ABSTRACT
In Japan, Max von Pettenkofer is highly regarded as a pioneer of modern hygiene. The contribution of Edmund Alexander Parkes, however, is not yet sufficiently appreciated. This paper outlines the life and achievements of E.A. Parkes and discusses his influence in Japan.
Subject(s)
Japan , MesonsABSTRACT
In Japan, Max von Pettenkofer is highly regarded as a pioneer of modern hygiene. The contribution of Edmund Alexander Parkes, however, is not yet sufficiently appreciated. This paper outlines the life and achievements of E.A. Parkes and discusses his influence in Japan.
ABSTRACT
Investigation was made on the characteristics of farmwork and its effects on the health of people who engage in mixed farming (rice growing and dairy farming), cultivation of lotus roots, tulip growing, highland vegetable growing, rush growing, greenhouse cultivation of lotus, green pepper growing, chrysanthemum growing and vineyard management. Based on our findings, we pointed out several problems associated with rural medicine. As for a way of making workload assessment, we proposed a new method for analyzing postures farmers assume while they are working. We also suggested a modification to the cumulative fatigue symptoms index (CFSI) so as to make it suitable for farmers.
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In a series of studies of the workload of lotus growers and their health condition, we checked up on the results of group health screening of lotus growers in comparison with those of other farmers among Tsuchiura agricultural cooperative members in 1992. During that year, we also carried out a time study of lotus cultiration from planting through harvesting. In 1993, we investigated the lifestyle and behavioral pattern of lotus growers. In 1994, an index of cummulative fatigue symptoms was made for lotus growers and loads exerted on their circulatory system were examined.<BR>These studies brought to light hard facts about lotus growing. The farmers have to work in muddy fields laboriously, and for many hours at that, planting in the hottest season and harvesting in the coldest season for many hours. Even when they feel ill, they cannot afford to leave toiling off for their health. We found many signs and symptoms of physical disorder resulting from overwork and peculiar to lotus growing. To improve the working conditions of lotus growing, we recommended the use of the lotus center as a labor saving mode of work so as to facilitate the introduction of power harvesters or the use of greenhouses.<BR>Although there are many socioeconomic issues such as aging of the farming populace, lack of successors and decline in agricultural economy, we will continue to make efforts at health control to protect the health and welfare of farmers by accumulating our knowlege through studies of the state of lotus farming and the health condition of the lotus farmers in other areas as well.
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An epidemiological survey on allergic conditions of 58 male (aged 38.6±11.8yrs) and 47 female (aged 42.2 ± 9.6yrs) farmers engaged in growing chrysanthemums.<BR>Among the subjects, 47% of males and 62% of females had complaints of at least one of inquired allergic symptoms associated with the work. The immediate type of allergic reaction on nasal and/ or upper respiratory system raised in the process of sorting flowers in the working room and delayed ype of contact dermatitis in pinching the lateral bud of chrysanthemums or spraying agricultural chemicals in the field were the main complaints of those farmers.<BR>Incidence of positive reaction for patch testing to six kinds of chrysanthemums was 5% for males and 17% for females and that of eight kinds at agricultural chemicals was 34% and 45% for each sex. And relatively high incidence was also observed in those subjects from other immunological tests such as determination of serum immunoglobulin, prick testing and calculation of eosinophil in blood and rhinorrhoea.<BR>There were 39 (67%) males and 36 (77%) females who had at least one of the abnormal finding of those test items above mentioned. However, not the particular kind of Chrysanthemum cultivated in that area was found to be strong causative allergen for the observed allergic conditions.<BR>From these results, it is indicated that relatively high incidence of allergic disorders may be found in the chrysanthemum growers due to inhalation and/or contact of some kinds of allergens introduced from the process of growing to forwarding, such allergen as Chrysanthemum itself, agricultural chemicals and other elements.
