happy to know that simple, pee-on-a-stick type home pregnancy tests ( ninshin kensayaku ) can typically be found at any drugstore for a few hundred yen. To confirm your pregnancy head to your local hospital or ladies’ clinic for a checkup.
Hospitals and birth centers book up very fast, so you will want to get onto this fairly quickly.
I went for my confirmation appointment when I was six-weeks pregnant amid much ribbing from my husband—who thought I was being a little overeager—only to find that the delivery suite at Kawasaki Municipal Tama Hospital (my local) was already fully booked for anyone beyond the eight week mark. Note that you don’t need to go to the facility where you wish to give birth for this initial checkup, but depending on the hospital, it may mean your name gets pencilled in even before confirmation.
Your doctor will confirm your pregnancy via transvaginal ultrasound. This can be a blessing and a curse. While it’s exciting to have a scan and possibly see your tiny, flashing bean straightaway, it can also be unnecessarily concerning if no heartbeat can be found, since it’s not always possible at such an early stage. So if not, try not to worry—your doctor will likely ask you to return the following week to try again.
Once your doctor spies a heartbeat, you will be issued with a certificate declaring the pregnancy confirmed ( ninshin todoke ).
After confirmation, take the ninshin todoke and your foreign residence card to your local health center to register the pregnancy. Upon registration you will receive a pregnancy goodie bag which includes:
You will need to take this to all of your prenatal appointments, child’s health checkups and vaccinations in the future for medical staff to record and refer to your medical information. Many foreign language translations of the handbook are also available.
Prenatal care in Japan is not covered by the National Health Insurance. However, according to your ward’s policies, you can receive discount coupons for checkups. Note that (at my hospital, at least) the fees for your initial confirmation appointment(s) can be reimbursed after the pregnancy is confirmed and the coupon book is obtained.
This badge, which charmingly reads “there is a baby in my belly,” provides you with an all-access pass to priority seating areas on public transport and disabled car parks. Attach it to your bag so that other passengers know you are pregnant and will (in theory) offer you their seat. In reality, I found that its efficacy varies according to the time of day and crowdedness of the train or bus.
This will depend on where you live. In my bag, I found guidebooks about child health and facilities specific to Kawasaki City as well as other sponsored booklets and coupons for baby products. In Minato Ward, residents are issued with a free bus pass for use on Chii buses until the end of the month in which the child turns one.
Generally speaking, your prenatal checkup schedule will look something like this:
This corresponds to around 15 checkups total—heaps compared to that in other countries. Additionally, ultrasounds are performed each time, which means you end up with quite the collection of pictures of your child from long before he/she is born. While it’s nice to have the constant reassurance, it also adds to the cost and can be a little inconvenient, especially if you are working (although employers are required to allow you the time off for appointments). If you find it too much, you may be able to request to space the appointments out more.
While you might find your first appointment pretty daunting with all the people scurrying about, hospital noises and forms to be completed, be assured that each checkup will likely follow the same pattern so you will quickly get the hang of it. If your Japanese abilities are limited, I would suggest bringing a translator with you on your first visit at least.
At my hospital each checkup took the following course, and took between one to 2 1/2 hours:
According to Japan’s Labor Standards Act, employers are required to allow mothers maternity leave from six weeks (for one baby and from 14 weeks for twins and more) prior to the due date until eight weeks after delivery. In addition, the Act on Childcare Leave provides for childcare leave until the child turns one (and until the child reaches one year and six months of age, if the parents take turns). During this time, labor and social insurance will cover up to 66 percent of the mother’s base salary, but every company will have their own regulations—so please make sure you confirm all details with your employer.
The best time for announcing your pregnancy to your employers will, of course, depend on your company’s culture, size and your relationship with your direct supervisors. You will also want to factor in whether you will need time off for prenatal appointments, morning sickness and when your precious baby bump starts to show. It goes without saying that your boss should find out privately and directly from you—this is particularly important in Japanese work culture.
I worked at a tight-knit office of seven workers and was the only person in my role. I also suffered from terrible morning sickness, so I told my boss quite early on—at around 13 weeks as soon as the initial “danger zone” of the first trimester had passed. He was very gracious and quick to give me time off as necessary, saying that I needed to prioritize my health.
In future articles on giving birth in Japan, we will provide an overview of birth options and the birth experiences of a number of other women in Japan. If you have any specific questions, please leave a comment and we’ll be happy to address it.
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