Assessment of environmental sustainability in renal healthcare / Journal of Rural Medicine

The health effects of climate change are becoming increasingly important; there are direct effects from heatwaves and floods, and indirect effects from the altered distribution of infectious diseases and changes in crop yield. Ironically, the healthcare system itself carries an environmental burden, contributing to environmental health impacts. Life cycle assessment is a widely accepted and well-established method that quantitatively evaluates environmental impact. Given that monetary evaluations have the potential to motivate private companies and societies to reduce greenhouse gas emissions using market mechanisms, instead of assessing the carbon footprint alone, we previously developed a life cycle impact assessment method based on an endpoint that integrates comprehensive environmental burdens into a single index—the monetary cost. Previous investigations estimated that therapy for chronic kidney disease had a significant carbon footprint in the healthcare sector. We have been aiming to investigate on the environmental impact of chronic kidney disease based on field surveys from the renal department in a hospital and several health clinics in Japan. To live sustainably, it is necessary to establish cultures, practices, and research that aims to conserve resources to provide environmentally friendly healthcare in Japan.

Description of environmental determinants of quality of life in children with intellectual disability in Japan using the Delphi technique

<p><b>OBJECTIVES</b>The present study aimed to define the framework of an environment conducive to the well-being of children with intellectually disability (CID).</p><p><b>METHODS</b>A questionnaire composed of 31 items was developed through literature review. Then a 2-round Delphi survey was conducted with 3 different panels: health professionals (HPs), parents of CID, and teachers. The participants were asked to rate each item, select and rank the 10 most important items, and suggest additional ones.</p><p><b>RESULTS</b>A total of 71 participants responded to the first round: 24 HPs, 22 parents, and 25 teachers. In the second round the overall response rate was 83%. At the end of the exercise, 12 items reached global consensus, i.e., in all groups. Only 5 items were ranked as most important by all groups: attitudes of family members at home; attitudes of HPs and teachers; support from family members at home; support at school (classmates and teachers); and government policies. Nevertheless, the panelists' views diverged on the remaining items. Several additional elements were suggested.</p><p><b>CONCLUSIONS</b>The views of HPs, teachers, and parents are complementary for the improvement of quality of life (QOL) of CID. The present findings will be used as a basis for the development of an instrument to assess the living environment of CID.</p>

Incidence and Consequence of Falls among Stroke Rehabilitation Inpatients in Convalescent Rehabilitation Ward : Data Analysis of the Fall Situation in Multi-institutional Study / The Japanese Journal of Rehabilitation Medicine

We collected and analyzed large-scale data concerning the fall of stroke inpatients in convalescent rehabilitation wards. Three hundred seventy-four of 1,107 inpatients experienced one fall or more, and 16 factors associated with falls were clarified by the chi-square test. To extract the significant item from a multifactor, the logistic regression analysis of 16 factors was carried out, and we developed an assessment sheet for the risk degree of first fall prediction in stroke inpatients. We selected eight variables as the items on the assessment sheet : history of previous falls, central paralysis, visual impairment, sensory disturbance, urinary incontinence, use of psychotropic medicines, mode of locomotion, and cognitive impairment. The total score of the assessment sheet was ranged from 0 to 10 and the mean score of fallers (6.4±1.5) among subjects was significantly higher than that of non-fallers (5.1±1.9) (<i>p</i> <0.001). When the subjects were classified into three groups, a significant difference (<i>p</i><0.001) in the tendency of fall incidence in term of days after admission was found among the three groups on the basis of the Kaplan-Meier survival curve.

