We have examined the influence labor causing upon health for inhabitants at Yuri district in Akita prefecture. Labor was defined in the light of the following factors ; style of agricultural management, field space, working days, working time a day, etc. Health was defined in the light of the following factors; red blood cell, hemoglobin, cholesterol, triglyceride, HDL-cholesterol, fast blood sugar, choline estelase, GPT, uric acid, alkaline phosphatase, obesity rate and blood pressure. 1) We discovered that in case of male workers the great amount of labor they engaged in, the higher level average index of HDL-ch and GPT reached. As the labor amount increases more numbers of patient appears with abnormality in choline estelase. We have not observed the similar tendency for female.
2) As the labor amount decrease (a) in case of male workers the average index gets higher in cholesterol, triglyceride, FBS and choline estelase, (b) in case of female workers the average index gets higher in triglyceride, FBS, choline estelase, uric acid and albumin. As the labor amount decreases (a) in case of male workers abnormality rate increases in choline estelase, triglyceride and HDL-ch, (b) in case of female Hb, HDL-ch, cholesterol and obesity. 3) For inhabitants over 70 years old male or female those living in plain and open field (Nishime town) are more active and show the lower percentage of getting ill than those in mountains (Higashiyuri town).

The rate of obesity both in man and woman in this district reached the highest (male 18.1%, female 27.8% Minowa Method) in 1978, but has been decreasing since then. It came down to 16.5% in case of male adults and 23.0% in case of female adults. These figures clearly show that the obese rate of female is higher than that of male. Skin-fold thickness meassurement corresponded to direct meassurement performed at the time of gastrectomy (=0.956). Compared with rate of obesity (Minowa Method) skin-fold thickness measurement proved particularly corresponding in navel area of male and in back of female. Regarding relationship between obesity and morbidity, a greater number of thin people suffered from atony or ptosis of the stomach or anemia. On the contrary the following diseases were more common with people as they grew fatter; hyperlipidemia, hypertension, ischemic heart diseases and diabetes mellitus. Patients with diabetes mellitus or hypertension who succeeded in losing weight improved their conditions or completely recovered. Our survey conducted in 1978 proved that residents over the age of forty in our district were not well aware of their obesity. Few of them were concious that their obesity were due to over-feeding. Regarding the effect of weight control conducted at three groups, instituts for the handicapped showed the most effective and successful result, 68.0% succeeded in losing more than 4 kg in a year at the instituts. The rate is incredibly high compared with 33.0% at our obesity clinic or 4.3% at field.

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 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.

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 scattering of 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 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.

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.
The actual state of respiratory diseases among rural people, as investigated by the present study group, can be summarized as follows:
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.
2) Pathologically, farmer's pneumoconiosis attributable to farm operation dust was evidenced, crying for the necessity of dust prevention measure during farm operations.
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.
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.
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.

We have carried out the mass survey for diabetes mellitus by a 50 g GTT as the first screening since 1971. Average incidences of diabetic pattern, IGT pattern, borderline pattern and normal pattern in a Glucose Tolerance Test (GTT) were 2.3±1.8%, 6.6±1.7%, 19.8±6.6% and 71.4 ±7.8%, respectively. 21 males and 6 females were found to be diabetic by this survey for 11 years. Insulinogenic indices (I. Is.) of diabetic, IGT, borderline and normal patterns were 0.13±0.07, 0.70±0.37, 0.58±0.40 and 1.05±0.30, respectively, and the values of I. I. in diabetics and borderline diabetics were significantly lower than that in the normal pattern. A I. I. in the subjects who have revealed the normal glucose tolerance every year for 11 year, 2.62±1.28, was high in the normal range. On the other hand, a I. I. in the subjects who became overtly diabetic from the IGT, borderline or normal pattern, 0.36±0.31, was significantly lower. Therefore, taking into consideration that one of the characteristics of NIDDM is low insulin response to glucose, the mass survey for diabetes mellitus should be carried out by a Glucose Tolerance Test (GTT) as the first screening with the measurement of plasma insulin concentrations. A follow-up study for the low insulin responder is considered to be one of the most preferable investigations for the detection of the early stage of diabetes mellitus.