Paraquat Poisoning in Japan: A Hospital-based Survey / Journal of Rural Medicine

Background: Paraquat has been a matter of grave concern around the world, including Japan, in light of high mortality rates and numerous fatalities.;Method: We undertook a cross-sectional survey of pesticide poisoning by collecting data for 6 years, from 1998 to 2003, from 102 hospitals affiliated with the Japanese Association of Rural Medicine. From these cases, we analyzed those with exposure to paraquat.;Results: There were 79 paraquat poisoning cases, including 71 cases of suicide. Of the suicide cases with 5% paraquat and 7% diquat products, more than 80% resulted in suicide deaths. All people who used 24% paraquat products completed suicide. The outcomes of these cases were related to age and volume of ingestion. The prognosis line proposed by Proudfoot in 1979 continues to explain the final outcome of almost all cases even though more than 25 years have passed since it was first proposed. More than 80% of fatalities died within the first three days of ingestion.;Conclusion: Numerous lifesaving methods have been proposed by physicians around the world. However, almost all of these methods treat pulmonary disorders in the sub-acute and subsequent periods and seem unable to effectively decrease mortality rates. It is necessary to take administrative measures to reduce paraquat concentrations in products and, furthermore, to impose strict restrictions on its distribution.

Nationwide Survey of Clinical Cases of Pesticide Poisoning/Disorders in Japan, 2001-03 / 日本農村医学会雑誌

Data concerning clinical cases of pesticide poisoning/disorders were collected from members of the Japanese Association of Rural Medicine during 2001-2003, and were analyzed statistically.A total of 194 cases of poisoning/disorders by pesticide exposure were reported from 36 hospitals and other medical institutions. Suicide cases accounted for 74% of the total number of cases, which was followed by the cases caused by exposure during spraying (17%) and drinking/eating by mistake (7%).In 144 suicide cases, those of males accounted for 52%, the middle-aged and older people constituted the majority. By types of clinical manifestations, almost all of the cases were acute or subacute pesticide poisoning (98%). Organophosphate insecticides were the most frequent inducers of the cases (39%), which was followed by bipyridylium herbicides (23%). When it comes to the outcome, more than 80% of suicide cases with paraquat products resulted in death.There were 39 cases of pesticide poisoning/disorders resulting from exposure during spraying, preparation or settling, and working in sprayed area. In these cases, males accounted for 70% the middle-aged and older people made up the majority. By types of clinical manifestations, the cases of acute or subacute pesticide poisoning accounted for 39%, which was followed by acute dermatitis (33%), chemical burn (14%), and ocular disorders (11%). The pesticides that induced clinical cases varied greatly. Main factors contributing to the onset of pesticide poisoning/disorders were insufficient protective clothing (44%), self conceit (19%), insufficient information (14%), and carelessness (12%).

Clinical and Epidemiological Studies of Ixodiasis and Infectious Diseases Sequental to Ixodes Tick Bites in Rural Areas: Report II / 日本農村医学会雑誌

This is the second report of the findings of the clinical and epidemiological studies on pathogen-carrying madani tick bites (ixodiasis) and the vector-borne diseases conducted by a study group of researchers specially organized by the Japanese Association of Rural Medicine. The report covers the period from January 1 through December 31, 2004.The same questionnaires that had been prepared in the previous survey were sentto 80 JARM-affiliated medical facilities and 11 non-member medical institutions to collect information about tick bites and resultant infections.It was found that during 2004 there were 134 cases (67 for men and 67 for women) of skin lesions caused by ixodid tick bites, 14 cases of Lyme disease (7 for men and the same for women), and none for Japanese spotted fever. These ixodiasis cases did not show any speciffic difference from those reported previously. All the Lyme disease patients developed erythema migrans which characterize stage 1 infection.As there is still plenty of catching up to do in terms of coping with the tick bite problems in Japan, we referred to some literature on the control of ixodid ticks, serologic testing techniques for Lyme disease, administration of prophylactic antibiotics and therapeutic methods.

