Primary, Environmental and Health Care in Asian Communities

1. 孟加拉国调查：1998年11月进行了密集的实地调查。1999年2月至3月和1999年7月至8月，在孟加拉国西北部纳瓦布甘杰县的两个村庄（共350户）。研究项目包括调查区域内所有管井的砷污染情况和使用情况调查、人体测量、尿液和毛发取样、皮肤病学检查以及砷中毒认知和知识调查问卷。水和尿液样本被带回日本，随后用氢化物发生原子吸收光谱法分析砷和硒的含量。在跨度超过两个数量级的管井之间，砷的浓度存在相当大的差异，这使得即使在很小的区域内也很难假定一个暂定的“平均”暴露水平。个人尿液中砷的浓度与他/她使用过的管井中砷的浓度呈强正相关。皮肤症状（角化病和黑化病）与尿液浓度之间的剂量-反应关系仅在一个村庄的男性中建立。在这两个村庄中，即使暴露水平相似，男性表现出的症状也比女性严重得多，这强烈表明慢性砷中毒在皮肤易感性表现上存在性别差异。研究还表明，体重指数（或脂肪百分比）较低的受试者往往有更严重的皮肤病症状。泰国调查：1999年2 - 3月和1999年7 - 8月在泰国东北部亚索通州5个村庄（共55Q户）进行了密集的实地调查。研究项目包括关于各种农业活动中农药使用情况的访谈、食物频率问卷、妇女生殖史；抽样尿液和环境介质（鱼和池塘水）用于农药分析，以及测量血液胆碱酯酶活性。研究发现，该地区主要使用多种农药，主要用于西瓜种植，而且许多雌性西瓜从事农药的施用，这些农药不仅对其自身可能产生影响，而且对其生殖性能也可能产生影响。少

1. Survey in Bangladesh: Intensive field surveys were conducted on November 98. Feb-Mar 99, and, Jul-Aug 99, in two villages (total ; 350 households) of Nawabganj prefecture, northwestern Bangladesh. Study items included survey on the usage and state of arsenic contamination for all the tube-wells located in the survey area, anthropometry, urine and hair sampling, dermatological examination, and a questionnaire regarding the awareness and knowledge regarding the arsenic poisoning. The water and urinary samples were brought back to Japan and subsequently analyzed by Hydride-Generation Atomic Absorption Spectrometry for arsenic as, well as selenium content. There was a considerable difference regarding As concentration among the tube-wells which well spanned more than two order of magnitude, which would make it difficult to assume a tentative "average" exposure level even for a very small area. The As concentration in the urine of an individual and that of tube-well which he/she has been … More using show a strong positive correlation. Dose-response relationship in terms of the correlation between dermatological symptoms (keratosis and melanosis) and urinary concentrations were only established in males in one village. In both of the villages, man showed much severe symptoms than women even the exposure level were similar, which strongly suggests the existence of gender difference in the susceptibility to skin manifestation of the chronic arsenic toxicity. It was also, suggested that subjects having a lower BMI (or %fat) tended to have more severe dermatological symptoms.2. Survey in Thailand : Intensive field survey were conducted on Feb-Mar 99, and Jul-Aug 99, in five villages (total 55Q households) of Yaso-thon prefecture, northeastern Thailand. Research items Included an interview regarding the usage of pesticides for a various agricultural activities, food frequency questionnaire, reproductive history of women ; sampling urine and environmental media (fish and pond water) for pesticide analyses, and measurement of blood cholinesterase activity. It was found that a variety of pesticide has been used in this area mainly, for water-melon cultivation, and many females were engaged in the application of pesticides, which pause a concern for possible effects of these chemicals not only for themselves but also for their reproductive performance. Less