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

<p><b>OBJECTIVE</b>We conducted a study to develop an assessment sheet for fall prediction in stroke inpatients that is handy and reliable to help ward staff to devise a fall prevention strategy for each inpatient immediately upon admission.</p><p><b>METHODS</b>The study consisted of three steps: (1) developing a data sampling form to record variables related to risk of falls in stroke inpatients and conducting a follow-up survey for stroke inpatients from their admission to discharge by using the form; (2) carrying out analyses of characteristics of the present subjects and selecting variables showing a high hazard ratio (HR) for falls using the Cox regression analysis; (3) developing an assessment sheet for fall prediction involving variables giving the integral coefficient for each variable in accordance with the HR determined in the second step.</p><p><b>RESULTS AND DISCUSSION</b>(1) Subjects of the present survey were 704 inpatients from 17 hospitals including 270 fallers. (2) We selected seven variables as predictors of the first fall: central paralysis, history of previous falls, use of psychotropic medicines, visual impairment, urinary incontinence, mode of locomotion and cognitive impairment. (3) We made 960 trial models in combination with possible coefficients for each variable, and among them we finally selected the most suitable model giving coefficient number 1 to each variable except mode of locomotion, which was given 1 or 2. The area under the ROC curve of the selected model was 0.73, and sensitivity and specificity were 0.70 and 0.69, respectively (4/5 at the cut-off point). Scores calculated from the assessment sheets of the present subjects by adding coefficients of each variable showed normal distribution and a significantly higher mean score in fallers (4.94 +/- 1.29) than in non-fallers (3.65 +/- 1.58) (P = 0.001). The value of the Barthel Index as the index of ADL of each subject was indicated to be in proportion to the assessment score of each subject.</p><p><b>CONCLUSION</b>We developed an assessment sheet for fall prediction in stroke inpatients that was shown to be available and valid to screen inpatients with risk of falls immediately upon admission.</p>

Improving ability of married women to prevent reproductive tract infections in rural western China

<p><b>OBJECTIVES</b>The purposes of this study are to investigate and analyze the status of reproductive tract infections (RTIs) in married women in rural western China, and to develop effective strategies for improving the ability of married women to prevent RTIs in this region.</p><p><b>METHODS</b>We conducted in-depth interviews of 142 married women from four villages in three townships. Two questionnaires were used to gather data on married women's health care status, family income, knowledge about RTIs, relevant behaviors, and attitudes toward RTIs. Descriptive, parallel, and logistic regression analyses and the Chi-square test were applied to analyze the relationships between basic conditions and several influential factors.</p><p><b>RESULTS</b>Over 80% of the respondents were of limited income and had with poor knowledge of and a lack of experience in preventing RTIs. Some 83.3% of the married women had experienced menstrual irregularities; 70.3% of those interviewed had experienced malodorous vaginal discharge with or without perineal itching. It was found that 80.7% of the interviewees did not have good personal hygiene habits in daily living regarding RTIs. It was found that the prevalence of RTIs was lower in women who had accurate information about RTIs. Most married women lacked basic knowledge of ways to prevent RTIs, and this, together with the limited support of the health care system and the absence of medical insurance schemes, was responsible for the observed high prevalence of RTIs.</p><p><b>CONCLUSIONS</b>There is an urgent need to improve the capability of married women in rural China to prevent RTIs, and it is important to find effective ways to prevent these diseases. Three health promotion strategies are presently being implemented to prevent RTIs and to build capacity for disease prevention among married women in rural western China.</p>

Effect of estradiol on heme biosynthetic pathway in lead-poisoned rabbits

<p><b>OBJECTIVES</b>To clarify the effect of the female hormone estradiol (Est) on heme biosynthesis in lead-poisoned rabbits, parameters indicating lead exposure, such as free erythrocyte protoporphyrin (FEP) level and δ-aminolevulinic acid dehydratase (ALA-D) activity, were determined.</p><p><b>METHODS</b>Twenty-six male Japanese white rabbits (body weight (BW), 3kg) were divided into four groups: I (control), II (Est), III (Pb), IV (Est+Pb). About 3 weeks after castration, Est (3 mg/kg of BW) was injected intramuscularly, and 2 weeks thereafter, lead (1.2 mg/kg of BW) was injected intravenously. After the initial injection of each of these substances, the same dose of each of these substances was injected once a week until the 9th week.</p><p><b>RESULTS</b>In groups III and IV, FEP level increased and ALA-D activity in the erythrocytes, bone marrow and liver decreased with an increase in lead concentration in blood. FEP level decreased significantly (p<0.01) in the 8th and 10th weeks after Est injection in group IV compared to with that in group III and was not elevated in group II compared with that in group I. ALA-D activity in the erythrocytes, bone marrow and liver increased significantly in group II compared with that in group I, whereas Ht and Hb levels decreased in group II compared with those in group I, and decreased in group IV compared with those in group III. The level of iron in plasma (Fe-P) was within the normal range during experiment.</p><p><b>CONCLUSIONS</b>In this study, Est did not increase FEP level. From the above results regarding FEP level and ALA-D activity, Est may prevent an increase in FEP level caused by lead. Ht and Hb levels, which are the parameters of anemia, decreased mainly as a result of Est exposure rather than lead exposure.</p>

