Background: Paraquat has been a matter of grave concern around the world, including Japan, in light of high mortality rates and numerous fatalities.;Method: We undertook a cross-sectional survey of pesticide poisoning by collecting data for 6 years, from 1998 to 2003, from 102 hospitals affiliated with the Japanese Association of Rural Medicine. From these cases, we analyzed those with exposure to paraquat.;Results: There were 79 paraquat poisoning cases, including 71 cases of suicide. Of the suicide cases with 5% paraquat and 7% diquat products, more than 80% resulted in suicide deaths. All people who used 24% paraquat products completed suicide. The outcomes of these cases were related to age and volume of ingestion. The prognosis line proposed by Proudfoot in 1979 continues to explain the final outcome of almost all cases even though more than 25 years have passed since it was first proposed. More than 80% of fatalities died within the first three days of ingestion.;Conclusion: Numerous lifesaving methods have been proposed by physicians around the world. However, almost all of these methods treat pulmonary disorders in the sub-acute and subsequent periods and seem unable to effectively decrease mortality rates. It is necessary to take administrative measures to reduce paraquat concentrations in products and, furthermore, to impose strict restrictions on its distribution.
Paraquat ; Cancer patients and suicide and depression ; Surveys ; Japan ; seconds

Pesticide poisoning is one of the most inportant health issues associated with rural medicine, and chronic nervous and mental disorders are its importnat sequelae. We investigated suquela cases nationwide, and reviewed chronic nervous and mental disorders from a clinical and epidemiological point of view.
Our nationwide survey found one reported case of delayed neuropathy. The patient ingested organophosphorus insecticides, and showed delayed neuropathy dozens days after.
Cases of delayed neuropathy attributable to Mipafox was reported in1951.This disease is mainly caused by organophosphorus insecticides. Carbamate insecticides are also known as the agents to induce delayed neuropathy. Herbicide Glufosinate (Basta^TM) was put on the market in 1984. The case reports published during the 1990's pointed out that some Glufosinate poisonings cause amnesia and disorientation. Thesecases were reviewed according to the types of pesticides or their groups.
An epidemiological investigation of neurological and psychiatric desorders among such workers exposed to several types of pesticides as plantation workers and sheep dippers was made. These exposed workers were at high risk of mild cognitive dysfunction, tremor, weakness, and so on to a significant extent. Those children who were exposed to organochlorine insecticide and pollutant via placenta or milk were also surveyed whether they had impairments of nervous and mental development. Highly exposed children were significantly slow in development relative to their peers. The results of these investigations were also reviewed.

We have carried out mass health screenig projects and health-related educational programs including those for health promotion and lifestyle improvements. The purpose of this study was to clarify how instrumental those activities are in preventing disease and cutting down outlays for medical care. The findings are as follows:
1. In an analysis of the costs shared by all municipalities in Kumamoto Prefecture under the National Health Insurance Scheme (NHIS), the larger the number of public health nurses and the higher the response rate of the basic health screening, the lower the various outlays for health care of seniors and others.
2. In the municipalities where activities for health care are briskly evolved, the percapita outlay for medical care under the NHIS is low-significantly low for the medical care of seniors, in particular-and the drop in the outlay for medical care is large as against the cost involved in health screening. Conversely, in the municipalities where the per-capital expenditure for medical care under the NHIS was low, the activities for health screening and health-related education were brisk.
3. In an analysis of Rezept, or bills for medical care, the higher the willingness to undergo a health screening, the lower the expenditure for medical care under the NHIS. This holds true particularly of the NHIS expenditure for the medical care of inpatients.
4. Gastric mass screenig is instrumental in reducing the mortality rate of stomach cancer. Its cost-effectiveness could be ascertained when the lost profit was included.
5. Mass health screening was not directly tied in with a drop in the morbidity prevalence rate, but it was found instrumental in improving everyday life practices.