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In order to observe the actual work types and the work load of female farmers in various kinds of agriculture that have gradually become a large part of agriculture in Japan as a result of changes in the structure of agricultural production, the authors performed a questionnaire and interview with a large number of female farmers (2, 113) and women in non-agricultural households.<BR>Greenhouse farming was the most common work type for female farmers, followed by tobacco cultivation. The jobs conventionally undertaken by men, that have required a large dynamic work load, have been progressively mechanized, while auxiliary work before and after machinary work remain as manual labor by women. Some clear differences in the work type between full-time farming and part-time farming of female farmers were observed. On the other hand, it does not seem to be easy to estimate the work strain due to the work loads as mentioned above.
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In the farm household of “vegetable planting by plastic green house”, “mandarin orange”, “rush (igusa)”, “dairy-farming” and “silk worm”, measurement of energy expenditure in agricultural work and analysis of daily working hours were conducted at the busy season of each crops. The results are as follows:<BR>The energy consumption per day are estimated respectively to be 3300 Cal for male and 2900 Cal for female in the household of the “plastic green house”; 3500 and 2500 Cal in the “mandarin orange”, 3800 and 3600 Cal in the “rush”, 3300 and 2700 Cal in the “dairy-farming”, 3400 and 2700 Cal in the “silk worm”.<BR>The agricultural machines and tools are mainly operated by male and so attached muscular works not yet machanized are carried by female. And management of animals or crops specially required prudent care have a tendency to be also carried by female. Then the average relative metabolic rate (RMR) a working day is relatively higher in female than male, except “mandarin orange”.<BR>In the “rush harvesting” and “dairy-farming”, having the most development of the agricultural mechanization it seems obviousely to be rising the labor efficiency, but because of expansion of management scale and decreasing number of employee the reduction of work load for a worker is not necessory obvious.
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Mass health survey was conducted to discuss the relationship between obesity and some factors of agricultural managements and living and working conditions among 349 pairs of housewives and their husbands selected from the rural communities in Kumamoto prefecture.<BR>The prevalence rates of obesity (20% over of the Minowa's standard weights) were 13.1% for housewives of farmers, 13.7% for their husbands and 15.6 % for housewives of non-farmers, 9.2% for their husbands. The significant correlationship was found in the degree of obesity by Minowa's standard between housewives and their husbands (r= 0.1566, P<0.05).<BR>Being compared the prevalence of obesity according with the kinds of each household's producting crops, peoples of the household of “shiitake: cortinellus shiitake”, “vegetables by plastic greenhouse”, “tabacco” and “animal husbandary ” were more likely to be obese and, inversely, those of “barley”, “vegetables in upland” and “sericulture” were less, than those of “rice”, “mandarin orange” and “forestry”. In the household of “vegetables by plastic greenhouse”, “rice”, “barley”, “mandarin orange” and “vegetables in upland” husbands were more obese than housewives and, inversely, in the household of “shiitake” and “forestry” housewives were more obese than husbands.<BR>Peoples of fishing households were less likely to be obese than those of the farm households and/or other profession. Among the households of non-farmers it was noteworthy that higher prevalence rates of obesity were found in housewives than husbands, being inverse finding in the farmers case.<BR>The results suggested that the agricultural management and it's labor conditions, as well as the level of agricultural economics, might strongly affect the occurrence of obesity in the Japanese rural community.