Research on Prevention of Pesticide Poisoning in Asia : A Review / 日本農村医学会雑誌

In japan, pesticides have been used increasingly after World War II and pesticide poisoning has been a major issue of rural medicine. In other Asian countries, pesticide poisoning also seems to be a great concern of rural medicine and occupational and environmental medicine as well. We reviewed the results of research on the prevention of pesticide poisoning in Asia with the reports of international organizations and articles which appeared in medical journals.The WHO Glabal Information Network on Chemicals worked out an international protocol to collect and analyze the cases of pesticide poisoning, and is carrying out hospital-based surveys in east and south Asia from 1998. These data were discussed in comparison with the results of our hospital-based survey of pesticide poisoning in 1998-2000.Also, FAO has been exploring the concept of “community integrated pest management (CIPM)” from 1999, in Asian countries. In a project related to this, farmers were asked to report their pesticide use and symptoms, and researchers analyzed the data and gave advice to the farmers, and these practices produced so fruitful findings that the farmers have come to refrain from using hazardous pesticides of their own accord. These research projects are expected to complementarily contribute to the prevention of pesticide poisoning. We resumed the hospital-based survey of pesticide poisoning in 1996, and have collected and analyzed several hundreds cases. In order to reduce pesticide poisoning in Japan and other Asian countries, we are interested in rendering cooperation in those projects.

Clinical and Epidemiological Studies of Ixodiasis and Infectious Diseases Sequential to \it{Ixodes} Tick Bites in Rural Areas : Report I / 日本農村医学会雑誌

This paper describes the results of clinical and epidemiological studies of pathogen-carrying madani tick bites and the vector-borne diseases. The studies were conducted by a group of researchers specially organized by the Japanese Association of Rural Medicine.Questionnaires were sent out to JARM-affiliated 108 medical institutions to collect information about cases of ixodiasis, Lyme disease and Japanese spotted fever. It was found that during 2002, there were 151 cases of Ixodes tick bites (67 males and 84 females) and 17 cases of Lyme disease (13 males and 4 females). The incidence of Japanese spotted fever was zero.The survey also found that before that year, 24 out of the 108 medical institutions had treated tick bite cases and 13 handn’t. No reply came from the rest. As to Lyme disease, six hospitals had experienced in treating this vector-borne disease, 31 hadn’t and the rest did not reply. Japanese spotted fever was confirmed by one hospital. Thirty-three hospitals said they had not encountered this disease. The remaining 74 facilities did not respond. It was regrettable that more than a half of the 108 institutions did not respond to the survey. Considering that new types of infectious diseases caused by new forms of pathogens are raging nowadays, we, professionals affiliated with the Japanese Association of Rural Medicine, must keep careful watch on these diseases.

A Study on Glucomannan's Function to Reduce Cholesterol / 日本農村医学会雑誌

We have checked into the function of <I>konjak</I>, or the devil's-tongue (<I>Hydrosme vivieri</I>) to reduce cholesterol in order to cast light on its significance as a health food. We processed chipped glucomannan into crackers (hereinafter referred to as “mannan crackers”) and examined its impacts on lipid metabolism. Enrolled for this study were hospital staff members whose total cholesterol exceeded 200mg/dl and students boarding in the hospital's nursing college.<BR>The findings attested to the fact that the intake of mannan crackers may serve to reduce the values of total cholesterol. The higher the value of total cholesterol before this study, the greater the drop. Since we could not detect any effect on either HDLcholesterol or triglyceride, the mannan crackers were considered capable of specifically reducing LDL-cholesterol. We observed no numerical changes in the complete blood cell count (CBCC) and blood chemistry, either. Some of the subjects had abdominal swelling, diarrhea and other digestive problems but theirs were not serious cases. Yet in another aspect, there was no difference in body weight between before and after this study, but the intake of energy and lipid dropped during the period, suggesting that the intake of mannan crackers would produce an effect on the dietary pattern. Having said that, <I>konjak</I> (mannan crackers) may be considered capable of directly or indirectly reducing cholesterol, particularly LDL-cholesterol, suggesting that mannan crackers are of significance as a health food.<BR>The significance of this study for agriculture and rural community must not go unmarked. This study will contribute to the development of agriculture as an industry, while the farm product by the name of <I>konjak</I> has something to do for health, and will be instrumental in protecting the rural environment, not to mention the lives of farm workers engaged in its production. It is a task for us to grapple with by associating itself with farm work and rural villages with the close collaboration of those farm producers.