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Welcome address About half of the human population lives and works in rural areas, mainly engaged in agricultural activities. This ancient human activity produces food and uses land in a world where the demand for food is growing very quickly, and the quality and quantity of food are basic needs to ensure the health of millions of people. At the same time, agricultural activities are capable of causing environmental resource depletion and varying levels of pollution. Likewise, rural areas are directly linked with the wellbeing of entire communities, as demonstrated by the recent outbreaks of infectious diseases that were triggered in rural settings. Despite their major social, cultural, ecological and demographic relevance, rural areas are largely neglected by scientific research, health prevention and social protection. Rural inhabitants are suffering from an evident gap in life quality, sanitation, income, and distribution of social protection and economic benefits, including occupational health protection and services, as compared to urban dwellers. Importantly, rural communities are organized in villages, where agriculture and related activities are carried out very often by entire families, in which women, children and elderly represent an important proportion. The village is the target of all preventive interventions in rural areas. Only a healthy village, inhabited by healthy dwellers, can produce healthy food for the entire community while respecting the living environment. At the end of the 16th International Congress on Rural Health, held in Lodi (Italy) on June 2006, the “Lodi Declaration on Healthy Villages” was approved, and the Campaign on Healthy Villages was launched. The Lodi Declaration highlighted that, due to the complexity and specificity of rural areas, the approach to rural health needs to be holistic, crosscutting, and integrative. Cross cutting needs include different levels of expertise (involving, for example, academia, rural health practitioners, rural community leaders and others), integration among disciplines (involving general medical practitioners, occupational and environmental medicine, agronomic sciences, veterinary medicine, rural sociology, and health systems), and collaboration among countries, particularly addressing the rural differences between the industrialized world, the growing developing countries and those countries still in transition. Consensus on these needs was partially achieved by the Cartagena Declaration issued during the 17th International Congress in Agricultural Medicine and Rural Health in October 2009, by means of which Latin America committed to strengthen Rural Health and Medicine in its region. The Lodi Declaration was adopted by the 18th International IARM Congress, and the Goa Declaration of December 12th, 2009 reaffirmed the relation between health, human rights, and economic growth underlining that health is more than a medical issue and that women’s and children’s health is a human rights issue and closely interlinked with the empowerment of women and girls resulting in gender equality. However, the following specific objectives remain to be achieved: • Promoting universal coverage and access of disadvantaged populations to Primary Health Care and Occupational Health Care, to improve the health status of rural workers and dwellers and to reduce social inequalities; • Improving the overall quality of rural enterprises, to produce adequate amounts of high quality food, taking into account nutritional, safety and hygienic issues; • Reducing the environmental impact of agricultural activities all over in the world, through the diffusion of “green economy” principles; • Reducing the burden of disease attributable to occupational and environmental risks at the workplace, environmental pollutants generated by agricultural activities, and an unhealthy diet.

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The opportunity: Milan is hosting the Universal Exhibition in 2015. The central topic is “Energy for Life, Feeding the Planet”, by means of which the centrality of agriculture and rural areas in the world is strongly highlighted. This event constitutes a unique opportunity for organizing a four day event and calling professionals, experts and stakeholders from different areas of health and rural sciences unite jointly to address the varied aspects of agriculture and rural health, aimed at priority setting, making rural health problems visible, and finding feasible and sustainable solutions for rural populations. The proposal This event is targeting all international experts in rural health in the world. It will be organized in such a way to ensure the participation of the main national and international associations and organizations involved in Rural Health along the lines already defined by WHO including its efforts towards the “Health for All” programme, by reinforcing Primary Health Care services as the way to achieve universal health service coverage, and, as highlighted in the den Haag Conference, towards the need of an integration of Occupational Health services within Primary Health Care. The main international associations active in the field will be also present: the International Association of Rural Medicine and Health (IARM), which has decided to organize during this Congress its own 18th World Congress, the Wonca party on Rural Practice, which will organize specific sessions and lectures, the International Commission on Occupational Health (ICOH), which will be present with five Scientific Committees, those on Rural Health, Occupational Toxicology, Toxicology of Metals, Occupational Health and Development, and Indoor Air quality and health together with the European Rural and Isolated Practitioners Association (EURIPA). This means that in this event all the main actors active in the world in the field of rural health will be present: this is a promise for a future of prevention and health in Rural Areas.

Prof. Claudio Colosio Congress President

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Minutes Executive Board Meeting The 19th International Congress of International Association of Rural Health and Medicine

At 14:30 on September 10, 2015 Room Chiostro, Province of Lodi, Italy Attendees: Dr. Ashok Patil – Chair, Dr. Shuzo Shintani – Vice Chair Prof. Petar Bulat, Prof. Claudio Colosio, Prof. Hans Joachim Hannich, Dr. Tomihiro Hayakawa, Prof. Kanae Hamano, Dr. Kyeong Soo Lee, Dr. Hyun Sul Lim, Dr. Prof. Peter Lundqvist, Dr. Shengli Niu, Mr. Kazumi Ichikawa Apologies from: Prof. Istavan Szilard, Dr. Masanobu Tatsumi 1. 2. 3. 4.

Opening address by the chair Self-introduction was received from attendees. The minutes of the Board Meeting at the 18th Congress in Goa was confirmed. Agenda items 1) Statutes After circulating a draft of the new statutes which was prepared by Prof. H.J.Hannich with cooperation of Prof. P.Lundqvist and Prof. I.Szilard, comments on several articles were submitted from Japanese members. Taking the comments into consideration, Dr. A. Patil proposed his submission on the regarding articles. -Art.4-2 National associations should become an affiliated member. Any members of the national association can become a full member with the payment of the full membership fee. -Art.7 Regional Divisions will not need to be established. -Art.9 The number of members present will constitute a quorum for the General Assembly and proxy should be permitted. -Art.10.2 The Executive Board comprises the President, the President-elect, the Immediate Past President, three vice presidents, the Secretary General, the Treasurer as well as elected members. -Art.10.3 Maximum number of the Board members should be twenty and proxy is admitted. -Art.10.4 The Executive Committee will decide where to hold a meeting with general consensus.

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-Art.10.5 A quorum for making binding decisions should not be set in the Board Meeting. Any decisions should be based on the number of members present. -Art.13 Candidates for the leaders could be recommended by other members or be nominated by themselves. -Art.14.4 Regarding election to the Executive Board, decisions will be made by simple majority and proxy voting should be permitted. We will have to explore more simple and easy ways of voting such as electronic ballot. Prof. Hannich proposed in place of Prof. I. Szilard that the Past Presidents and the Secretary Generals should become Honorary Members and that should be added to the new statutes. He also referred that the WHO goal stated in Article 2 should be “Health in all” instead of “Health for all”. The original “Health for all” was adopted. Dr. S.Niu suggested that we would have to ensure main functions of IARM with certain visions. He emphasized to focus more on our congress which has been and will be one of the important objectives of our association. We will need to maintain good history of our association and appeal it to attract participants from agricultural countries especially in Asia. All attendees approved the above and agreed to present them to the General Assembly. 2) Next Congress Dr. S. Shintani presented a proposal for holding the 20th Congress in Tokyo Japan, 2018. This proposal was unanimously accepted. 3) Lodi Declaration Dr. A. Patil made a few suggestions for Lodi Declaration. Prof. C. Colosio, the congress president of Lodi International Rural Health, accepted to consider the suggestions and try to incorporate them into the declaration which will be sent to Italian governments and could also be delivered to several other governments and authorities by attendees. 4) Others Dr. A. Patil requested transfer of the responsibility for the website management to the Secretariat for an easier membership application. The Secretariat will check with the responsible committee for website administration of JARM.

