This study investigated the relationship between total cadmium intake and mortality among rural inhabitants of the Jinzu River Basin, Japan. A follow-up survey was conducted for 6,128 days on 3,236 inhabitants. The rural communities were divided into 2 groups, one with a total cadmium intake of < 2.0 gm and the other > or = 2.0 gm. Standardized mortality ratios and a Cox's proportional hazard model indicated mortality risk was greater in the > or = 2.0 gm group, compared with the < 2.0 gm group. In the Jinzu River Basin, a total cadmium intake > or = 2.0 gm exerts an adverse influence on life prognosis.