Effect of Estradiol on Heme Biosynthetic Pathway in Lead-Poisoned Rabbits

Objectives: To clarify the effect of the female hormone estradiol (Est) on heme biosynthesis in lead-poisoned rabbits, parameters indicating lead exposure, such as free erythrocyte protoporphyrin (FEP) level and δ-aminolevulinic acid dehydratase (ALA-D) activity, were determined. Methods: Twenty-six male Japanese white rabbits (body weight (BW), 3 kg) were divided into four groups: I (control), II (Est), III (Pb), IV (Est+Pb). About 3 weeks after castration, Est (3 mg/kg of BW) was injected intramuscularly, and 2 weeks thereafter, lead (1.2 mg/kg of BW) was injected intravenously. After the initial injection of each of these substances, the same dose of each of these substances was injected once a week until the 9th week. Results: In groups III and IV, FEP level increased and ALA-D activity in the erythrocytes, bone marrow and liver decreased with an increase in lead concentration in blood. FEP level decreased significantly (p<0.01) in the 8th and 10th weeks after Est injection in group IV compared to with that in group III and was not elevated in group II compared with that in group I. ALA-D activity in the erythrocytes, bone marrow and liver increased significantly in group II compared with that in group I, whereas Ht and Hb levels decreased in group II compared with those in group I, and decreased in group IV compared with those in group III. The level of iron in plasma (Fe-P) was within the normal range during experiment. Conclusions: In this study, Est did not increase FEP level. From the above results regarding FEP level and ALA-D activity, Est may prevent an increase in FEP level caused by lead. Ht and Hb levels, which are the parameters of anemia, decreased mainly as a result of Est exposure rather than lead exposure.

Behavior and lifestyle factors related to quality of life in junior high school students

<p><b>OBJECTIVES</b>To analyze actual conditions of the quality of life (QOL) in junior high school students, we developed a questionnaire based on the PRECEDE-PROCEED model, and we conducted a survey by using this questionnaire.</p><p><b>METHODS</b>We conducted a workshop organized with 29 specialists on school health and community health to develop the questionnaire. The QOL outcome was assessed by the QOL Profile-Adolescent Version (QOLPAV). The subjects of the questionnaire surveys were 1600 general students in four junior high schools. To investigate a correlation between QOLPAV, behaviors and three enhancing factors, two different multiple regression models were constructed.</p><p><b>RESULTS</b>The question battery for QOLPAV was found to be a high value of Chronbach's α. Among present subjects, 16.5% were categorized as "problematic" or "very problematic" classified by QOLPAV scores. In the first multiple regression model, significantly high odds ratios were obtained between the QOLPAV and 4 questions for behaviors, such as "studying with high motivation" (OR 1.64), "getting along well with my friends" (2.72), "having things I am interested in" (1.70), and "making my own decisions" (1.80). In the second model, significantly high odds ratios were obtained commonly between the above 4 questions about behaviors and 2 questions on enabling factors, such as "easy to understand lessons" (1.32-1.71) and "speaking to friends easily" (1.30-3.22).</p><p><b>CONCLUSIONS</b>1) We developed a questionnaire to analyze the actual condition of QOL in junior high school students with sufficient validity and availability. 2) Among the present subjects, 16.5% were found to be problematic QOLPAV, 3) Among the factors of behaviors, those representing positive willing and high coping ability with the elements of each school life contributed significantly to the QOLPAV. And among enhancing factors, "enabling factors" and "reinforcing factors" were stronger contributors to the behaviors strongly related to the QOLPAV than that of "predisposing factors".</p>

Behavior and Lifestyle Factors Related to Quality of Life in Junior High School Students

