Today's one of the most important problems both in the industrial hygiene and the community health care is the health protection of farmers who are working in factories. There are many such farmers in the San'in rural districts. We surveyed the working conditions of 370 factories in Shimane Prefecture and found that they had many problems to be solved. The problems in the factories, mostly small-scale factories, are summarized as aging of workers, long working hours, insufficient rest, harmful work and night work.
Even in Sada-cho, where the local government is promoting the comprehensive community health care and encouraging the health care activity of inhabitants, the health care for factory workers is performed insufficiently. Some factories do not carry out even a periodical health examination of the workers.
We established the Sada-cho Occupational Health Association in cooperation with the local government, Izumo Health Center, Shimane Labor Standard Inspection Office and the factories in Sada-cho for the purpose of promoting the unified activity of the industrial hygiene and the community health care.

The rise of the average age of the population in Shimane Prefecture has become more and more conspicuous in these years. According to the estimation of the future population the aging phenome-non in Shimane Prefecture is going about fifteen years ahead of the average of Japan. Therefore it is significant to perform a community experiment of the comprehensive health care for the elderly in this prefecture, in the sense that its results will offer many useful experiences to other districts of Japan, where the aging of the population is proceeding a little more slowly.
We carried out an experiment called “the Service Package System for the Bedridden Elderly”, in Sada-cho, Shimane Prefecture in cooperation with Sada-cho, Izumo Health Center and Izumo Medical Association. It is an improvement on the health care system for the bedridden elderly and their family, which has been performed in Scandinavian countries.
The results of our experiment obviously showed the existence of many problems stemming from the lack of integration among different fields such as health care, medical care, social welfare, working and cultural life. To establish the comprehensivehealth service system for the elderly and their family the integration of these fields is most urgently demanded.

In order to develop the health care system for the elderly we need to analyse fundamentally the phenomenon that the average age of population in each community is rapidly becoming older, as well as we have to grasp life conditions and health needs of old people. We investigated the rate of increase or decrease of population, rate of the elderly living by themselves and the index of the aging of population of each community, classified these communities into several types, and presented the points necessary to develop a community-based comprehensive health care for the elderly as to each type by considering the meanings the indices of health care, medical care and social welfare of the communities disclose.

Recently, while the medical technology developed remarkably on the one hand, the soscial need for preventive medicine largely increased on the other. In Japan, it is an urgent problem of the medical education how to create effective methodology and technology of the preventive medicine that can attract students who generally prefer to become professionals in clinical medicine.
Since 1978 we have practiced an educational programme in which each student looks after one family picked up from the agricultural district for one year, caring for the health of the family members and helping them out of health problems, if there are any. In this way students can learn primary health care and community health of their own will.
Compared with the traditional method, this method is effective in making the students understand with real interest the meanings of comprehensive primary health care through concerning themselves in the health care of a family as “a socio-economical-psycho-complex”.

In a farm village of Shimane Prefecture we conducted an investigation on the difference of nutrition between young, middle-aged and old generations. The result showed that nutrition was below the necessary level in the old generation, with many foods being scantily taken. Irrespective of generation the diet was of Japanese style. It will be necessary to guide people to the improvement of dietary life according to generations.
The dietary life of bedridden people and of those who attend to them was the worst of all. Some social measures to improve the situation, as well as the repletion of primary health care for old people are urgently required.
Women in rural communities generally have concrete demands for improvement of the dietary life. It is important to carry out the improvement in harmony with the actual condition of life in the community and the demand of inhabitants.

We treated two elderly patients who contracted amebiasis in a foreign country. They ate a watermelon in Peking, the People's Republic of China. From their account, the watermelon was considered the most probable source of infection.
In Case 1, the patient complained of acute nausea, vomiting, diarrhea and unconsciousness following severe dehydration. The trophozoites of Entamoeba histolytica were found by stool examination. The treatment with metronidazole was not so effective in Case 1 patient with fulminating amebic colitis. In Case 2, he had no subjective symptoms, but the cysts of Entamoeba histolytica were found by stool examination.
Recently, traveling abroad has become popular. The number of travelers has been increasing in Japan from not only urban districts but also rural districts. Therefore, it is necessary to exercise strict rigilance over the imported protozoan parasites and possible mass outbreak of amebiasis in tour groups.

OBJECTIVESTo assess trends in smoking prevalence among Japanese adolescents and to analyze possible causal factors for the decrease in smoking prevalence observed in a 2004 survey.

METHODSNationwide cross-sectional surveys were conducted in 1996, 2000 and 2004. Survey schools, both junior and senior high schools, considered to be representative of the whole of Japan were sampled randomly. Enrolled students were asked to complete a self-reporting anonymous questionnaire on smoking behavior. The questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. School principals were asked about the policy of their respective school on smoking restrictions.

RESULTSCigarette smoking prevalence (lifetime, current, and daily smoking) in 2004, based on the completed questionnaires, had decreased relative to previous years in both sexes and in all school grades. The most important trends were: a decrease in smoking prevalence among the fathers and older brothers of the students; an increase in the proportion of students who did not have friends; a decrease in the proportion of current smokers who usually bought cigarettes in stores decreased in 2004, in particular for the oldest boys. An association was found between a lower smoking rate at a school and a smoke-free school policy.

CONCLUSIONSJapan has experienced a decrease in the prevalence of smoking among adolescents. A decrease in smoking prevalence among the fathers and older brothers, limitations to minors' access to tobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decreasing trend.

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.