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議事録 第 19 回国際農村医学会 理事会 日時：2015 年 9 月 10 日 14：30 場所：Room Chiostro, Province of Lodi, Italy 出席者：Dr. Ashok Patil （議長）, Dr. Shuzo Shintani（副議長）, Prof. Petar Bulat, Prof. Claudio Colosio, Prof. Hans Joachim Hannich, Dr. Tomihiro Hayakawa, Prof. Kanae Hamano, Dr. Kyeong Soo Lee, Dr. Hyun Sul Lim, Prof. Peter undqvist, Dr. Shengli Niu, Mr. Kazumi Ichikawa

1. 議長より挨拶 2. 出席者自己紹介 3. 第 18 回学術総会（ゴア、インド）理事会議事録承認 4. 定款について 新定款（案）の下記条項に関する変更が Patil 会長より提案され、承認された。 Art.4.2 国内組織は国際農村医学会の準会員となる。国内組織の会員は会費を支払い正会員になるこ とができる。 Art.7 地方部会の設立は必要ない。 Art.9 総会の定足数は定めない。出席者数で定足数を満たすこととする。委任状は有効である。 Art.10.2 理事会は会長、次期会長、前会長、副会長 3 名、事務総長、財務理事、ほか選出された会 員で構成される。 Art.10.3 理事の人数は 20 人までとする。委任状は有効である。 Art.10.4 エグゼクティブコミッティーが会議の場所を検討し、決定する。 Art.10.5 理事会において拘束力のある決議をする際も定足数は定めない。その会議に出席している 会員で決議することができる。 Art.13 立候補は自薦でも他薦でもよい。 Art.14.4 理事会の選挙について、決議は単純多数によってきまり委任投票は可能である。電子投票 のような簡単でシンプルな投票方法を早急に検討しなければならない。 Szilard 教授から過去の会長、事務総長は名誉会員に含むとの提案あり。今回改めて定款に盛り込む ことで一致した。Art.2 にある WHO のゴールについて”Health for all”ではなく”Health in all”では ないかとの質問があったが、これに関しては当初の”Health for all”でよいとの結論になった。

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Dr. Niu より、様々な議論をするうえで IARM の主な目的、ヴィジョンを明確にすることが必要で はないかとの助言があった。また、IARM の大きな存在意義のひとつが学術総会であることをあげ、 さらなる充実と特にアジアの農業国からの参加を促す努力をしていくべきとの提言がなされた。 定款に関する上記の承認を受けて、総会にかけることで一致した。 5. 第 20 回国際学術総会について 新谷先生より東京開催の提案発表がおこなわれ、次回学術総会は東京で開催されることが全員一致で 承認された。 6. ロディ宣言 Dr. Patil よりいくつか提言がなされ、Prof. Colosio がそれを受けロディ宣言に取り込んでいくよう 検討することになった。また、各理事がそれぞれの国の政府機関にロディ宣言を送ったほうがよいと いう意見がでた。 7. その他 Dr. Patil より日本の事務局で IARM のウエブサイトを、会員登録システムを含めて管理してほしい との要望があった。日本側で担当者と検討することとなった。

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Minutes General Assembly

The 19th International Congress of International Association of Rural Health and Medicine

At 17:00 on September 10, 2015 Room Chiostro, Province of Lodi, Italy Dr. Ashok Patil chaired the General Assembly. 1. New statutes After careful, prospective and profound discussion about our new statutes, it was finally agreed to adopt the draft agreement as it is for the new statutes of IARM for next three years while incorporating the revisions that were approved at the preceding Board Meeting held on the same day. An article about email and electronic ballot which can be used for election will also be added to the statutes. However, the statutes will have to be fully considered, modified and revised in next three years, and should be finalized at the next congress in Tokyo. The new executive board will be in charge of working on this task. It was agreed unanimously. 2. Election of the president, the vice presidents, the president elect, and the members of the Board The Nomination committee nominated following members and approved by the Board. The Secretary General presented at the General Assembly and it was approved unanimously. The secretariat will announce the member of the Board shortly. The President: Prof. Hans Joachim Hannich The Vice President: Prof. Claudio Colosio, Prof. Peter Lundqvist, Dr. Kyeong Soo Lee Treasurer: Dr. Tomihiro Hayakawa Secretary General: Dr. Shuzo Shintani President Elect: Dr. Shuzo Shintani Secretary General Elect: Dr. Hiroyuki Tomimitsu 3. The 20th Congress The Board confirmed that the 20th of International Congress of IARM would be held in Tokyo, Japan 2018. Dr. S. Shinatani will be the congress president. It was presented at the General Assembly and approved unanimously. 4. Others Dr. A. Patil asked for the financial statement to be submitted to the General Assembly or circulated later to the members by the Secretariat. It was agreed by the Secretariat. 5. Speeches were made by the New President-Prof. H.J.Hannich, the Secretary General and the next congress president-Dr. S.Shintani, and the Immediate Past President-Dr. A. Patil.

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議事録 第 19 回国際農村医学会 総会 日時：2015 年 9 月 10 日 17：00 場所：Room Chiostro, Province of Lodi 議長 Dr. Ashok Patil、副議長 Dr. Shuzo Shintani 1. 定款について ハニッヒ教授が作成した新定款が、慎重かつ十分な協議の結果、先の理事会で承認され た変更を取り入れつつ今後 3 年間の定款として採用された。加えて email 投票あるいは 電子投票が可能になるよう条項を追加することが承認された。 しかしながらこの新定款は今後さらに見直しと修正が加えられ、2018 年東京で開催さ れる第 20 回学術総会で最終版として承認されることとなった。新理事がこの作業を遂 行することで一致した。 2. 会長、副会長、次期会長について 推薦委員会によって推薦を受けた候補者が理事会の承認のもと総会で発表され、全員一 致で承認された。 会長 Prof. Hans Joachim Hannich（ドイツ） 副会長 Prof. Claudio Colosio（イタリア）、Dr. Kyeong Soo Lee（韓国） 、Prof. Peter Lundqvist（スウェーデン） 財務理事 Dr. Tomihiro Hayakawa（日本） 事務総長 Dr. Shuzo Shintani（日本）   次期会長 Dr. Shuzo Shintani（日本） 次期事務総長 Dr. Hiroyuki Tomimitsu（日本） 3. 第 20 回学術総会 事務総長により第 20 回学術総会を東京で開催することが発表され、全員一致で承認さ れた。 4. その他 今後事務局が総会で会計報告を行うこととする。今回は追って報告をする。 5. 挨拶 新会長 Prof. H.J.Hannich 第 20 回学術総会学会長、事務総長 Dr. S. Shintani 前会長 Dr. A. Patil

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New statutes of International Association of Rural Health and Medicine (IARM): Draft Article 1: NAME The International Association of Rural Health and Medicine (IARM) was originally founded under the name of "The International Association of Agricultural Medicine and Rural Health" in 1961. Its name has been changed into “International Association of Rural Health and Medicine” in 2009. Article 2: OBJECTIVES The International Association of Rural Health and Medicine is an independent Association of Rural Health experts from different scientific disciplines. According to the WHO goal of “Health for All in the 21st century”, it aims at the sustainable health development of people living in rural and remote areas in the fields of - Health of the general population - Rural occupational health - Environmental health. To achieve these aims, the tasks of the association are:   

  

to publish professional journals and publications, to formulate the official opinion of the Association on professional questions to provide professional advice and opinion to governmental or social organisations on the national and/or international level, on request or by decision of the executive board to conduct professional competitions in various issues and aspects of rural health and medicine to establish awards, commemorative medals and prizes, to collaborate with expert individuals organizations, as and when required, in undertaking various tasks for realising the objectives of the Association to establish regional, national organisations and specialised commissions for the improvement of this branch of science

Article 3: MEMBERSHIP 3.1 The association recognizes four types of member: 1. 2. 3. 4.

Full Members (individual and collective) Honorary Members Associated Members Affiliated members 1. FULL MEMBERSHIP is available for professionals and scientific bodies / organisations who are interested or involved in the field of rural health and medicine. Full members accept the statutes of the Association and pay a prescribed fee for a period of minimum three years. They are admitted by

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the Association by passing a resolution to this effect at its Executive Board meeting. They will have voting rights. 2. HONORARY MEMBERSHIP is given to individuals who, because of their work in the field of rural health and medicine are elected by the General Assembly after being recommended by the Executive Board. Such persons once elected become permanent life members of the Association. They will have voting rights. 3. ASSOCIATE MEMBERSHIP is available for public or private corporate bodies who support the aims of the Association. Such bodies are expected to pay the prescribed membership fees. Associate members may participate in the General Assembly and other meetings. They may move motions and participate in discussions. However, they do not have the right to vote and cannot be elected to the Executive Board. 4. AFFILIATED MEMBERSHIP: Other scientific societies with an interest in rural health and medicine shall be eligible for Affiliated Society Membership 3.2 Application for membership shall be submitted in writing. The executive committee decides on the admission. A letter of complaint may be filed against a rejecting decision within a month after delivery, which is decided upon on the next statutory meeting of the members. The complaint decision shall be delivered in writing. There is no right of membership. 3.3 All members are entitled to advantages, given by the Association. Any member of the Association or its Boards may submit a proposal through the Executive Board to award a prize to an outstanding member. 3.4 The membership ends a) in the case of death (natural person) or dissolution (legal entity) of the member b) by withdrawal c) by exclusion from the association d) by exclusion due to removal from the membership list. Article 4: MEMBERSHIP FEES 4.1 Individual members pay a membership fee valid for three years. The amount is decided on by the majority of the General Assembly (Art. 9) respectively effecting the following financial year. 4.2 Affiliated Societies and National Associations ( Art. 6) pay an annual membership fee. The amount of the gross fee for these members is based upon the number of individual members they have, calculated from Jan. 1 to cover the year ahead. The amount of the fee is decided by the General Assembly with the proviso that the per capita fee charged to any Member Society will not exceed 10% of the fee for the individual membership of that Affilated Society.

