The “tatami” mat production is one of the most important farming in Japan. It is all year domestic labor, being consisted of rush cultivating and “tatami” mat weaving process. From the industrial health point of view the working process have several problems.
1. Rush harvesting process
Rush is reaped for 3 weeks in July. The process, cutting, smearing, drying and storing, is hard physical work and energy consumption was estimated 3500-4500 kcal. per day. The workers are exposed to the scorching heat of the sun and the average value of WBGT-index of the working times a day was culculated 29.3°C. The process requires 5-10 co-workers per each household. The reaped rush bundles are carried hand in hand with each workers from the field to the storing room.
The workers are exposed to dense concentrated dusts of “sendo” used for “dorozome”, smearing rushes into mud in order to keep it's color unfaded. Especially, in the process of drying to storing, for 1-3 hours per day, over 100mg/m³ of dusts was observed. And average values of the working space was 44mg/m³ for male and 41mg/m³ for female during 7: 00-18: 00. Seventy eight percent of particles of the floating dusts in the working space were under 5μ in diameter. The “sendo” is clayey dust mixed with quartz, chlorite, kaolin, sericite and other minerals and contains 20-30% of free silica.
2. “Tatami” mat weaving process
The stored rushes are weaved into “tatami” mat domestically for all seasons. It contains the process of sorting length of rushes and weaving. The intensity of works are relatively low, but it's compulsory working times are very long.
The workers are exposed chronically for long-term to low dencity (1-5mg/m³) of “sendo” dusts through the process. And occasionally, the workers are exposed to relatively dense concentrated dust (15-25mg/m³) in the storing process. Seventy five to eighty five percent of the floating dusts were under 5μ in diameter.

Farmers engaged in rush cultivating and “tatami” mat weaving process are exposed daily to “sendo” dusts. We conducted a health survey of the rush farmers. The results are as follows.
Forty four cases, 32 males and 12 females, of slight fibrosis (PR 1) were devided from 326 subjects examined, 179 males and 147 females, by chest roentogenograms. And 37 cases, 17 males and 20 females, were suspicious (RX) of pneumoconiosis. The longer the working periods in rush labor, the higher prevalence of chest roentogenogram findings were found. And other factors on rush managements also related to the prevalence. The severity of pneumoconiosis is still in early stage and almost PR 1 cases were classified as “the first division of health control” settled by “the Act of Pneumoconiosis” in Japan. But, those subjects examined had complaints of some respiratory symptoms higher percentages than that of farmers not engaged in rush labor. Furthermore, in those subjects relatively high percentages of the cases were defined as impaired lung function, especially with air way obstruction.
The results suggest that the prevalence of respiratory findings of rush farmers relate to the amount of inhaled particles of “sendo” dusts.

Farmers engaged in “tatami” producing process are exposed to “sendo” dusts. “Sendo” means dyeing materisl being used for the process of. “dorozome”. to keep rushes' and “tatami” products' color unfaded. It is clayey dust and contains 20-30% free silica.
1. “Sendo”
The experimental study on fibrogenesity to rat's lung by intratraheal infusion of 3.5% and 10% suspension of “sendo” dusts was made. The results are as follows.
Evident dust foci and slowly but steadily progressed collagenous fibrogenic reaction were observed histologically in the lung tissue of rats treated “sendo” at 3 to 6 month after infusion. This suggests that rush farmers' pneumoconiosis raise due to long-term inhalation of “sendo” dusts.
2. Substitute materials for “sendo”: eight trial productions.
The exploitation of substitute materials for “sendo” has been made. And eight kinds of trial productions, consisting of TiO₂, ZnO, MgO, CaCO₃ and some amount of “sendo”, were provided. These materials were examined fibrogenesity to lung tissue with comparison of “sendo” by same method of former experiment. The results are as follows.
These materisls showed less stronger fibrogenetic reaction to lung tissue than that of “sendo” histologically. And contents of hydroxyproline of lung tissue of rats were estimated 4.0-5.5mg per total dry weight of right lung at 6 month after infusion. On the contrally, 6.0-7.0mg were the controlled lungs treated by “sendo”, quartzsands and kaolin. But these materials contain some amount of “sendo” and/or TiO₂ which fibrogenesity to lung tissue has been already observed. So the further study were undertaken.
3. Substitute materials for “sendo”: three markettable goods.
Three kinds of new substitute materials for “sendo”, mainly consisting of ZnO+CaCO₃+BaSO₄ or MgO+CaCO₃, were provided for rush farmers. Contents of free silica of these new materials were 0.0-1.0%. And experimental study showed these materials relatively weak fibrogenesity to lung tissue than that of “sendo” histologically, and tissue hydroxyproline of right lungs were estimated 3.5-4.5mg. This suggests that these three kinds of new substitute materials for “sendo” were available for the dust control of rush labor.