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One is inclined to imagine that the incidence of respiratory diseases will be negligible among rural people who live and work in fresh and clean air. On the contrary, however, we have reports on the high incidence of chronic obstructive pulmonary diseases and on the existence of a variety of specific respiratory diseases which are incidental to farm work. To clarify this situation, the Japanese Association of Rural Medicine organized a special study group and carried out various studies with grants from the Ministry of Health and Welfare. This is the study group's summary report of the four year research project prepared in conclusion of the project.<BR>The actual state of respiratory diseases among rural people, as investigated by the present study group, can be summarized as follows:<BR>1) In rural districts, in spite of its freedom air-pollution, there exist in high percentages people suffering from respiratory symptoms and patients of obstructive pulmonary diseases. As the important cause of this phenomenon, farm operations, especially thrashing, rice-hulling, compost preparation, scattering of agricultural chemicals can bementioned, which invite the development of symptoms and their aggravation.<BR>2) Pathologically, farmer's pneumoconiosis attributable to farm operation dust was evidenced, crying for the necessity of dust prevention measure during farm operations.<BR>3) In connection with atopic asthma the study group proved the antigenicity of rice-straw, wheat-straw, celiae of tea-sprout, young leaves, and chrysanthemum leaves. There are also anumber of already known antigens. It is necessary to establish measures for its prevention and treatment.<BR>4) In rural districts of Japan, esp. in stock-raising farm houses, there are in comparatively high percentages those who react positive to fungous antigens which are the causes of farmer's lung. However, there have hitherto been reported only two cases, and the study group added one more. In the future, more extensive practice of immunological tests and clinical follow-ups of the positive cases will be necessary.<BR>5) In view of the results reported above, it is considered that there are numerous questions concerning respiratory troubles and diseases in rural districts which are awaiting further study.
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In the previous study, relatively high prevalence of asthma-like attacks associated with handling rushes was observed. In this connection, mass survey of the intradermal skin test (×10000, 0.02ml) by the extracts of rush (Juncus effusus L. var decipiens Buch. forma utilis Makino) and the dusts in the weaving room containing rushes, dyeing materials (sendo) and other house dusts was conducted for the rush farmers (65 males, 143 females), other farmers (21 males, 91 females) and women without farming (28 females). The results were summerized as follows.<BR>1) The positive rates in skin test were estimated to be 7.7% for males and 2.1% for females of the rush farmers by the extracts of rush, and 23.1% for males, 10.5% for females by the extracts of dusts in the weaving room. On the centrally, 4.8% for males, 1.1% for females of the controlled farmers by the former extracts, and 19.0% for males, 8.8% for females by the latter extracts. And among females without farmiing, 0% and 3.6%, were positive respectively.<BR>2) The positive rates were not associated with age, respiratory symptoms and past history of asthmalike anfall. The rush farmers were observed relatively higher percentages of positive reaction than the controlled groups, but not signifficantlly.<BR>3) The results do not clarify the causative agent of antigen-antibody reaction to the asthmatic anfall among the rush farmers, but suggest that peoples, whether farmer or not farmer, may be sensitized by the rush antigen through the farm works and or using tatami mat and other rush products in daily life.
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One hundred and thirty one city inhabitants, have been lived in Kumamoto city over 20 years, were examined by gel diffusion test for precipitins to 12 antigens of fungi and 2 pigeon proteins. And the prevalence of positive reactions to these antigens was compared with the former research for the farmers in mountain district in last year. The results were summerized as follows.<BR>Fifteen positive sera of 131 tested (11.5%) were detected to c. acremonium. And, 6.7% to candida, 6.1% to s. granarius, 5.9% to p. pullulans, 3.8% to t. vulgaris, 1.5% to m. faeni and positive to other 7 antigens tested. Thirty seven cases (28.2%) were positive to at least one antigen of all 14 tested. The proportion of positive selological tests in city inhabitants was rather higher than that of the farmers. The results suggest that the city inhabitants in Kumamoto prefecture have been exposed relatively high amount and/ or various kinds of fungi antigens as well as farmer's case.