Objectives: To analyze actual conditions of the quality of life (QOL) in junior high school students, we developed a questionnaire based on the PRECEDE-PROCEED model, and we conducted a survey by using this questionnaire. Methods: We conducted a workshop organized with 29 specialists on school health and community health to develop the questionnaire. The QOL outcome was assessed by the QOL Profile-Adolescent Version (QOLPAV). The subjects of the questionnaire surveys were 1600 general students in four junior high schools. To investigate a correlation between QOLPAV, behaviors and three enhancing factors, two different multiple regression models were constructed. Results: The question battery for QOLPAV was found to be a high value of Chronbach’s α. Among present subjects, 16.5% were categorized as “problematic” or “very problematic” classified by QOLPAV scores. In the first multiple regression model, significantly high odds ratios were obtained between the QOLPAV and 4 questions for behaviors, such as “studying with high motivation” (OR 1.64), “getting along well with my friends” (2.72), “having things I am interested in” (1.70), and “making my own decisions” (1.80). In the second model, significantly high odds ratios were obtained commonly between the above 4 questions about behaviors and 2 questions on enabling factors, such as “easy to understand lessons” (1.32-1.71) and “speaking to friends easily” (1.30-3.22). Conclusions: 1) We developed a questionnaire to analyze the actual condition of QOL in junior high school students with sufficient validity and availability. 2) Among the present subjects, 16.5% were found to be problematic QOLPAV. 3) Among the factors of behaviors, those representing positive willing and high coping ability with the elements of each school life contributed significantly to the QOLPAV. And among enhancing factors, “enabling factors” and “reinforcing factors” were stronger contributors to the behaviors strongly related to the QOLPAV than that of “predisposing factors”.

Quantification of α-methylene-λ-butyrolactone extracted from different parts ofAlstroemeria wilhelmina and evaluation of it's antigenicity using the guinea-pig maximization test

To detect the type of contact dermatitis caused due to the handling ofAlstroemeria wilhelmina, 1% α-methylene-λ-butyrolactone (α-MBL) dissolved in physiological alien and a five-fold diluted saline solution of original extracts of flowers, leaves and stems of the flower were applied to guinea-pigs for extracts were applied to the animals as the challenge treatment in compliance with the guinea-pig maximization test (GMT). As a consequence, not only primary irritant dermatitis was observed, but also delayed type allergic contact dermatitis due toAlstroemeria wilhelmina was observed. α-MBL determined in the extracts using high-performance liquid chromatography (HPLC) was found to be the biochemical material cause of the contact dermatitis. the flower region contained α-MBL in the highest concentrations compared with those of the leaves and stems. Therefore, the quantification of α-MBL in the extracts was concluded as being a useful evaluating method for contact dermatitis due to the handling ofAlstroemeria.

Self-evalutions of Hearing Disorders and Their Relation to Quality of Life (QOL) Components among the Middle Aged and Elderly in the Community / 日本農村医学会雑誌

Objectives: This study was carried out to verify the usefulness of the Japanese version of the Hearing and Disability and Handicap Scale (HDHS) in the self-evalution of hearing disorders and to clarify the relationships between the hearing disability/handicap scores and such QOL components as life satisfaction, self-rated health conditions and social support networks, etc.<BR>Methods: A questionnaire survey was conducted in Soyo village in Kumamoto Prefecture. The subhects were 136 residents aged 40 years or older who had received health check-ups in accordance with the Health and Medical Service Law for the Aged and who had complained of mild to profound hearing loss in one or both ears. The questionnarie was composed of three parts; back-ground question, the HDHS, and question regarding QOL components. Evalution of language adequacy regarding the Japanese translation of HDHS was carried out with the assistance of four bilinguals.<BR>Results: Data from 123 respondents who completed the questionnaire were analyzed. The results were as follows:<BR>1) Chronbach's alpha coefficients for the three subscales of HDHS ranged from 0.873 to 0.899-all within satisfactory levels.<BR>2) Maximum likelihood factor analysis with varimax roataion suggested that 20 items of HDHS could be categorized according to three factors: Fl-handicaps; F2-detection of such verbal sound as the TV or radio or daily conversation; F3-detection of such nonverbal sound as door chimes or the sound of boiling water.<BR>3) The response rates of “Always or Sometimes” for five questions regarding verbal sounds ranged from 65.8% to 82.1% compared with 47.9% to 58.6% for those questions regarding nonverbal sounds. Those for 10 questions regarding handicaps showed a great disparity; 25.2% for Q15 and 60.1% for Q4.<BR>4) Analysis of covariance structures suggested that increases in hearing disability and handicap scores were indirectly related, through the lowering of self-rated health levels, to a perceived deterioration of QOL.<BR>Conclusion: To ensure high QOL levels among middle aged and elderly residents, the creation of supportive environments that contribute to the alleviation of the affects of communication disorders induced by age-related hearing impairments is extremely important.