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Article 5: RESIGNATION 5.1 Any member wishing to resign from IARM may do so by writing to the President or Secretary-General. Resignations have to be received before Jan. 1 of the year of resignation. Resignations are accepted by the Executive Board (Art.10) on the recommendation of President/Secretary. 5.2 Any Society or individual member can be removed from the membership list, if there are arrears of three (3) membership fees or if there exist other arrears of the member of at least this amount at the association. 5.3 A member can be excluded from the association, in case of a serious act against the interests of the association. Such termination is carried out by the General Assembly on the recommendation of the Executive Board. The exclusion is decided on by General Assembly with 2/3 majority. The Executive Board shall send a copy of the request for exclusion, including justifications, to the concerned member at least two weeks before the General Assembly. If there is a written statement of the concerned member, it shall be brought to the attention of the meeting of the members. The exclusion decision shall be communicated to the members by the Executive Board in writing and becomes effective upon delivery. Article 6: NATIONAL ASSOCIATIONS 6.1 Considering the pecularities of rural health problems in different countries, National Associations may be established in the field of rural health and medicine. They organize activities in their country in association with other specialities and in accordance with the organisational framework of the country. They may hold independent meetings, collaborate with other organisations and elect their own Executive Board. National associations are acknowledged as members cooperating with the IARM. 6.2 The national associations may formulate their independent statutes and national programs. They acknowledge the Statutes of IARM and accept it. They coordinate their activities with the programs of IARM. 6.3 Representatives of the National Associations can participate in the Board Meeting of IARM with consultative rights 6.4 They shall remit an annual membership fee as prescribed by the Association. The membership will he cancelled if they do not pay the fee for three consecutive years (Art. 4.2). 6.5 The National Associations are actively involved in the activities of the Regional Divisions (Art. 7). The Presidents and Secretaries- General of National Associations have voting rights in the Regional Councils.

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Article 7: REGIONAL DIVISIONS 7.1 Considering the peculiarities of rural communities due to different on geographical, life and work conditions, the Association may decide on the establishment of Regional Divisions on the recommendation of the Board. The Regional Divisions assist with the establishment of National Associations or Special Committees and support their work. They coordinate the activities of organisations in the field of rural health and medicine in the region and collaborate with other likeminded associations. They may also hold independent meetings. 7.2 The Regional Divisions comprise individual members working in rural health and National Associations. 7.3 The Regional Divisions are directed by the Regional Council comprising the President of the Regional Council , the Secretary-General of the Regional Council, the presidents of National Associations working in the region, Secretaries-General of National Associations and three to seven elected members. 7.4 The President, the Secretary-General and the members of the Regional Divisions are elected by open vote by the Regional Assembly on the recommendation of the President of IARM. 7.5 Assembly Meetings of the Regional Divisions are held once a year . Members of the Association and representatives of National Associations have voting rights. 7.6 Regional Divisions shall remit an annual membership fee as prescribed by the Association (Art. 4.2). The membership will be cancelled if they do not pay the fee for three- consecutive years. Article 8: BODIES OF THE ASSOCIATION 8.1 The bodies of IARM are: -

the General Assembly the Executive Board the Nomination Board

8.2 Only members of IARM may be appointed to one or more of this body. Article 9: GENERAL ASSEMBLY 9.1 The General Assembly is the main organ of the Association. It comprises all the members of the Association. It is responsible for all tasks, as far as they are not allocated to the Executive Board or other representative bodies of the Association. 9.2 The General Assembly is exclusively responsible for the following affairs:

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a) Authorization of the budget that is set up by the Executive Board for the next financial year b) Election of the auditors and the acceptance of the auditing report from the auditors c) Regulation of the amount and maturity of the membership dues d) Electing and recalling the members of the Executive Board e) Change of the Charter f) Liquidation of the Association g) Decision on the complaint against the refusal of an application for membership h) Exclusion of an Association member i) Nomination of honorary members j) Decision on the establishment of further boards or representative bodies of the Association 9.3 The statutory meeting of the General Assembly takes place in conjunction with the International Congress which is normally held in every three years. 9.4 An extraordinary General Assembly may be held if requested by one third of the membership. An extraordinary meeting of the members shall be called up, if the Executive Board decides the summoning for urgent and important reasons or one tenth of the members demand the summoning of the Executive Board in writing to the President or Secretary-General while indicating reasons. 9.5 The General Assembly is called up by the Secretary-General of the Association in text form, complying with a term of at least one month, indicating the agenda. The invitation letter is considered as delivered to the member if it was directed to the address that was last given to the Secretariat of the Association. 9.6 Each member can demand the extension of the agenda until one week before the beginning of the meeting of the General Assembly by means of a message in text form. The Executive Board decides on the extension of the agenda. Afterwards and during the General Assembly requests for extending the agenda can only be accepted by decision of the meeting of the members with a 2/3 majority. 9.7 The General Assembly is led by the President, if prevented by the Vice-President. If no member of the board is present, the meeting determines the leader. 9.8 A decision of the General Assembly requires the assent of more than 50% of the valid members at the meeting. Such assent is shown by open vote. 9.9 The resolutions of the meeting have to be documented in a transcript. The person who takes the minutes is directed by the leader the meeting. 9.10 The transcript has to be signed by the chairman of the meeting. In case of multiple chairmen chairing the meeting, the most recent has to sign the entire transcript. 9.11 Every member is eligible to read the transscript. 9.12 The General Assembly can give itself bylaws.

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Article 10: EXECUTIVE BOARD 10.1 As the executive organ of the Association, the Executive Board implements the policy decided by the General Assembly. It conducts the business of the Association and deals with all administrative tasks, as far as they are not assigned to another representative body of the Association by the charter or by law. In particular, it has the following tasks: a) Execution of the resolutions of the General Assembly, b) Summoning and preparation of the General Assembly , the chairing of the General Assembly by the president, the president elect or the three vice presidents, c) Planning of the budget for each financial year e) Admission and participation in the exclusion of members, f) Conclusion and termination of contracts of employment, g) Summoning of committees h) Outlining plans for cooperation with other scientific Associations and establishing programs, workshops and ad hoc working groups 10.2 The Executive Board comprises the President, the President Elect, the Immediate Past President, , three Vice Presidents, the Secretary General, the Treasurer, Presidents and Secretary Generals of Regional Chapters, the Presidents and Secretaries of Special Commissions as well as elected members. As a temporary member, it also comprises the Congress President of the Congress, at which the Executive Board meets. 10.3 The Executive Board is elected for three consecutive years by open vote by the General Assembly. It remains in office until the following election. If a member retires during the term of office, the full Board may elect a substituting member for the remaining term of office. 10.4 The Executive Board shall meet once a year. Between meetings of the Board, the President and the Secretary General are responsible for the administration of the Association. If necessary, they may consult with other members of the Board. The President reports on such work to the next meeting of the board. 10.5 In the Board meeting, the Board can make binding decisions if more than one third of its members are present. Such decisions are made by open vote with the President having a casting vote in addition to his/her substantive vote. 10.6 The third party authorisation of the Executive Board is limited. Acquisition, sale, burden and other liabilities of estate (and comparable estate based rights) as well as taking out a loan requires approval by the meeting of the members. 10.7 The Executive Board cannot alter the statutes of the Association. It can establish its own rules of procedure. Article 11: THE PRESIDENCY 11.1 The Presidency comprises the President, the President Elect, the Immediate Past President. the Congress President, the three Vice Presidents, and the Secretary

