Akio Uchida

A Study on Relations Between Actual Patterns of Dietary Life and Work and Health in Rural Communities.

農業存亡の危機さえ感ずるような変貌著しい情勢下の農村の食生活, 労働の実態を調査し, 健康との関連を追及した。食生活は, 全般的には糖質の摂取が減少 (農家でも米の摂取減少) し, 蛋白質, なかでも脂質の摂取増加が著しい。しかし, 地域によっては依然として糖質摂取の多い昔ながらの食生活の慣行がみられた。農業労働は機械化が進み, 労働負担の大きい農作業が減少し, 中等度から軽度の労働負担になったが, 未だ固定した休日をとる農家は少なく, 年間多忙であり, 一日の労働時間は長い。また兼業農家では土日の休日に農作業を行う世帯も多い。運動・スポーツを行う農業従事者は少ない。健康指標では, かつて多発した貧血は減少したが, 肥満は増加傾向で, 高血圧等の循環器疾患や腰痛は多く, 成人病は増加傾向にあり, 一層の健康管理が望まれるが, それにはまず経済的に, 社会的に安定した農家の育成が必要であろう。

Blood test findings among inhabitants of middle age in rural districts.

千葉県安房郡3地域の農村に居住する30～69歳の男女について, 血液成分検査を中心に健康調査を実施し, 身体計測, 血圧, 血液諸成分間の関連を検討した。血液成分値には周知の赤血球系成分, 尿酸をはじめ, 他にAG比, 血清GOT, GPT, 中性脂肪, HDL-コレステロール等に性差が見られた。検査値相互の関連は, 赤血球系成分間, 肥痩の指標間, 血清総蛋白とアルブミン, GOTとGPTなどに高い相関を認めるが, 他に対象全地域に共通した種々の相関が見られる。そこで内部構造を明らかにすべく主成分分析を行なったところ, 栄養状態の特徴を示唆すると考えられる第1主成分が全地域男女共通にひき出された。ほかにGOT, GPTに相関の高い主成分, 肥痩の指標に負だが赤血球系成分に正に相関する主成分などが見い出された。

Primary health care in rural communities.

静岡県2山村 (人口約8,600人, 約5,400人) と千葉県2農漁村 (人口約12,700人, 約7,100人) を対象に, プライマリー・ヘルスケア (PHC) に関する調査を行なった。調査4町は, 老年人口比率17%以上で粗死亡率は高く, 人口自然増加率はマイナスである。乳児死亡率や死産率は低い。死因としては悪性新生物, 脳血管疾患, 心疾患が高く, 肺炎, 不慮の事故, 自殺の死亡率も全国平均を上回る。国民健康保険の歳入・歳出は全国平均より低く, 入院では精神疾患, 循環器疾患, 外来では循環器疾患が圧倒的に多い。町内医療機関は不十分で, 町外医療の利用が多く, 入院では75%以上と高い。一山村では一般予算からの病院繰入れがきわめて多額で, 町財政の問題となっている。健康教育, 保健組織活動としては, 栄養指導や高血圧教室の開催がある。健康診断受診率は結核・乳幼児健診受診率はきわめて高いが, 癌・循環器健診は20%前後であった。かかりつけ医師は中高年層では多いが, 若年層では低く, 家庭医としての機能すなわち, 全人的医療, 日常の健康管理・相談, 専門医への紹介, 往診等の機能は低い。しかし, 病気の説明は, かかりつけ医が高く, 医師と患者の信頼関係がみられ, PHCの確立にはかかせぬ存在といえる。また, 高令化社会である農村では, 健康教育, 家庭訪問, 家庭看護等保健婦の役割りはますます増大する。ヘルスマンパワーの充足が望まれる。

農作業に起因する呼吸器障害 (農夫肺等) に関する研究 (総括)

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:(1) There were a variety of farm operations which produced or increased respiratory symptoms, including thrashing and scatteringof agricultural chemicals;(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”(3) Among the cultivators of rush, raw material for Tatami, there existed cases of pneumoconiosis;(4) There were a variety of agents to produce bronchial asthma, such as rice straw, chaff, tea-leaves and chrysanthemum-leaves;(5) In Japan only two cases of farmers 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.

MEASURES TAKEN TO PREVENT AND EXTERMINATE ASCARIS INFECTION IN A MOUNTAIN VILLAGE IN SHIZUOKA PREFECTURE

Examination of feces and deworming were carried out five times every other month between May 1962 to February 1963 in 5 communities (a total of 202 households, 1, 050 inhabitants) of Urakawa, Sakumamachi, Shizuoka Prefecture. After about a year has elapsed, in which no countermeasures were taken, examination of feces was carried out again in January 1964 to study a change in the rate of positivity. Examination was carried out by the cellophane thick layer smear method (values obtained with two sheets).(1) The rate of positivity for Ascaris eggs ranged from 13.7% to 55.1%, with an average of 28.0% in the initial examination. The rate was higher in two commnities in the mountainous district. By sex and age, the rate was high among infants, school boys and adult females.(2) A study of the change in the rate of positivity during the two years has shown that the rates of reinfection and new infcction were higher in communities where the rate of positivity was higher in the initial examination, indicating how difficult it is to exterminate Ascaris infection. On the contrary, there was no substantial rise in the rate of positivity in communities where the rate of positivity in the initial examination was under 10%(3 out of 5 communities), even though no countermeasures were taken during the period of one year. This seems to show that it is not required to carry out deworming frequently.It has been found that the rate of Ascaris infection was lower in communities where persons positive for unfertilized eggs alone accounted for higher percentages among the total of persons positive for Ascaris eggs, there being a marked inverse corelation between persons positive for unfertilized eggs alone and persons positive for all kinds of Ascaris eggs. There has been a marked tendency to familial concentration of Ascaris infection.(3) The results of the present study have shown that, in taking measures to exterminate Ascaris infection, it is necessary to take into consideration the rate of positivity for Ascaris eggs, the ratio of persons positive for unfertilized Ascaris eggs to persons positive for all kinds of Ascaris eggs, and a tendency to familial concentration of infection in the community.