Quantification of $\alpha$-Methylene-$\gamma$-butyrolactone Extracted from Different Parts of \it{Alstroemeria wilhelmina} and Evaluation of it's Antigenicity Using the Guinea-Pig Maximization Test

To detect the type of contact dermatitis caused due to the handling of Alstroemeria wilhelmina, 1% α-methylene-γ-butyrolactone (α-MBL) dissolved in physiological saline and a five-fold diluted saline solution of original extracts of flowers, leaves and stems of the flower were applied to guinea-pigs for induction treatment, and 0.1% α-MBL physiological saline and a ten-fold diluted solution of the original extracts were applied to the animals as the challenge treatment in compliance with the guinea-pig maximization test (GMT). As a consequence, not only primary irritant dermatitis was observed, but also delayed type allergic contact dermatitis due to Alstroemeria wilhelmina was observed. α-MBL determined in the extracts using high-performance liquid chromatography (HPLC) was found to be the biochemical material cause of the contact dermatitis. The flower region contained α-MBL in the highest concentrations compared with those of the leaves and stems. Therefore, the quantification of α-MBL in the extracts was concluded as being a useful evaluating method for contact dermatitis due to the handling of Alstroemeria.

Stress and Stress Coping in Japanese Agricultural Workers / 日本農村医学会雑誌

We developed a questionnaire for analysing actual state of stress and determining affective stressors in agricultural workers based on their works and lives. Using that we conducted the collaborative surveys to agricultural workers in 5 different districts in Japan. The results were as follows;<BR>Among agricultural workers (662 males, 1, 084 females) 48% of males and 59% of females were being felt stress with higher prevalance rates in younger age group (under 59yr.) than in elders (over 60yr.). Affective stressors were found in various situations of agricultural works and lives, such as, factors related to work demand category by Karasek's psychological work model, and to agricultural work elements, i. e., dangerous equipments, dust generating condition, works under the sun, long work hours, irregular meal, etc, and to life-events, i. e., a debt, decrease of products, difficulty of relation to neighbors, care of the aged, personal and family member's disease and injury, etc. It was noticeable that the intensity to develop stress by those stressors was manifested stronger in female workers than in male workers. The results of the multiple regression analysis with the scores of those items indicated that the most affective factor for disturbance of quality of life (QOL) was to be the stress and for improvement of QOL was to be the social support. Those results indicated that to keep advantageous factors in the agricultural works categorised by Karasek's psycological work model, i. e., high control and low demans work, and to improve stressful work elements leading to high demand and low control work might be the most effective measure to improve the QOL of agricultural workers. To construct an appropriate network system for the social support in the rural communities using JA and other organizations might be also essential.<BR>The present study also revealed that the process of the present investigation, i. e., to develop the questionnaire and to analyse an actual state of stress and factors of stress coping in agricultural workers using that questionnaire was to be useful to propose appropriate measures for improving QOL of agricultural workers based on actual state of their work and living conditions.

Community-based Analysis of the Factorial Structures of the Recent Increase in Low Birthweight Infants

This study was conducted to determine whether the regional factors were related to the increase in the percentage of low birthweight(LBW: <2, 500g) infants in Kumamoto Pref., and to establish a tentative structure model for predicting low birthweight infants. Analyses for frequency of LBW infants between 1974 and 1997, and a multiple regression model and covariance structure model were conducted using data from the vital statistics between 1992 and 1997 and regional indicators concerned with LBW infants from official registered statistical data between 1992 and 1997. The 72 regional factors were clustered into four groups linked with agricultural areas such as Urban, Flat, Hilly and Mountainous areas. The recent increase in the incidence of LBW infants resulted from the increase in moderate−LBW(MLBW: 2, 000−2, 500g) infants of full term−LBW infants. There was a steady annual increase in the Urban agricultural area LBW infants since 1992. The two structure analyses revealed that the Urban area had a marked effect on the increase in LBW infants, whereas, farm villages in Hilly or Moutainous areas had less effect on the increase in LBW infants. These findings suggest that the regional factors relating to the mothers’ life−style or regional environments play a key role in the etiology and prevention of LBW, and will be a useful in the analyses using official registered material.