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General, the Treasurer. The function of the Presidency is to control the financial expenditure of the Association (see article 4). 11.2 The responsibility of the President is to - represent the Association for matters which are the responsibility of the Association in all dealings with Third Parties - preside over the Executive Board and the Presidency. If the President is indisposed, the President Elect or one of the Vice Presidents will serve in that capacity. 11.3 The responsibility of the Congress President is to - organize and manage the next international scientific meeting of the Association - ensure accurate and complete financial accounting methods for the Congress as well as a balance sheet provided to the Board. 11.4 The responsibilitiy of the President Elect is to - represent the Association in absence of the President 11.5 The responsibility of the Secretary General is to - provide operational support to the Association - summon and prepare the Executive board meeting in cooperation with the President - keep the minutes of the meetings and to distribute them to the members of the Executive Board, the Presidency and the General Assembly - create the annual report and distribute it - to ensure implementation of Resolutions adopted by the General Assembly, the Executive Board or the Presidency - represent the Association for matters which are delegated to him/her in all dealings with Third Parties 11.6 The responsibility of the Treasurer is to - carry out the routine operations of the Association’s bank account - prepare a balance sheet for the Executive Board Article 12: THE SECRETARIAT 12.1 The Secretariat is composed of the Secretary General appointed by the General Assembly and staff members as may be necessary, appointed by the Secretary General, in consultation with the President. 12.2. The functions of the Secretariat are to - execute all decisions of the President - prepare the annual work plan and budget and submit it to the General Assembly for approval - execute the work plan approved by the President and manage the activities of Association - manage the personnel and financial resources of the Association and sign the

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commitment and disbursement authorisations in the name of Association - prepare the annual meeting of the Association and the meetings of other Committees as may be instituted by the Association - establish and implement regulations and procedures for the Secretariat - present to the Association an annual report on the activities and operations of the Association after the close of each fiscal year - prepare the report of the annual Meeting of the Executive Board - perform such other tasks and functions assigned by the Board / President. Article 13: NOMINATION COMMITTEE The Nomination Committee makes proposals for the nomination of the leaders / executives of the Association to the Board meeting. Proposals discussed and accepted by the Board are forwarded to the General Assembly. The Nomination Committee consists of three persons. The General Assembly on the recommendation of the Bureau elects them for three-years. Article 14: MODE OF ELECTION 14.1 The elections take place at the meeting of the General Assembly. Its mode is determined by the leader of the General Assembly. The election must take place in writing and/or secretly, if 1/3 of the present members entitled to vote should request so. 14.2 Elections of the Executive Board take the form of written elections. 14.3 The General Assembly is quorate if at least one third of the members entitled to vote is present. Each member has one vote. A delegation of votes is not allowed. Decisions are made with a simple majority of the cast valid votes. Abstentions are not taken in account. 14.4 The members of the Executive Board are elected individually, first the President, then the Vice-President and at last the remaining members. The candidate who received more than half of the cast valid votes is considered to be elected. Article 15: COMMISSIONS The Executive Board may organise special commissions and approve their programs. Those convening such commissions are responsible for drafting their terms of reference, which must be approved by the Board. The Chairperson of the respective Commission is responsible for presenting an annual report of the work of the Commission to the Executive Board.

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Article 16: FINANCE 16.1 The financial expenses of the Association are met by subscription and membership fees. The amount of subscription (individual, national and associate) is determined by the General Assembly following a proposal from the Executive Board. 16.2 The Treasurer is responsible for the financial routine operations of the Association (11.6). The Treasurer shall get the Balance sheets of the Association audited by the registered Chartered Accountant or follow any other such rule which is the law of the land. 16.3 The Executive Board will take the stock of the financial situation of the Association every year and prepare a budget for ensuing year. 16.4 The Presidency is responsible for all expenditure incurred by the Association. Article 17: COLLABORATION WITH OTHER ASSOCIATIONS 17.1

The Collaborating Organizations / Associations will have reciprocal arrangements with IARM as regards the Executive Bureau. If the Collaborating Organization invites the IARM to become the Member of its Executive Committee / Board, then IARM shall also reciprocate the same. In case the Collaborating Organization offers any other position, e.g. observer to the Executive Committee, then IARM would also have the same and equa reciprocal arrangement.

17.2. This arrangement will not be applicable to any UN/WHO/ILO or similar organizations. Their official representatives will always be invited to join the Executive Bureau as its full-fledged members to perform an advisory function. Article 18: CHANGES OF THE STATUTES 18.1 Amendments to the charter require the approval of 3/4 of the individual members. 18.2 To change the Association’s purpose one half of the members entitled to vote has to be present at the General Assembly. In the case of the absence of a quorum, the votes can also be cast by postal vote or by electronic vote during an election period defined by the Presidency in the interim time between two General assemblies. Article 19: DISSOLUTION The dissolution of the Association will proceed with the agreement of the General Assembly 'when its objectives can no longer be achieved. The General Assembly may decide on its dissolution by a two -third majority of the members present at the General Assembly supporting this action following a secret ballot. Such ballots cannot be carried out unless all members have been given three months notice in writing of the intention to dissolve the Association.

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Article 20: SIGNATURES All instruments committing the Association shall be signed by the President or his/her representative, except for the matters delegated to the Secretary General Article 21: LIABILITY The Association is responsible for its liabilities on all its assets. Members and officers of the Association or its organs shall incur no personal liability in respect of the commitments of the Association

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International Association of Agricultural Medicine and Rural Health (IARM) 定款（案）  名称 本学会は 1961 年に The International Association of Agricultural Medicine and Rural Health として設立されたのち、2009 年に現在の名称：国際農村医学会 The International Association of Rural Health and Medicine(IARM)となる。  目的 本学会は異なる分野における地域医療の専門家で構成される独立団体である。WHO の目標「21 世紀に全ての人に健康を」に沿って、農村や遠隔地域に暮らす人々の健康、労働衛生、環境衛生 において持続可能な発展を目的とする。 上記目的を達成するため、本学会は次の事業を行う。 ・学会誌を刊行する。 ・専門的な問合せに対する本学会の公式見解をまとめる。 ・要請があれば、あるいは理事会の決定で政府や民間組織に対して国内外の見地で専門的な助言 と見解を述べる。 ・賞を創設し、地域医療の様々な分野の問題において専門知識の競合をはかる。 ・本学会の目的を達成するための様々な活動の中で、必要に応じ専門家や組織と協働する。 ・この分野の発展の為に、地方組織、国内組織、専門委員会を設置する。  会員 3.1 本学会の会員は次の４種類とする。 1.正会員（個人及び団体） 2.名誉会員 3.賛助会員 4.準会員 1. 正会員は地域医療に携わる、または興味のある専門家、機関、組織とする。本学会の定款に同 意し最低３年分の会費を納入する。入会は理事会の決議をもって承認される。正会員は議決権を もつ。 2. 名誉会員は地域医療の分野での活動を鑑み理事会により推挙され総会で選出された個人とす る。名誉会員に選出されると本学会の永久会員となる。名誉会員は議決権をもつ。 3. 賛助会員は本学会の目的を支持する公的、または民間法人とする。所定の会費を納入する。総 会、その他の会議に参加することができる。動議の提出や討論の参加もできる。しかしながら、 議決権は付与されず、理事への選出はなされない。 4. 準会員は地域医療に関心のあるそのほかの団体とする。

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3.2 入会申込は書面で行われ、理事会で決議される。申請却下に対する訴状は、通達後一カ月以 内に提出し、定款に定められた会議で決議される。決定通知は書面で行われる。この間会員の権 利は付与されない。 3.3 全会員は本学会の様々な特典を享受する。会員あるいは理事は理事会を通して優れた会員に 賞を贈る提案ができる。 3.4 会員は下記により資格を喪失する。 a)本人の死亡、組織の解散・消滅 b)任意退会 c)本学会からの除名 d)会員名簿からの除籍 会費 4.1 正会員は３年分の会費を納入する。総会の過半数により次年度の会費が決定される。 4.2 関連団体や国内組織は年会費を納入する。これらの会費は各団体にその年の 1 月 1 日から所 属する会員数をもとに総会にて決められる。ただし、一人あたりの会費がその所属団体の個人会 費の 10％を超えないものとする。  退会 5.1 退会届は会長または事務総長宛に退会する年の１月１日までに書面で提出する。会長あるい は事務総長の助言をもって理事会にて承認される。 5.2 会費の滞納あるいは本学会において同等の滞納が発生した会員は会員名簿から除籍されるこ とがある。 5.3 会員は本学会に対し著しく不利益になるような行動をとった場合除名となる。これは理事会 の勧告をもって総会で決議され執行される。除名は総会にて３分の２以上の賛成をもって決議さ れる。理事会は総会の少なくとも２週間前に除名要請のコピーを理由とともに当該会員に送付す る。除名の決定は書面で理事会より当該会員に送付され、通達と同時に有効となる。  国内組織 6.1 各国における地域医療問題の特性を考慮し、その分野における国内組織を設立する。各国の 組織的な枠組みに従い、専門家と協力しながら国内の活動をまとめる。独自に会議を開催し、他 団体と協働し、理事を選出する。国内組織は IARM と提携する会員と認められる。 6.2 国内組織はそれぞれの定款と活動計画を策定する。IARM の定款に同意することとし、その 計画と連携しつつ活動する。 6.3 国内組織の代表者は IARM の理事会に顧問として参加できる。 6.4 国内組織は本学会規定の年会費を送金する。３年間会費納入がなされない場合会員資格は取り 消しとなる。