We developed a questionnaire for analysing actual state of stress and determining affective stressors in agricultural workers based on their works and lives. Using that we conducted the collaborative surveys to agricultural workers in 5 different districts in Japan. The results were as follows;
Among agricultural workers (662 males, 1, 084 females) 48% of males and 59% of females were being felt stress with higher prevalance rates in younger age group (under 59yr.) than in elders (over 60yr.). Affective stressors were found in various situations of agricultural works and lives, such as, factors related to work demand category by Karasek's psychological work model, and to agricultural work elements, i. e., dangerous equipments, dust generating condition, works under the sun, long work hours, irregular meal, etc, and to life-events, i. e., a debt, decrease of products, difficulty of relation to neighbors, care of the aged, personal and family member's disease and injury, etc. It was noticeable that the intensity to develop stress by those stressors was manifested stronger in female workers than in male workers. The results of the multiple regression analysis with the scores of those items indicated that the most affective factor for disturbance of quality of life (QOL) was to be the stress and for improvement of QOL was to be the social support. Those results indicated that to keep advantageous factors in the agricultural works categorised by Karasek's psycological work model, i. e., high control and low demans work, and to improve stressful work elements leading to high demand and low control work might be the most effective measure to improve the QOL of agricultural workers. To construct an appropriate network system for the social support in the rural communities using JA and other organizations might be also essential.
The present study also revealed that the process of the present investigation, i. e., to develop the questionnaire and to analyse an actual state of stress and factors of stress coping in agricultural workers using that questionnaire was to be useful to propose appropriate measures for improving QOL of agricultural workers based on actual state of their work and living conditions.

At the process of rush harvesting farmers are exposed to high concentratedusts of “sendo” for short times a day during 3 weeks in summer, and in continuously for all seasons low density of chronic long-term exposure of dusts are observed in the process of weaving.
We examined 320 rush farmers in Yatsushiro district in 1970 and found pneumoconiosis as1p in their direct chest x ray films, 32 men (18%) and 12 women (9%).
In 1975, 36 men and 34 women amang them were reexamined, contrasting their respiratory findings with that of the former examination. The chest x ray film of each subject was classified according to the ILO U/C International Classification of Pneumoconiosis 1971 (ILO).
In this definition, 15men (42%) and6women (18%) of the subjects were classified as pneumoconiosis (1/0, 1/1, 1/2) of the p type of rounded small opacities except one case of irregular type (s): on the contorary, 9men (25%) and 2 women (6%) in the formers. Thirteen cases of men (36%) and11cases of women (32%) showed increasing numbers of opacities and/or extention of disorder zones. It sugests that the intensity of lung disorders in rush farmers have been becomming slowly into more serioustages. Small opacities were seen in the middle and lower, especially lower (47%), zones of the lung. Adding, 3 men and 2 women were tuberculosis (activity uncertain) cases.
Twenty men (58%) and 15 women (42%) have complaints of respiratory symptoms, such as cough (17%), phlegm (34%), short breath (17%), wheezing (16%), and nasal catarrh (22%). Four men (14%) and5women (15%) showed slightly impairment of lung functions.
These findings shown in chest x ray films or respiratory symptoms were related significantly to the amount of cigarett smoking.
Increasing intensity of their respiratory disorders, we may consider, due to increasing dust exposure of “sendo” according to expantion of rush management. Then we must accomplish an improvement of working environment and hygienic control for dusts. In addition, we must exploit a new “sendo” containing less amount of free silica and technical improvements of working process.

Two hundreds and seventy one cases of sera of farmers (48.8±10.8 yr.) in mountain district of Kumamoto prefecture were examined by gel diffusion test for precipitins to M. faeni, T. vulgaris and other 12 antigens of fungus and pigeon proteins.
Ten positive sera (3.7%) from 271 sera tested were detected to M. faeni and 13 were to T. vulgaris. The confidence intervals (95%) of the positive ratiowas calculated 1.8%-6.6%and 2.3%-7.4%, respectively. To other 10 antigens 1-22 sera were positive, such as C. corticale (0.1%-2.7%, as confidence intervals), S.granarius (4.9%-11.4%), P. pullulans (0.4%-3.7%), Aspergillus mix (0.6%-4.2%), Pigeon serum & droppings (0.2%-3.1%), C. acremonium (0.8%-4.7%), T. viride (0.0%-2.0%), Candida (1.6%-6.2%) and P.casei (0.2%-3.1%). NO cases were positive toCladsporium and Alternaria. And 61 cases (17.5%-27.5%) were positive to at least one antigen of all 14 tested.
There was no significance of the proportions of positive reactions between male and female, or age groups. But higher percentagewas found in farmers longer experience of works with hay, straw and compost. Thepresence of a positive precipitin test has been considered as unsatisfactory criterion for the diagnosis of the farmer's lung. However, the findings of our survey suggest that farmers in West Japan has been exposed relatively high amount and/or various kinds of fungus antigens throughout the farm works with hay, straw and compost.