As regards the chronic disorders brought about by pesticides to human bodies, attempts have been made to review theses that have been published both at home and abroad in the last several years on the basis of epidemiological studies. The chronic disorders that are found to have something to do with pesticides are neurological disorders (Parkinson's disease, peripheral nervous symptoms, poor coordinations and abnormal deep tendon reflexes), mental disorders (mild cognitive dysfunction and neurosis), pulmonary and bronchial disorders, hematopietic disorders (aplastic anemia), thyroid disorders, ocular disorders, immune disorders, natal disorders and birth defects (teratism, spontaneous abortion, complete transposition of the great arteries and cryptorchism), disorders in childhood growth (disorders in social development and attention deficit disorders, among others), genital disorders (reduction in fertility, erectile dysfunction (ED) and oligozoospermia), oncogenesis and carcinogenesis (childhood cancer, leukemia, non-Hodgkin lymphoma, multiple myeloma, others and pulmonary, mammary, cystic, pancreatic, and prostatic cancers).The findings of epidemiological studies do not necessarily produce casual relationships but, as identical findings have come out in many epidemiological studies, it may be argued that they produce findings the casual relationship of which is considerably suspicious. The working of pesticides as chemicals to stir incretion (the working similar to that of estrogen), the working of dioxin contained as a byproduct and the impairment of DNA have something to do with causes to chronic disorders.With not only acute poisoning by pesticides but also chronic disorders, the greatest adverse impacts fall on farmers who are directly engaged in the spraying of pesticides. When it comes to genital disorders, birth defects and tumorigenesis, among others, the spraying of insecticides and the extermination of white ants in and out of the houses ought to be taken into full account.
seconds ; Pesticides ; Chronic Disease ; findings ; epidemiologic

We have studied the degree to which health screenings and health education activities, including health promotion and improvements in the lifestyle, are contributory to the reduction of outlays for disease prevention and medical care.
An analysis of all municipalities in one prefecture reveals that the larger the number of public health nurses and the rate of undergoing a health checkup, the smaller the expenses required for inpatient and outpatient services. In a comparison between the municipalities where adequate health screenings and health education are provided and those in which no such activities are evolved yet in another prefecture, the outlays necessary for the medical care of seniors are significantly lower in the former.
An analysis of Rezept, or the monthly bills for medical treatment forwarded by hospitals to the associations that take charge of the National Health Insurance Scheme, shows that the coverage of per-capita costs under the scheme for the treatment of people who undergo a health screening on a regular basis is lower than that of those who do not do so, despite the fact that the latter more often undergo treatment at medical institutions after they suffer from some kind of disease or the other. In a comparison of municipalities that differ in terms of the per-capita share in the coverage of the scheme, the lower the medical outlay, the higher the rate of undergoing a health screening, that of receiving treatment at local hospitals and that of deaths at home.
An analysis of persons who have regularly undergone a health checkup over a period of five years indicates that the improvements made in the everyday lifestyle, and in dietary practices, exercises and calisthenics are more significant than is the case with people who have not undergone it. In stomach cancer screenings (mass X-ray stomach screenings or endoscopy), the rate of deaths from cancer and the outlay for inpatient services are lower than those of people who have not undergone a health-checkup. When outlays for health screenings, those for inpatient services and a deathderived losses in the benefit are all taken into account, it follows that the benefit is higher for people who have undergone a health screening on a regular basis.

The authors reviewed the English language papers concerning chronic health effects of agricultural chemicals, focusing on the incidence of cancer in pesticide users. These papers were collected using MEDLINE between 1988 and 1998 as a referencetool. According to the standard study design, the epidemiological literature is classified into cohort studies and case-control studies. These studies suggested the association between pesticides and various types of cancer such as soft tissue sarcoma, non-Hodgkin's lymphoma, lung cancer, and breast cancer. Categories of pesticides included in these studies, varied greatly, including herbicides and insecticides.
In this paper, we discussed about such problems as the selection of control groups and the assessment of pesticide exposure levels, which may pose some problems in conducting epidemiological research on the relationship between pesticides and cancer.
A model for a method of epidemiological study of health hazards due to pesticide exposure was also presented.

A China-Japan joint project was carried out to study the incidence of fluorosis caused by coal burning in China from 1995 to 1997.
The health survey covered a control area and two flourosis areas. In those research areas, drinking water was not polluted with fluorides. The survey was designed to analyze the health status of people exposed to fluorides and evaluate the relationships between the dose and incidence of fluorosis. The concentration of airborne pollutants in both indoor and outdoor air was measured. The concentration of fluoride in the urine was analyzed and definite diagnoses for dental fluorosis and skeletal fluorosis were determined.
As a result, the incidence of coal burning fluorosis was confirmed in studied areas. Moreover, the fluorosis was caused not only by the direct inhalation of the airbone fluorides in indoor air but also by the intake of cereals polluted with fluorides. Fluoride was contained in both coal and soil. Therefore the mixture of coal and soil used for the adjustment of fire energy contributed to the air pollution to a great extent. The typical polluted crops were red pepper, corn and potato. An extremely high concentration of fluoride in the urine of residents in the polluted areas was detected.