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It is to be noted that in rural districts where they live and work in fresh and clean air the incidence of chronic obstructive pulmonary diseases is as high as in the districts of air-pollution. Besides, there are a variety of respiratory diseases particularly incidental to life-environment and farm work. To be more informed of their actual conditions, the Japanese Association of Rural Medicine organized a special study group and has carried out various studies for four consecutive years with grants from the Ministry of Health and Welfare. The major results obtained are as follows<BR>(1) There were a variety of farm operations which produced or increased respiratory symptoms, including thrashing and scattering of agricultural chemicals;<BR>(2) It became clear that there existed in an advanced age group certain cases of “agricultural pneumoconiosis” which could be regarded as the terminal of the so-called “thrash-bronchitis”<BR>(3) Among the cultivators of rush, raw material for Tatami, There existed cases of pneumoconiosis;<BR>(4) There were a variety of agents to produce bronchial asthma, such as rice straw, chaff, tea-leaves and chrysanthemum-leaves;<BR>(5) In Japan only two cases of farmer's lung were reported prior to this study. One more case was added to the list by this study group. Besides, cases positive to fungous agents were found among farmers in considerably high percentage.
ABSTRACT
It is to be noted that in rural districts where they live and work in fresh and clean air the incidence of chronic obstructive pulmonary diseases is as high as in the districts of air-pollution. Besides, there are a variety of respiratory diseases particularly incidental to life-environment and farm work. To be more informed of their actual conditions, the Japanese Association of Rural Medicine organized a special study group and has carried out various studies for four consecutive years with grants from the Ministry of Health and Welfare. The major results obtained are as follows:<BR>(1) There were a variety of farm operations which produced or increased respiratory symptoms, including thrashing and scatteringof agricultural chemicals;<BR>(2) It became clear that there existed in an advanced age group certain cases of “agricultural pneumoconiosis” which could be regarded as the terminal of the so-called “thrash-bronchitis”<BR>(3) Among the cultivators of rush, raw material for Tatami, there existed cases of pneumoconiosis;<BR>(4) There were a variety of agents to produce bronchial asthma, such as rice straw, chaff, tea-leaves and chrysanthemum-leaves;<BR>(5) In Japan only two cases of farmer's lung were reported prior to this study. One more case was added to the list by this study group. Besides, cases positive to fungous agents were found among farmers in considerably high percentage.
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Two hundreds and seventy one cases of sera of farmers (48.8±10.8 yr.) in mountain district of Kumamoto prefecture were examined by gel diffusion test for precipitins to M. faeni, T. vulgaris and other 12 antigens of fungus and pigeon proteins.<BR>Ten positive sera (3.7%) from 271 sera tested were detected to M. faeni and 13 were to T. vulgaris. The confidence intervals (95%) of the positive ratiowas calculated 1.8%-6.6%and 2.3%-7.4%, respectively. To other 10 antigens 1-22 sera were positive, such as C. corticale (0.1%-2.7%, as confidence intervals), S.granarius (4.9%-11.4%), P. pullulans (0.4%-3.7%), Aspergillus mix (0.6%-4.2%), Pigeon serum & droppings (0.2%-3.1%), C. acremonium (0.8%-4.7%), T. viride (0.0%-2.0%), Candida (1.6%-6.2%) and P.casei (0.2%-3.1%). NO cases were positive toCladsporium and Alternaria. And 61 cases (17.5%-27.5%) were positive to at least one antigen of all 14 tested.<BR>There was no significance of the proportions of positive reactions between male and female, or age groups. But higher percentagewas found in farmers longer experience of works with hay, straw and compost. Thepresence of a positive precipitin test has been considered as unsatisfactory criterion for the diagnosis of the farmer's lung. However, the findings of our survey suggest that farmers in West Japan has been exposed relatively high amount and/or various kinds of fungus antigens throughout the farm works with hay, straw and compost.
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An epidemiolgical survey as well as a case study on the skin hazards due to dithiocarbamate fungicides, such as Maneb and Manzeb (Mancozeb), were carried out. The results were summarized as follows;<BR>1. From the epidemiological survey, the incidence rate of skin lesions due to the dithiocarbamates in three areas were 42.4%(39/92), 43.3%(113/261) and 27.6%(42/151), respectively.<BR>2. The skin lesions appeared generally in face, hands and nape of neck and collar areas and also in covered areas of the body such as breast, back and so forth.<BR>3. By patch testing with a dithiocarbamate “Maneb” the positive reactions in 40 cases tested were observed in 18%, 23% and 15% of the subject with 0.1%, 0.05% and 0.025% preparations, respectively.<BR>The results suggested that allergic type of contact dermatitis is involved in the skin hazard due to the dithiocarbamate fungicides.
