Katsumi Yamanaka

Tuberculosis among the homeless people of Nagoya, Japan

A survey was conducted in order to clarify the tuberculosis (TB) situation in the homeless during the period from 1982 to 1991 in an urban district of Nagoya, using the registration cards of pulmonary TB patients and the data of chest roentgenograms of the Nagoya City Nakamura Health Centre. The incidence and prevalence of pulmonary TB per 100,000 among the homeless were estimated at 950-2150 and 1900-3250, respectively, which were around 30 and 20 times higher than those for the non-homeless. An increase in the incidence rate among homeless pulmonary TB patients was found in 1989, after a gradual decrease to the year 1988. The detected prevalence rate by chest examinations of the homeless was also around 30 times higher than that for the non-homeless. The percentage of patients with cavities indicated by chest roentgenograms when they were first registered was 76.9% among the homeless, but only 42.9% among the non-homeless.

Criteria for acceptable levels of the Shinkansen Super Express train noise and vibration in residential areas

A survey of 1187 housewives living in 18 areas along the Shinkansen Super Express (bullet train) railway was conducted by means of a self-administered health questionnaire (modified Cornell Medical Index). In addition, geographically corresponding measurements of noise level and vibration intensity were taken. The relationship of noise and vibration to positive responses (health complaints) related to bodily symptoms, illness and emotional disturbances was analyzed. The factors which correlated with an increase in the average number of positive responses included noise, vibration, age and health status. Such factors as marital status, educational level, part time work, duration of inhabitancy and occupation of the head of the houshold correlated poorly with the number of positive responses. Unhealthy respondents compared to healthy respondents are more frequently affected by noise and vibration. The rate of positive responses in the visual, respiratory, cardiovascular, digestive and nervous systems, sleep disturbances and emotional disturbances increased accordingly as noise and vibration increased. Combined effects of noise and vibration stimuli on the total number of positive responses (an indicator of general health) were found. This study has produced results indicating that the maximum permissible noise level should not exceed 70 dB(A) in the residential areas along the Shinkansen railway.

Family clusters of pulmonary tuberculosis in a suburban area of Japan

A survey was conducted in a metropolitan suburb to examine family clusters of pulmonary tuberculosis patients and related factors. Firstly, a descriptive study was done based on the review of tuberculosis registration cards over a 11-yr period. Of 1106 cases, 109 (9.9%) were found to occur in households which had already had one or more pulmonary tuberculosis patient during the period. The most affected were four- and eight-member families with infants and adolescents accounting for most of the second or later patients. Secondly, a home visit survey was performed to investigate factors associated with family clusters of phthisis. Results showed that significant variables were the length of patients delay (interval between perception of physical symptoms and visit to the physician), the number of rooms, and lack of self-motivation to seek treatment. Log-linear analyses revealed interaction among these variables.