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6.5 国内組織は地方組織の活動に積極的に関与する。国内組織の会長と事務総長は地方評議会の 議決権を付与される。 7. 地方部会 7.1 異なる地理的条件、生活と仕事の状況の違いによる地域社会の特性を考慮し、理事会の助言 によって本学会は地方部会を設立する。地方部会は国内組織または特別委員会の設立を補助しそ の活動を支援する。各地方の地域医療分野における組織の活動を調整し、目標を同じくする他団 体と協働する。また独自の会議を開催することができる。 7.2 地方部会は地域医療に従事する会員と国内組織の会員から構成される。 7.3 地方部会は地方評議会によって管理される。地方評議会はその会長、事務総長、その地域の 国内組織の会長、事務総長、加えて選出された３～７名の会員によって構成される。 7.4 地方部会の会長、事務総長、会員は、IARM の会長の助言のもと地方総会の選挙により選出 される。 7.5 地方部会の総会を毎年１回開催する。本学会の会員と国内部会の代表者は議決権を付与される。 7.6 地方部会は本学会規定の年会費を送金する。３年間会費納入がなされない場合会員資格は取 り消しとなる。  学会組織 8.1 IARM の組織    総会    理事会    選考委員会 8.2 上記に任命されるのは IARM の会員のみである。  総会 9.1 総会は本学会の主要機関であり全ての会員をもって構成される。本学会のほかの担当機関あ るいは理事会に割り当てられた職務でない限り全ての事業に対し責任を負う。 9.2 総会は特に以下に対し責任を負う a)理事会が提出する次年度の予算承認 b)監査人の選出と監査報告の承認 c)会費の納入や金額に関する規定 d)理事の選出と解任 e)学会憲章の変更 f)学会の解散 g)入会申請の却下に対する訴状に関する決議 h)法人会員の除名 i)名誉会員の推薦 j)本学会の機関と委員会の設立に関する決議

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9.3 総会の法定会議は通常３年ごとに開催される国際学術総会と同時に行われる。 9.4 臨時総会は会員の３分の１以上の要求で開催される。臨時会議は緊急かつ重要な理由で理事会 が召集を決定した場合、あるいは会員の１０分の１以上が書面で会長あるいは事務総長に召集を 要請した場合に開催される。 9.5 総会は本学会の事務総長により、少なくとも１カ月前に議事を提示して召集される。その招 待状は、宛先が事務局の保有する最新のものであれば会員へ送付されたこととする。 9.6 会員は総会の会議開始一週間前までテキストフォームで議事項目の追加を要求でき、理事会に より決定される。それ以降及び総会開催中の議事項目の追加に関しては会員の３分の２以上の賛 成をもって承認される。 9.7 総会は会長によって進められる。会長が不可の場合は副会長が進める。理事の出席がない場 合は当該総会において出席者の中から決定される。 9.8 総会での決議は総会において記名投票による会員の５０％以上の賛同を必要とする。 9.9 会議の決定事項は文書化されなければならない。議事録を作成する者はその議長に指示を受 ける。 9.10 記録文書は当該会議の議長によって署名される。議長が複数の場合は最終会議の議長がすべ てに署名する。 9.11 全会員は記録文書を閲覧することが可能である。 9.12 総会は附則を定めることができる。 理事会 10.1 本学会の執行機関として理事会は総会で決定された方針を執行する。憲章あるいは規約で本 学会の別の機関に任命されていないかぎり、理事会が本学会の業務と運営事務を執行する。 a)総会における決議事項の執行 b)総会の召集、準備。会長、次期会長あるいは副会長３名により総会の議長を務める。 c)次年度予算計画の作成 d)会員の除名に関する承認と関与 f)雇用契約の締結と解消 g)委員会の召集 h)他団体との協働計画の企画や、活動計画、ワークショップ、特別ワーキンググループの企画 10.2 理事会は会長、次期会長、前会長、副会長３名、事務総長、財務理事、地方部会の会長、同 事務総長、選出された会員と特別委員会の会長、事務局長で構成される。理事会が開催される学 術総会の学会長も一時的に含まれる。 10.3 理事会は３年ごとに総会にて記名投票で選出される。次の選挙までメンバーは変わらないが、 任期中に退職者が出る場合は残りの任期を務める代理理事を理事全員で選出する。 10.4 理事会は毎年１回開催することとする。次の理事会までの学会業務は会長と事務総長が担当 する。必要であれば他の理事に相談する。会長は次の理事会にて活動結果報告をする。 10.5 理事会で３分の１以上の理事の出席があれば拘束力のある決議が可能である。その決議は記

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名投票で行われる。会長は決定投票権をもつ。 10.6 理事会の第３者機関の認可は制限されており、財産の取得、売却、負担、その他の債務、銀 行ローンは会議で会員の承認が必要である。 10.7 理事会は本学会の定款を変更することはできないが、変更手順の規約を制定することができ る。 会長職 11.1 会長職は現会長、次期会長、前会長、学会長、副会長３名、事務総長、財務理事で構成され る。会長職の機能は本学会の財政支出を管理することである。 11.2 会長の責任 -第三者が関わる本学会の事案に関し学会を代表する -理事会と会長職を統轄する。 会長が上記を遂行できない場合は次期会長あるいは副会長１名がその業務を代行する。 11.3 学会長 -本学会の次の国際学術総会を組織し運営する。 -国際学術総会の財政運営を確実なものとし理事会に貸借対照表を提出する。 11.4 次期会長は現会長不在時に本学会を代表する。 11.5 事務総長 -本学会の運営を支持する -会長とともに理事会の召集及び開催準備をする。 -議事録の作成。理事、役員、総会の会員へ配布。 -年次報告の作成、配布。 -総会、理事会または会長職の決議事項を確実に執行する。 -第三者の関わる事案で事務総長に委託されたものにおいて本学会を代表する。 11.6 財務理事 本学会の銀行口座を管理する。 理事会へ貸借対照表を提出する。 事務局 12.1 総会において任命された事務総長と、必要であれば会長の助言のもと事務総長が任命した事 務員で構成される。 12.2 事務局機能 -会長による決定事項を執行する。 -年間活動計画と予算を総会に提出し承認を得る。 -会長により承認された活動計画の執行と管理 -本学会の人事及び財務管理と、学会名で執り行われる契約、支出行為の管理 -本学会の定例会議と委員会等の会議の準備 -事務局規約や手順などの作成と遂行

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-年度末に年次活動報告を提出する。 -理事会の定例会議報告 -理事または会長に指示された任務の遂行 選考委員会 本学会の役員または執行役員を理事会に推薦する。 理事会にて議論のうえ承認された提案を総会へ提出する。選考委員会は３名で構成され、総会の 選考事務局により３年の任期で選出される。 選挙方法 14.1 選挙は総会の会議にて行われる。方法は総会の議長によって決定される。当該会議に出席し、 かつ議決権をもつ会員の３分の１以上が要求すれば、選挙は記名または無記名で行われなければ ならない。 14.2 理事会の選挙は記入方式で行われる。 14.3 総会は当該会議に出席し、かつ議決権をもつ会員の少なくとも３分の１で定足数に達する。 会員１人につき１票の投票権が付与される。委任投票はできない。有効票の単純多数で決議され、 棄権票は考慮されない。 14.4 理事会の会員は、まず会長、副会長、そして最後にその他のメンバーの順で選出する。有効 票の半数以上を獲得した候補者も選出されたこととなる。 委員会 理事会は特別委員会を組織し活動を承認する。委員会は付託事項の作成し理事会により承認され なければならない。議長は年次報告を理事会に提出する。 財務 16.1 本学会の財政は寄付と会費でまかなうものとする。寄付（個人、国、団体からの）について は理事会の提示に基づき総会で決定される。 16.2 財務理事は本学会の経理業務を執行する。財務理事は公認会計士あるいはその国の法律に従 い貸借対照表の監査を受ける。 16.3 理事会は本学会の財務状況を評価し、次年度予算の準備をする。 16.4 会長職につくものは本学会により発生する全ての支出に対し責任を持つ。 他組織との協働 17.1 組織や団体との協働は相互に調整を行う。協働する団体から理事、あるいは役員就任の要請 がなされた場合、IARM からも同様の申し入れをする。その他の役職への要請があった場合（例： 理事会オブザーバー）も同様に相当の申し入れをする。 17.2 上記に関しては UN/WHO/ILO と類似する団体はその限りではない。それらの代表者は、助 言を与える立場の正会員として理事に加わる要請を常に受けている。

