Based on the results of health examinations and questionnaires, this study was made to find out about the health characteristics of women aged 30-69 who live in fishing villages and a mountain village, Shimane Prefecture. The subjects were divided into the obese group and the normal group in accordance with the Minowa method to clarify the difference in various health factors between the two groups. The normal group was made up of those women who have a normal body weight.
The major findings are as follows:
1. A significant difference was noted in TG, blood pressure level and hypertension incidence (based on WHO criteria) between the two groups.
2. The frequency of complaints about subjective symptoms of disorder in locomotive organs and other parts of the body was higher among the obese group than the normal group. The number of those women undergoing medical treatment was also larger among the obese group than the normal group.
3. Women in both groups were concerned about obesity because they were well aware of the consequences of adult diseases.
4. Only half of the women in the obese group succeeded in decreasing their body weight after they tried to control obesity by using moderation in eating sweets, improving their nutrition, practicing exercises and so on.

For the purpose of studying the systematization of community health care in the rural district, we made health examinations and investigations into labor conditions and daily life of women working in grape farms.
The health conditions of the women working in grape farms were considerably unfavorable. They were compelled extremely busy lives including agricultural labor, households, childcare and nursing of the elderly who were lying ill in bed.
The health examinations revealed the high prevalence of cervicobrachial disorder, lumbago, fatigue of the sensory-nervous system and some health hazards by agricultural chemicals, in addition to anemia and hypertention which show generally higher prevalence among farmers in Japan. Taking into account that the new technical know-how and agricultural chemicals will be more and more introduced to the intensive agricultural system, it will become important to raise the health level both through approaches of the community health and through industrial hygiene.
The cooperative activities which we carried out with the Agricultural Cooperative Association, Municipality, Health Center, the Agricultural Mutual Benefit Association and the Agricultural Guide Center, improved the health condition, health care delivery system and participation of workers in the activities. These effects also proved the necessity of improving living conditions in parallel with the promotion of the comprehensive health care system.

A health examination and an occupational health investigation were executed to find health problems of workingwomen in a rural factory which produces the disposable medical tools on the line. The results were as follows
1) Most of workingwomen complain of fatigue of muscle and neuro-sensory systems which is due to simple work of assembly-line operation. Mild hypertension, anemia, backpain and eyestrain are also prevalent.
2) The exposure to organic solvents was scarcely defined by our occupational environmental investigation, but an attention should be paid to the chronic intoxication by long-term, trace exposure to organic solvents. Recently organic solvents are so often used in factories in rural districts that it is very important to arrange the health check system for the intoxication by organic solvents, and to call special attentions of workingwomen to the occupational disease through the health education.
3) As many workingwomen must work hard not only at the factory but also at their homes after their duties, carrying on agricultural cultivation, household and nursing of infants, they are usually fatigued and are chronically in anemic condition. To promote the health level of workingwomen in rural district, it is very important to realize the comprehensive health care. from the standpoint of promoting community health and occupational health care.

The new community-based curriculum in Shimane Medical University, Japan, which are mainly based on family health practice and community health approach, is useful for students to understand the comprehensive medicine and holistic approach to community-based primary health care.
It is important to introduce district health workers in the preventive education for medical students to obtain to humanistic attitude and to change their value and behavior.
The importance of the exposure to the community health activities organized with man power and social resources should be more stressed in the improvement of the medical education curriculum and also of educational methodology to learn the essential physicians' nature such as humanity, responsibility, cooperation, positive attitude, and ability of problem solving.

OBJECTIVESWe conducted an epidemiological study of the relationship between lung cancer incidence and smoking, with special reference to the benefits of smoking cessation for reducing lung cancer incidence, to promote a local smoking control program.

METHODSThe study was a retrospective cohort study. The population studied was 16,383 male examinees of lung cancer health examinations in 1995 in Tottori Prefecture, Japan. Smoking status from the questionnaire during the health examination was used as the exposure variable. Endpoint (lung cancer incidence) was obtained from the Tottori population-based cancer registry. A multivariable analysis using the Cox proportional hazard model was adapted for statistical analysis. The average follow-up period was 4.3 years.

RESULTSThe hazard ratio of current smokers for the incidence of lung cancer was 4.9, whereas that of ex-smokers was 2.2. The dose-response relationship between lung cancer incidence and lifetime cigarette consumption (pack year) was determined. The ratio increased among younger subjects (under 65 years old). The hazard ratio of ex-smokers decreased with years just after quitting smoking, and reached the level of never smokers after 10-19 years from smoking cessation.

CONCLUSIONSWe reconfirmed that the magnitude of risk estimates of smoking for lung cancer incidence was similar to those of previous studies, and smoking cessation was effective for reducing lung cancer risk.