Determinants of Life satisfaction among Japanese Agricultural Workers

The purpose of this study was to investigate the factorial structure of life satisfaction in agricultural workers. One hundred and sixty−five (87 males and 78 females) agricultural workers mainly engaged in plastic greenhouse cultivation in southern Japan, ranging in age from 19 to 72 years (mean = 44.3 years), completed a questionnaire. Scores of life satisfaction showed a higher tendency in males than in females, and those in elders were higher than in younger people. Conversely, females showed higher stress scores than males, and younger people’s score were higher than the elders. Multiple regression analysis was performed to analyze the factorial structure of satisfaction. It is suggested that the level of life satisfaction is positively related to social support, and is negatively related to the impact of stressful life events, globally perceived stress and subjective symptoms of ill health. Stress levels depended on factors concerning the psychological demands of work, work posture, work hours and work environment. Different factorial structures were observed between female and male workers. Findings from this study suggest that a strong social support network may assist in enhancing life satisfaction. Furthermore, the ill health and stress experienced in agricultural work were associated with a reduced life satisfaction.

Components of QOL and Its Determinants and Moderating Conditions / 日本農村医学会雑誌

A research team from the Center for Health Promotion (CHP) at the University of Toronto published a book entitled “Quality of Life in Health Promotion and Rehabilitation” in 1996. In this paper we will introduce the conceptual models of QOL made up of the components of QOL and the QOL field presented by the CHP researchers. They defined QOL as “the degree to which a person enjoys the important possibilities of his or her life” and proposed a QOL model comprised of nine measurable areas, which are grouped into three broad categories of “Being, ”“Belonging” and “Becoming.” The “Being” cluster encompasses the most basic aspects of human beings as individuals, consisting of such three sub-components as physical, psychological and spiritual being. The “Belonging” cluster is concerned with the fit between individuals and their environment, consisting of social, community and ecological belonging. The “Becoming” cluster focuses on the purposeful activities in which individuals engage in an attempt to realize their goals, aspirations and hopes, consisting of practical, leisure and personal growth becoming. In the QOL field as a conceptual model of comprehensive health and well-being and QOL framework, QOL is viewed as the result of identifiable determinants, divided into environmental and personal categories in interaction with such moderating conditions as control, potential opportunities, resources, support systems, skills, life events, political changes and environmental changes. Recently the importance of understanding health issucs at community level from the ecological and phenomenological viewpoints and of directing our attention to the people's living has been recognized anew. The conceptual models presented by the CHP team are considered to have great potential for guiding health and social policy and for implementing various health promotion practices in the community.

Focal Segmental Glomerular Sclerosis: Effects of Steroids and Prognosis. A Retrospective Study in 30 Patients / 日本農村医学会雑誌

We performed a retrospective study of the effects of steroids and the factors that deteriorate renal function in 30 patients with primary focal segmental glomerular sclerosis. The mean observation periods from the onset of proteinuria and from the histological diagnosis by renal biopsy were 6.1 ± 5.0 years and 3.9 ± 3.01 respectively. 87% of the patients had been recerving steroid therapy with or without other drugs. In this study, the patients were divided into 3 groups by the initial dose of steroids. A multivariate analysis was performed on the laboratory findings of the 3 groups. In a short-term observation, there were no significant defferences among the groups. However, in a long-term observation (more than one year) it was clarified that the patients who had been given high doses of steroids tend to maintain their renal functoin. We also found that the patients responding to steroids showed a significantly better prognosis than steroid-resistant patients upon examination their nephrotic status and renal functoin.<BR>This statistical analysis confirmed that the factors deteriorating the renal function are hypertension and hyperlipidemia.<BR>In addition, it was revealed that hyperuricemia, is responsible for the renal dissease, failure?