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定款の変更 18.1 憲章の改訂は正会員の４分の３以上の賛成を必要とする。 18.2 本学会の目的を変更するには、総会において議決権をもつ会員の過半数の出席が必要である。 定足数に満たない場合、会長職にあたるものにより決められた次回総会までの選挙期間中に電子 メールあるいは郵送での投票も可能である。 解散 本学会の解散は、その目的達成遂行ができなくなったときに総会の同意のもとすすめられる。総 会に出席する会員により無記名投票が行われ、３分の２以上の同意で解散が決まる。この投票は ３か月前に全会員に書面にて本学会解散の主旨が伝えられないかぎり実行されない。 署名 本学会に帰する全ての文書は会長またはその代理人が署名をする。事務総長に委任された事案は このかぎりではない。 責任 本学会は全ての財産においてその責任を持つ。本学会またはその機関の会員と役員は本学会の約 定についてなんら個人的責任を負わない。

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The 20th Congress of International Association of Rural Health and Medicine (IARM), in Tokyo, Japan, 2018 Greeting from Japanese colleagues, First of all, on behalf of the Japanese Association of Rural Medicine (JARM), we would like to extend our sincere congratulations to all the participants for your contribution to the 19th Congress in Lodi, Italy. We would also like to take this opportunity to express our deepest gratitude to Professor Colosio and his team for all the efforts in organizing this successful Congress. Japanese colleagues are honored to hear that the Board of IARM decided to hold the 20th Congress in Tokyo, Japan, 2018. We will try our best to prepare for the Congress. The theme for the 20th congress will be “Challenges to community-based rural medicine in aging societies with declining productive populations“. The following explains what this exactly means. In 2014, the number of births in our country was about 1 million and the number of deaths was 1.26 million. That led to the population decline of 260,000. The population thus dropped for the eighth straight year. By the year of 2025, it is widely reported, almost one in every five Japanese people (18.1%) will be age 75 or over, and elderly needing long-term care and requiring help will increase to 8.17 million. In September 2011, a medical journal the Lancet released a special series on Japan that commemorated the 50th anniversary of its attainment of a universal health insurance system. The world sees Japan as a rare country that provides access to prompt and high-quality medical care equitably at low cost for the people and maintains the world’s longest life expectancy. The series made scientific analysis and verification of many facets of the Japanese universal health care system: the reasons of Japan’s remarkable achievements in life expectancy in a brief period of time; the advantages and limitations of the system; the actual status of high-quality medical care at low cost; the results and challenges of the long-term care insurance system for elderly people with a rapidly aging society; and the future of the system which enables people to keep an excellent health level equitably at low cost. The series also provided recommendations for experts inside and outside of Japan. Recently, global attention, particularly that of countries facing similar problems, is drawn to the universal health insurance system in Japan and how we address issues of declining birthrates and an aging society. JA Koseiren Hospitals (Agricultural Cooperative Hospitals), which we work for, play

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important roles as public hospitals in community-based rural medicine throughout Japan. They would like to present their achievements and future visions to international medical professionals. JARM has a long history and a large membership base of 4,500 physicians and researchers. Dr. Wakatsuki (one of the founders of the association) organized the 4th IARM Congress in Nagano, Japan in 1969. It has been quite some time since then. So, we are excited to host a joint congress of IARM and JARM in Tokyo where we would be able to offer all IARM members high-quality scientific programs as well as a platform for discussion on rural medicine of this century with experts from all over the world. I look forward to seeing you again in Japan, 2018. English will be the official language. We will provide simultaneous interpretation services at lectures and symposiums to overcome language barriers. ■2018 Joint Congress on Rural Medicine in Tokyo, Japan The 20th International Congress of the International Association of Rural Health and Medicine (IARM) The 67th Annual Meeting of the Japanese Association of Rural Medicine (JARM) ■Theme Challenges to community-based rural medicine in aging societies with declining productive populations ■IARM Past Congresses As of Sep.10, 2015

Year

Date

Country

City

President

1

1961

July 6-12

France

Tours

J. Vache

2

1964

May 4-9

Germany

Bad Kreuznach

G. Preuschen

3

1966

September 26-30

Czechoslovakia

Bratislawa

P. Macúch

4

1969

Sept. 30-Oct. 4

Japan

Usuda

T. Wakatsuki

5

1972

May 10-15

Bulgaria

Verna

Karaijev

6

1975

September 22-26

U.K.

Cambridge

C.K. Elliott

7

1978

September 17-21

USA

Salt Lake City

L.W. Knapp

8

1981

September 14-18

France

Avignon

J. Dubrisay

118

9

1984

September 10-14

New Zealand

Christchurch

J. Stoke

10

1987

August 27-31

Hungary

Pecs

J. Tényi

11

1991

November 10-12

China

Beijing

Zhang Zikuan

12

1994

July 10-13

Sweden

Stockholm

S. Hoglund

13

1997

September 7-10,

USA

Iowa City

L.W. Knapp

14

2000

May 25-27

Hungary

Pecs

J.Tenyi

15

2003

July 20-23

Thailand

Ayutthaya

Mukda Trishnananda

16

2006

June 18-21

Italy

Lodi

C. Colosio

17

2009

October 13-16,

Colombia

Cartagena

J.R. Guzman

18

2012

December 10-12

India

Goa

Ashok Patil

19

2015

September 8-11

Italy

Lodi

C. Colosio

October 21, 2015

Tomihiro Hayakawa, MD President, Japanese Association of Rural Medicine (JARM) Treasurer, International Association of Rural Health and Medicine (IARM) Shuzo Shintani, MD Director of the International Committee, Japanese Association of Rural Medicine (JARM) Secretary General, International Association of Rural Health and Medicine (IARM)

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第 20 回国際農村医学会(IARM)・学術総会 in 東京 2018 日本から、各国の皆さまにご挨拶申し上げます。 最初に、日本農村医学会 Japanese Association of Rural Medicine (JARM)を代表して、第 19 回国際農村医学会 International Association of Rural Health and Medicine (IARM) 学術総会 in Lodi, Italy に参加された全ての皆さまのご功績に、心から感謝申し上げます。また、この 学会を組織企画され、成功に導かれた学会長の Professor Colosio に、深い敬意を表したい と思います。 我々、日本の学会員は、この学会中に開かれた国際農村医学会(IARM)の理事会で、第 20 回の学会 Congress を、2018 年東京にて開催することに決定したと聞いて光栄に存じます。 我々一同、この学会に向けて全力を尽くす所存です。学会の主テーマとして、“Challenges to community-based rural medicine in aging societies with declining productive populations（高齢 化・生産人口減少社会の中での地域医療構築への挑戦）“を掲げました。その意図すると ころを、以下にご説明申し上げます。 昨年、2014年の我が国の出生数約100万人、死亡者数126万人で年間26万の人口減少とな りました。これは8年連続の人口減少です。現在注目されている2025年には、日本人の5 人に1人近く (18.1％) が75歳以上となり、要介護要支援の高齢者は817万人と増加します。 さる2011年9月、 「ランセット」誌が日本の国民皆保険制度50周年を記念し「日本特集号」 を出しました。日本は、国際的には迅速で低コスト、しかも高度な医療を公平に国民に提 供し、世界最長の平均余命を維持している極めて稀な国と映っています。この中で、日本 が短期間で長寿社会をなしとげた原因、国民皆保険制度の長所と限界、高品質かつ低コス ト医療の実態、急速な高齢化に対応する介護保険制度導入による成果と課題、優れた健康 水準を低コストで公平に実現する日本型保険制度の将来を、それぞれ科学的分析と検証を 行い、国内外に向けて提言しています。 昨今、世界的に日本の国民皆保険・少子高齢化への対応に関心が集まっており、50年も 前に皆保険を達成し、高い平均余命を誇る高齢化先進国日本の経験は、近い将来、同様の 問題に直面する海外の国々からも注目されています。とりわけ公的病院として、全国各地 域で地域医療（Community-based rural medicine）を担っている我々の厚生連病院は、その 実績と将来像を、世界の医療関係者に紹介したいと考えています。日本農村医学会は、長 い歴史を有し、4500名もの医師や研究者を擁しています。国際農村医学会は、1969年9 月に故・若月先生（当学会の創設者のお一人）が長野で開催されてから、日本ではその後