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At the process of rush harvesting farmers are exposed to high concentratedusts of “sendo” for short times a day during 3 weeks in summer, and in continuously for all seasons low density of chronic long-term exposure of dusts are observed in the process of weaving.<BR>We examined 320 rush farmers in Yatsushiro district in 1970 and found pneumoconiosis as1p in their direct chest x ray films, 32 men (18%) and 12 women (9%).<BR>In 1975, 36 men and 34 women amang them were reexamined, contrasting their respiratory findings with that of the former examination. The chest x ray film of each subject was classified according to the ILO U/C International Classification of Pneumoconiosis 1971 (ILO).<BR>In this definition, 15men (42%) and6women (18%) of the subjects were classified as pneumoconiosis (1/0, 1/1, 1/2) of the p type of rounded small opacities except one case of irregular type (s): on the contorary, 9men (25%) and 2 women (6%) in the formers. Thirteen cases of men (36%) and11cases of women (32%) showed increasing numbers of opacities and/or extention of disorder zones. It sugests that the intensity of lung disorders in rush farmers have been becomming slowly into more serioustages. Small opacities were seen in the middle and lower, especially lower (47%), zones of the lung. Adding, 3 men and 2 women were tuberculosis (activity uncertain) cases.<BR>Twenty men (58%) and 15 women (42%) have complaints of respiratory symptoms, such as cough (17%), phlegm (34%), short breath (17%), wheezing (16%), and nasal catarrh (22%). Four men (14%) and5women (15%) showed slightly impairment of lung functions.<BR>These findings shown in chest x ray films or respiratory symptoms were related significantly to the amount of cigarett smoking.<BR>Increasing intensity of their respiratory disorders, we may consider, due to increasing dust exposure of “sendo” according to expantion of rush management. Then we must accomplish an improvement of working environment and hygienic control for dusts. In addition, we must exploit a new “sendo” containing less amount of free silica and technical improvements of working process.
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Nowadays the agricultural production system in the farm area has remarkably been changed and this has influenced the farmers in many aspects of life.<BR>We tried by epidemiologic cross-sectional survey to ascertain the health level of 6, 597 farmers, who are self-supporting and middle class in the sixty-seven different districts of Kumamoto Prefecture. It is noticeable that judging from the difference of districts, the health level of the farmers who have a big gricultural production is low, and judging from the difference of the class, that of the farmers who have other jobs besides agriculture is low, too In general, the health level of males is relatively higher than that of females, but the health level of males is higher than that of females, depending on the class difference.<BR>Generally speaking, we noticed that the health level of female is very low, and at the same time the variation of the health level of females is more remarkable than that of males, depending on the quality of the district in which they live.<BR>These resutls of these investigations should be utilized as the basic materials source for a prospective survey of changing farm village from now.
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In order to study whether there is any relation between the cause of anemia in rural women and environmental factor from the epidemiological standpoint, we have followed up the seasonal change of the blood properties (GB, Hb, Ht, R, Serum iron) of 3 groups of women in different working and living circumstances.<BR>The results revealed a remarkable tendency to increase the values of the blood properties excluding serum iron in winter and to decrease in summer. The degree of seasonal change was found to be greater in rural women than that in factory workers. And among the factory workers, the married had more change than the unmarried, the rural residents than the urban. And among the rural women, only the establishmental gardeners who were especially busy in winter showed a tendency to decrease the values of the blood properties in winter.<BR>From these data, we can see that the seasonal change of the burden of agricultural work and the change of dietary life actually have direct influence on the change of the blood properties.