In the previous study, relatively high prevalence of asthma-like attacks associated with handling rushes was observed. In this connection, mass survey of the intradermal skin test (×10000, 0.02ml) by the extracts of rush (Juncus effusus L. var decipiens Buch. forma utilis Makino) and the dusts in the weaving room containing rushes, dyeing materials (sendo) and other house dusts was conducted for the rush farmers (65 males, 143 females), other farmers (21 males, 91 females) and women without farming (28 females). The results were summerized as follows.
1) The positive rates in skin test were estimated to be 7.7% for males and 2.1% for females of the rush farmers by the extracts of rush, and 23.1% for males, 10.5% for females by the extracts of dusts in the weaving room. On the centrally, 4.8% for males, 1.1% for females of the controlled farmers by the former extracts, and 19.0% for males, 8.8% for females by the latter extracts. And among females without farmiing, 0% and 3.6%, were positive respectively.
2) The positive rates were not associated with age, respiratory symptoms and past history of asthmalike anfall. The rush farmers were observed relatively higher percentages of positive reaction than the controlled groups, but not signifficantlly.
3) The results do not clarify the causative agent of antigen-antibody reaction to the asthmatic anfall among the rush farmers, but suggest that peoples, whether farmer or not farmer, may be sensitized by the rush antigen through the farm works and or using tatami mat and other rush products in daily life.

One hundred and thirty one city inhabitants, have been lived in Kumamoto city over 20 years, were examined by gel diffusion test for precipitins to 12 antigens of fungi and 2 pigeon proteins. And the prevalence of positive reactions to these antigens was compared with the former research for the farmers in mountain district in last year. The results were summerized as follows.
Fifteen positive sera of 131 tested (11.5%) were detected to c. acremonium. And, 6.7% to candida, 6.1% to s. granarius, 5.9% to p. pullulans, 3.8% to t. vulgaris, 1.5% to m. faeni and positive to other 7 antigens tested. Thirty seven cases (28.2%) were positive to at least one antigen of all 14 tested. The proportion of positive selological tests in city inhabitants was rather higher than that of the farmers. The results suggest that the city inhabitants in Kumamoto prefecture have been exposed relatively high amount and/ or various kinds of fungi antigens as well as farmer's case.

A research team from the Center for Health Promotion (CHP) at the University of Toronto published a book entitled “Quality of Life in Health Promotion and Rehabilitation” in 1996. In this paper we will introduce the conceptual models of QOL made up of the components of QOL and the QOL field presented by the CHP researchers. They defined QOL as “the degree to which a person enjoys the important possibilities of his or her life” and proposed a QOL model comprised of nine measurable areas, which are grouped into three broad categories of “Being, ”“Belonging” and “Becoming.” The “Being” cluster encompasses the most basic aspects of human beings as individuals, consisting of such three sub-components as physical, psychological and spiritual being. The “Belonging” cluster is concerned with the fit between individuals and their environment, consisting of social, community and ecological belonging. The “Becoming” cluster focuses on the purposeful activities in which individuals engage in an attempt to realize their goals, aspirations and hopes, consisting of practical, leisure and personal growth becoming. In the QOL field as a conceptual model of comprehensive health and well-being and QOL framework, QOL is viewed as the result of identifiable determinants, divided into environmental and personal categories in interaction with such moderating conditions as control, potential opportunities, resources, support systems, skills, life events, political changes and environmental changes. Recently the importance of understanding health issucs at community level from the ecological and phenomenological viewpoints and of directing our attention to the people's living has been recognized anew. The conceptual models presented by the CHP team are considered to have great potential for guiding health and social policy and for implementing various health promotion practices in the community.

Objectives: This study was carried out to verify the usefulness of the Japanese version of the Hearing and Disability and Handicap Scale (HDHS) in the self-evalution of hearing disorders and to clarify the relationships between the hearing disability/handicap scores and such QOL components as life satisfaction, self-rated health conditions and social support networks, etc.
Methods: A questionnaire survey was conducted in Soyo village in Kumamoto Prefecture. The subhects were 136 residents aged 40 years or older who had received health check-ups in accordance with the Health and Medical Service Law for the Aged and who had complained of mild to profound hearing loss in one or both ears. The questionnarie was composed of three parts; back-ground question, the HDHS, and question regarding QOL components. Evalution of language adequacy regarding the Japanese translation of HDHS was carried out with the assistance of four bilinguals.
Results: Data from 123 respondents who completed the questionnaire were analyzed. The results were as follows:
1) Chronbach's alpha coefficients for the three subscales of HDHS ranged from 0.873 to 0.899-all within satisfactory levels.
2) Maximum likelihood factor analysis with varimax roataion suggested that 20 items of HDHS could be categorized according to three factors: Fl-handicaps; F2-detection of such verbal sound as the TV or radio or daily conversation; F3-detection of such nonverbal sound as door chimes or the sound of boiling water.
3) The response rates of “Always or Sometimes” for five questions regarding verbal sounds ranged from 65.8% to 82.1% compared with 47.9% to 58.6% for those questions regarding nonverbal sounds. Those for 10 questions regarding handicaps showed a great disparity; 25.2% for Q15 and 60.1% for Q4.
4) Analysis of covariance structures suggested that increases in hearing disability and handicap scores were indirectly related, through the lowering of self-rated health levels, to a perceived deterioration of QOL.
Conclusion: To ensure high QOL levels among middle aged and elderly residents, the creation of supportive environments that contribute to the alleviation of the affects of communication disorders induced by age-related hearing impairments is extremely important.