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開かれておりません。それから長い年月が経ちました。私達は、世界各国の皆さまと、21 世紀の地域医療について高度な学究的課題を追求し、また討議する場として、2018年、 東京にて日本農村医学会・国際農村医学会（IARM・JARM）学術総会を共同開催（joint congress）したいと考えます。 皆さまと、2018年東京（日本）にてお会いできることを祈念しております。  英語を公用語としますが、講演やシンポジウムでは、同時通訳を用意しますので、言語の 障壁は無くなると存じます。  ■2018 Joint Congress on Rural Medicine in Tokyo, Japan The 20th International Congress of the International Association of Rural Health and Medicine (IARM) The 67th Annual Meeting of the Japanese Association of Rural Medicine (JARM) ■Theme Challenges to community-based rural medicine in aging societies with declining productive populations ■国際農村医学会の開催履歴 2015 年現在 回

会 期

開催地（国）

学会長

参加国数、参加者数 （日本からの参加者）

1

1961.7.6-12

ツール（フランス）

J. Vache

16カ国120名(1)

2

1964.5.4-9

バードクロイツナッハ

G.Preuschen

16カ国150名(11)

P. Macúch

24カ国450名(42)

臼田（日本）

若月俊一

25カ国496名(417)

（西ドイツ） 3

1966.9.26-30

ブラチスラバ （チェコスロバキア）

4

1969.9.30-10.4

5

1972.5.10-15

バルナ（ブルガリア）

カライジェーフ

36カ国653名(43)

6

1975.9.22-26

ケンブリッジ（英国）

C.K. Elliott

33カ国250名(38)

7

1978.9.17-21

ソルトレイクシティ（米国）

L.W. Knapp

18カ国130名(72)

8

1981.9.14-18

アビニョン（フランス）

J. Dubrisay

20カ国483名(85)

9

1984.9.10-14

クライストチャーチ

J. Stoke

18カ国250名(105)

（ニュージーランド） 10

1987.8.27-30

ペーチ（ハンガリー）

J. Tényi

20カ国360名(70)

11

1991.11.10-13

北京（中国）

張自寛

31カ国450名(52)

12

1994.7.10-13

ストックホルム

S. Hoglund

27カ国200名(64)

（スウェーデン）

123

13

1997.9.7-10

アイオワシティ（米国）

L.W. Knapp

13カ国170名(59)

14

2000.5.25-27

ペーチ（ハンガリー）

J.Tenyi

31カ国280名(48)

15

2003.7.20-23

アユタヤ（タイ国）

Mukda Trishnananda

9カ国215名(19)

16

2006.6.18-21

ロディ（イタリア）

C. Colosio

43カ国350名(38)

17

2009.10.13-16

カルタヘナ（コロンビア）

J.R. Guzman

27カ国142名(12)

18

2012.12.10-12

ゴア（インド）

Ashok Patil

25カ国400名(24)

19

2015.9.8-9.11

ロディ（イタリア）

C. Colosio

27カ国248名(29)

2015 年 10 月 21 日

早川富博 Tomihiro Hayakawa, MD 日本農村医学会 (JARM) 理事長 国際農村医学会 (IARM) 財務担当理事 新谷周三 Shuzo Shintani, MD 日本農村医学会 (JARM) 国際交流委員会会長 国際農村医学会 (IARM) 事務総長

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第19回 国際農村医学会・学術集会 International Congress on Rural Health &

The 4th International Conference Ragusa SHWA 2015 (Safety Health Welfare in Agriculture Agrofood and Forestry Systems)

Lodi, Italy September 8 – 11, 2015

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Table of Contents Keynote Lectures- September 9th 2015 Ethics in occupational and rural health Sergio Iavicoli, INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone, (Rome), Italy Agricultural Health and Medicine Education—engaging rural practitioners to make a difference to farmers’ lives. Susan Brumby RN, RM, DipFarm M’Ment, MHM, PhD. National Centre for Farmer Health, School of Medicine, Deakin University, Hamilton, Australia Indoor air pollution in rural areas: a priority for public health Paolo Carrer. Dpt. Biomedical and clinical sciences “L. Sacco Hospital”, university of Milan, Milan, Italy

Models and approaches for improving the access of rural workers to occupational health care Agricultural Health program in Iran's Primary Health Care (PHC) system. Reza Ezzatian. Ministry of health and medical education, Environmental and occupational health center, Tehran, Iran. Efficiency and quality of rural health services in region of Kazakhstan Kenesh Dzhusupov (1) - Karlygash Toguzbaeva (2) - Aigul Karakushikova (2) - Sirim Shayakhmetov (2), International school of medicine, International school of medicine, Bishkek, Kyrgyzstan (1) – Kazakh national medical university named after S.D. Asfendiyarov, Kazakh national medical university named after S.D. Asfendiyarov, Almaty, Kazakhstan (2) Occupational medicine and rural health in R. Macedonia - current perspective and future directions Dragan Mijakoski - Jovanka Karadzinska-Bislimovska - Sasho Stoleski - Jordan Minov, Institute of Occupational Health of R. Macedonia, WHO CC, Faculty of Medicine, University "SS. Cyril and Methodius", Skopje, Macedonia The use of occupational health care services and farmers' opinions concerning them in Finland Birgitta Kinnunen, Finnish Institute of Occupational Health, - Kuopio, Finland Migrant agricultural workers and Canada’s “not so universal” health care system: lessons learned from an effort to improve access to health care in the province of Ontario Stephanie Mayell (1) - Janet McLaughlin (2) - Michelle Tew (3), McMaster, University, Hamilton, Canada (1) Wilfrid Laurier, University, Brantford, Canada (2) – Occupational Health Clinics for Ontario Workers (OHCOW), Clinic, Hamilton, Canada (3)

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Slavery and other forms of human exploitation The exploitation of migrant workers in the Italian agricultural sector: a case study from a Ghanaian community of day-labourers in northern Apulia Gloria Carlini University, University of Milan-Bicocca, Milano, Italy Enduring marginalities: Social hierarchiesandAgricultural labor in Southern Morocco Laura Menin, University of Milano Bicocca, University of Milano Bicocca, Milan, Italy The Jijiyaabe and the Rimbe of Southern Senegal. The rural predicament of the legacies of slavery Alice Bellagamba, University of Milan-Bicocca, University, Milan, Italy The social life of the global greenhouses. Stigma, servile work and labourers’ vulnerability in Jordanian agribusiness. Van Aken Mauro, Dipartimento di Scienze Umane per la Formazione, Università Milano-Bicocca, Milan, Italy

Public Health Strategies and governance in rural areas The use of QFD for safety assessmkent of machinery. Mario Fargnoli (Italian Ministry of Agriculture), Massimo Tronci (Sapienza University of Rome) International and regional approaches to safety and health requirements for designing agricultural and forestry machinery. Antoon Vermeulen, CNH Industrial Belgium N.V. Market surveillance activity as a way to ensure health and safety of machinery, eliminate unfair competition and help manufacturers in designing. L. Vita A new way to register and prevent accidents involving agricultural and forestry machinery. E. Ariano, V. Laurendi

Diagnosis and prevention of musculoskeletal disorders in agriculture Comparison of the Strain Index and OCRA Checklist for Risk Analysis of MSDs JOHN ROSECRANCE (1) - LELIA MURGIA (2) - ROBERT PAULSEN (3), COLORADO STATE UNIVERSITY, OCCUPATIONAL SAFETY AND ERGONOMICS, FORT COLLINS, United States (1) UNIVERSITY FO SASSARI, AGRICULTURAL ENGINEERING, SASSARI, Italy (2) - COLORADO STATE UNIVERSITY, OCCUPATIONAL SAFETY ADN ERGONOMICS, FORT COLLINS, United States (3) Differences in musculoskeletal occupational disease incidence and notifications between the Po Valley and the Appennines. Bottoli E (1), Foresti C (1), Cervino D (2), Ottone M (1), Mattioli S (1), Department of Medical and Surgical Sciences, University of Bologna, Section of Occupational Medicine, S.Orsola- Malpighi Hospital, Via Palagi 9 -

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40138 Bologna – Italy (1), Workplace Prevention and Safety Service (SPSAL) of the south area of Bologna district – Italy (2).