We have checked into the function of konjak, or the devil's-tongue (Hydrosme vivieri) to reduce cholesterol in order to cast light on its significance as a health food. We processed chipped glucomannan into crackers (hereinafter referred to as “mannan crackers”) and examined its impacts on lipid metabolism. Enrolled for this study were hospital staff members whose total cholesterol exceeded 200mg/dl and students boarding in the hospital's nursing college.
The findings attested to the fact that the intake of mannan crackers may serve to reduce the values of total cholesterol. The higher the value of total cholesterol before this study, the greater the drop. Since we could not detect any effect on either HDLcholesterol or triglyceride, the mannan crackers were considered capable of specifically reducing LDL-cholesterol. We observed no numerical changes in the complete blood cell count (CBCC) and blood chemistry, either. Some of the subjects had abdominal swelling, diarrhea and other digestive problems but theirs were not serious cases. Yet in another aspect, there was no difference in body weight between before and after this study, but the intake of energy and lipid dropped during the period, suggesting that the intake of mannan crackers would produce an effect on the dietary pattern. Having said that, konjak (mannan crackers) may be considered capable of directly or indirectly reducing cholesterol, particularly LDL-cholesterol, suggesting that mannan crackers are of significance as a health food.
The significance of this study for agriculture and rural community must not go unmarked. This study will contribute to the development of agriculture as an industry, while the farm product by the name of konjak has something to do for health, and will be instrumental in protecting the rural environment, not to mention the lives of farm workers engaged in its production. It is a task for us to grapple with by associating itself with farm work and rural villages with the close collaboration of those farm producers.

In recent years, an increasing number of researchers have warned that depltion of the Earth's ozone layer by chlorofluorocarbons allows extra ultraviolet radiation from space to strike our planet, causing a rise in the incidence of skin cancers and precancerous dermatoses worldwide. This motivated us to perform a series of screening for skin cancers on the inhabitants at age 40 and above of the Saku District, Nagano Prefecture, where the intensity of the sun's harmful ultraviolet radiation is thought to be relatively high.
The first screening was carried out from 1993 through 1995. The number of subjects totaled 7, 528-2, 658 men and 4, 870 women-which represents 7.4% of the populace. Of the total, 67 people had a histopathological examination. The result revealed that there were four cases of malignancy and 45 cases of precancerous dermatosis. The malignant cases were made up of one case of malignant melanoma and three cases of basal-cell carcinoma, while the precancerous cases were one case of Bowen's disease and 44 cases of solar keratosis.
The follow-up examination was conducted in 1996 on 93 subjects (40.6%) of the 229 examiness who had been found to need to be watched in the first screening. Biopsy was indicated in five subjects. Treatment was suggested to 11 subjects. A visit to the department of dermatology at Sake Central Hospital was recommended to 10 people. Further observation was needed in 24 cases.
The screening project for skin cancers under a long-range plan would raise awareness of the diseases among the people and contribute to the early detection, treatment and prevention of various forms of skin cancer. It could also serve the purpose of protecting the environment from deterioration on n global srnle.

Koumimachi Clinic attached to Saku Central Hospital is located in an underpopulated rural area. We have annually performed a close medical examination by upper gastrointestinal endoscopy since 1982. Since 1986, it has been done early in the morning. In 1995, a total of 1, 513 radiographic examinations were performed and 555 cases were examined by upper gastrointestinal endoscopy. Two cases of gastric cancer-one being early stage and the other, advanced stage-were detected. Despite the busy season all the farmers who had been advised to have the endoscopic examination attended because it was performed early in the morning. The early morning examination was performed in cooperation with Saku Central Hospital, Naganoken Kouseiren Health Screening Center, and public health nurses of local governments. Without such cooporation, any health care project could not be carried out a rural area.