of metal interactions with subcellular biochemical systems usually
either are metabolites of the system affected (porphyrinurias) or
represent some specific function of a cellular system being impaired
(proteinurias). One typically finds a continuum of symptoms, from the
subtle or so-called "no effect" bio- chemical and physiological
indicators of exposure to severe clinical disease and death. This
continuum is the basis of much of the controversy since many health
officials follow the traditional practice of applying the "threshold-
health-effect" concept in evaluating the problems of environmental
exposure to metals. The past decade or so, however, has seen a vast
increase in our understanding of the effects of elevated concentrations
of toxic metals in local populations and ecosystems. At the same time,
there is a growing awareness that the effects of the metals which occur
naturally in the environment must be distinguished from those imposed by
the pollutant fraction. This point was amply document- ed in a recent
study of cadmium intake and cadmium in a number of human tissues in
Sweden, Japan, and the United States, which showed fairly conclu- sively
that the background exposure in Japan was about threefold higher than in
the other two countries (2). One immediate implication is that any
health ef- fect studies of cadmium in Japan using control groups within
that country are liable to underestimate the difference between the
exposed and the control groups simply because of the the high
"background" intake.