Related Factors in Outbreak of Health Disturbance from Pesticides in Farmers / 日本農村医学会雑誌

A questionnaire survey was conducted to clarify the actual states of pesticide poisoning (disorders) and its related factors amang 178 male and 232 female farmers.<BR>The results were as follows.<BR>1) Of the subjects 30.7% complained of some health disturbance from pesticides, without significant difference in prevalence between males and females.<BR>2) The most comman symptom was skin hazard (39.7%), followed by nausea (34.9%) and headache (32.5%).<BR>3) Captafol (21.4%) and methomyl (12.7%), which are contained in common pesticides, were recognized as the cause of poisoning.<BR>4) The highest prevalence of health disturbance from pesticides were seen in [orange only] growers (72.7%) among mixed crop groups, followed by [rice+ orange] producers (71.4%), and [rice+ sugar cane +sweet potato] cultivators (55.9%). These higher prevalence groups were also estimated to be the users of the higher amount of pesticide.<BR>5) Significant coefficient correlations were seen between the prevalence of health disturbance from pesticides and the duration and yearly times of pesticide spraying and daily spraying hours.<BR>6) A relatively larger proportion of farmers has a knowledge about pesticide poisonig. However a few of them take effective protective measures at pesticide handling.<BR>The reverse correlation was seen between the prevalence of health disturbance from pesticides and the degree of reliance on effectiveness of pesticides.<BR>The present study indicates that more effective education for safty use of pesticides to both producers and users, and development of non-pesticide use agriculture are essential to protect agricultural workers from health distubance from pesticides.

Residual Concentrations of Serum Organochlorines (BHC,DDT,PCB) in Farmers / 日本農村医学会雑誌

The residue levels of three kinds of organochlorines, BHC, DDT and PCB, in the serum were determined in farmers (40-59 years old, n=211), non-farmars (40-59 years old, n =27) and high school students (15-18 years old, n=56) to clarify the factors that contributed to the accumulation of those three compounds in the blood of farmers and rural inhabitants. The average values of those compounds were found to be 9.1±5.0 ppb for B-BHC, 9.2±6.3 ppb for pp'-DDE and 7.1 ±5.7 ppb for PCB. There was marked difference in the value between districts in which the subjects live. The subjects could be divided into the lower concentration group and higher concentration group, showing high discrimination ratio (72-83%) by Hayashi's quantification theory II. Statistical analysis showed that the factors contributing to the accumnlation of those compounds in the present subjects are related with digestion of chicken and fish, Hb concentration, serum cholinesterase activity, liver function and serum trigliceride and cholesterol levels, and use of organochlorines and other pesticides, duration and the mumber of days of pesticide spraying, experience of pesticide poisoing, cultivation of specific crops. Those results, in greater part, supported the general recognition that organochlorine residues in human body might be regulated by changning eating patterns and avoiding those food items containing those chemical compounds. On the other hand, attention should be focused on the exposure of those compounds through the use of specific pesticides including those compounds. And further investigation is necessary for clarifying the contributing factors to the accumulation of those compounds in human body especially in the higher residue group discriminated in the present study.

Skin hazards in workers cultivating okra(Hibiscus esculentus Linn) / 日本農村医学会雑誌

The outbreak of skin hazards from okra cultivation was studied by a field survey. About a half (46.2 %) of 186 workers investigated (male, 76 ; female, 110) reported to have experienced pastly or annually skin hazards from okra cultivation.The sites of lesion complained were mostly the arms (47.5%), neck (41.3%), fingers (32.5%) and so forth in total number. The degree of lesions were generally itching (85.0%) and flare (61.3%), but severe cases like vanishing fingerprints (16.3%) and fissures on the fingers (11.3 %) were also revealed. Portion of okra responsible for skin hazards seemed to be mainly leaves, trichomes and pods.<BR>Positive patch test reactions with preparations of immature okra pods in 46 workers (male, 12 ; female, 34), compared to 112 control subjects (male, 84 ; female, 28), were significantly higher in okra workers than in controls, which were 25% in males and 20% in total group.<BR>These results show that okra components cause irritant contact dermatitis and allergic contact dermatitis as well.