Dairy Consortium International Perspectives on Health and Safety among Dairy Workers: Challenges, Solutions & the Future Comparison of upper limb muscle activity between US and Italian industrialized Dairy operations Masci F.1, Mixco A.2, Colosio C.1, Rosecrance J. 2, 1 Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan - Italy 2 Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado - USA Dairy Worker Safety Training: Current Challenges and Opportunities for Enhanced Effectiveness I. Noa Roman-Muniz, DVM, MS, John Rosecrance, PhD, Lauren M. Menger, MS, Florencia Pezzutti, MA, Flor Amaya, MV, Lorann Stallones, MPH, PhD Ergonomic challenges in modern milking parlors Dr. Martina Jakob, Leibniz-Institute for Agricultural Engineering Potsdam Bornim e.V., Research Institute, Potsdam, Germany Occupational health and safety experiences in automatic milking Janne P. Karttunen (1) - Risto H. Rautiainen (2), TTS Work Efficiency Institute, -, Rajamaki, Finland (1) Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, United States (2) Milking their Health Susan Brumby (1) - Andrew Smith (2), National Centre for Farmer Health, Deakin University & Western District Health Service, Hamilton, Australia (1) - Faculty of Health, Federation University, Ballarat, Australia (2)

Health of the Rural Population and workers The current status of knowledge about risk of hemolymphatic cancer among farmers Pierluigi Cocco, University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, Monserrato, 09042, Italy Health of the Serbian rural population Petar Bulat (1) - Stefan Mandic-Rajcevic (2), School of Medicine, Serbian Institute of Occupational Medicine, University of Belgrade, Belgrade, Serbia (1) - International Centre for Rural Health and Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy (2) The potential to detect and prevent health problems in the agriculture sector by using OHS data Lode Godderis (2) - Chris Verbeek (1) - Matthias Coenen (1) - Martijn Schouteden (1), Idewe, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Heverlee, Belgium (1), Katholieke Universiteit Leuven, Centre for Environment and Health, Kapucijnenvoer 35/5, 3000 Leuven, Belgium (2)

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Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador – a cross-shift study of workers at risk of Mesoamerican nephropathy Ramón García-Trabanino (1) - Emmanuel Jarquín (2) - Catharina Wesseling (3) - Richard J Johnson (4) -, Marvin González-Quiroz (5) - Ilana Weiss (6) - Jason Gkaser (6) - Juan José Vindell (7) - Leo Stockfelt (8) Carlos Roncal (4) – Tamara Harra (4) - Lars Barregard (8), Scientific Board, Department of Investigation, Hospital Nacional Rosales, San Salvador, El Salvador (1) – Agency for Agricultural Health and Development, AGDYSA, San Salvador, El Salvador (2) - Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (3) - Division of Kidney Diseases and Hypertension, University of Colorado, Denver, United States (4) - Research Centre on Health, Work and Environment (CISTA), National Autonomous University of Nicaragua at León, León, Nicaragua (5) - the La Isla Foundation, the La Isla Foundation, León, Nicaragua (6) - Universidad Nacional de El Salvador, Universidad Nacional de El Salvador, El Salvador, El Salvador (7) - Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden (8) Long-term cognitive problems after toxic inhalation incidents Annet Lenderink (1) - Herman Bartstra (1) - Evelien van Valen (1) - Michelle Bertelkamp (1) - Gert van der Laan (2) - Frank van Dijk (1), Netherlands Center for Occupational Diseases/ Coronel Institute, AMC/University of Amsterdam, Amsterdam, Netherlands (1) - former: Netherlands Center for Occupational Diseases/ Coronel Institute, AMC/University of Amsterdam, Amsterdam, Netherlands (2) Promotion and coordination of health surveillance in agriculture in Mantua province Mauro D'Anna (1) - Roberto Trinco (2) - Maria Rosa Freddo (2) - Simona Donini (2) - Milva Barigazzi (2) Elena Toninelli (3), Unità Operativa Ospedaliera di Medicina del Lavoro, A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (1) - Servizio Prevenzione e Sicurezza Ambienti di Lavoro, Azienda Sanitaria Locale della Provincia di Mantova, Mantova, Italy (2) - Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Brescia, Brescia, Italy (3)

Exposure to organic dusts in rural settings Organic dust contaminated with LPS is still the predominant exposure in animal breeding operations Torben Sigsgaard, Aarhus University, Dept of Public Health Quantifying Farmers’ Exposure to Respirable Grain Dust while Performing Work around Grain Bin Storage Facilities S. Dee Jepsen (1) - Chris Harner (2) - Yang Geng (1), Department of Food, Agricultural & Biological Engineering, The Ohio State University, Columbus, Ohio, United States (1) - Berkley Agri-Business Risk Specialists, W. R. Berkley Company, Columbus, United States (2) Prevalence of chronic respiratory symptoms, lung function impairment, and airway responsiveness comparison between cow breeders and crop farmers Sasho Stoleski (1) - Jovanka Karadzinska Bislimovska (1) - Jordan Minov (1) - Dragan Mijakoski (1), Institute for occupational Health of R. Macedonia, Institute for occupational Health of R. Macedonia, Skopje, Macedonia (1)

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Exposure to organic dust in a farrowing-weaning farm as a possible risk for human and pigs: One Health Approach. C. Baldini (1), F. Beretta (2), C. Colosio (2), M. Guarino (1), Department of Health, Animal Science and Food Safety, Faculty of Veterinary Medicine, University of Milan (1), Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan – Italy (2)

Environmental Health in Rural Areas Across the globe: Healthy Farmers, Healthy Farms —The Sustainable Farm Families Project Jordan Jensen (1) - Susan Brumby (2) - Laura Nelson (1), Farm Safety Centre, Farmer Organization / Government, Raymond, Canada (1) - National Centre for Farmer Health, Deakin University / Western District Health Service, Hamilton, Australia (2) Mesothelioma and sinonasal cancer risk in agriculture Carolina Mensi (1) - Gaia Varischi (2) - Barbara Dallari (1) - Pier Alberto Bertazzi (3) - Luciano Riboldi (1) -, Dario Consonni (1), Department of Preventive Medicine, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy (1) - School of Occupational Health, University of Milan, Milan, Italy (2) - Department of Clinical Sciences and Community Health, Universty of Milan, Milan, Italy (3) Improving the professional competency of Health Professionals – locating the ‘lost tribe’ in Farm Family Health Andrew Smith (1) - Susan Brumby (2) - Amber McDonald (2), Federation University Australia, School of Nursing Midwifery and Health care, Ballarat, Australia (1) – National Centre for Farmer Health, Western District Health Service, Hamilton, Australia (2) Factors affecting sustainable solution for treatment of waste water treatment or small villages in the West Bank (Palestine) Rafael S. Carel, Zobida Esery School of Public Health, University of Haifa, Haifa, Israel and IPSO, Jerusalem Tremolite asbestos exposure in a rural area: personal sampling campaign results Antonio Baldassarre (1) - Luigi Vimercati (1) - Vito Luisi (1) - Gabriella Cauzillo (2) - Silvano Dragonieri (3) Marina Musti (1), Interdisciplinary Department of Medicine - Occupational Medicine "B. Ramazzini", University of Bari, Bari, Italy, (1) - Policy Office of Primary Prevention, Basilicata Region, Potenza, Italy (2) Department of Respiratory Diseases, University of Bari, Bari, Italy (3)

Zoonoses in agriculture and rural areas Hepatitis E virus infection in rural health: an emerging occupational risk? De Schryver Antoon (1) - François Guido (1) - Hambach Ramona (1) - Tabibi Ramini (2) - Van Sprundel Marc (1) - Colosio Claudio (2), Epidemiology and Social Medicine, University of Antwerpen, Antwerp, Belgio (1) Department Health Sciences, University of Milan, Milan, Italia (2) Zoonotic Pathogens are Occupational Hazards to US Livestock & Poultry Workers Richard Bruno, MD MPH - Ellen Silbergeld, PhD, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States

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The prevalence of zoonotic chlamydial infection in farmers of Kyrgyzstan Kenesh Dzhusupov (1) - Anara Kutmanova (2) - Vera Toigombaeva (3), International school of medicine, International school of medicine, Bishkek, Kyrgyzstan (1) - Kyrgyz state medical academy, Republican hospital, Bishkek, Kyrgyzstan (2) - Kyrgyz-Russian Slavic university, Kyrgyz-Russian Slavic university, Bishkek, Kyrgyzstan (3) The level of tetanus immunity in the agricultural workers in Lombardy Region, North of Italy Ramin Tabibi - Pietro Bianchi - Fancesco Beretta - Gabri Brambilla - Camilla Mussini - Claudio Colosio, ICRH, University of Milan, Milan, Italy The Status and Epidemiological Characteristics of Zoonoses in Korea Hyun-Sul Lim, Department of Preventive Medicine, College of Medicine; Center for Farmers’ Safety and Health for Infectious Diseases in Farmers, Dongguk University, Gyeongju, Republic Of Korea Biological hazards among meat industry workers Gabriella Luci Maria Martina (1) - Antonio Baldassarre (1) - Silvano Dragonieri (2) - Angela Longo (1) Sabrina Cannone (1) - Angela Dambrosio (3) - Giuseppina Caggiano (4) - Luigi Vimercati (1) - Marina Musti (1) Occupational Medicine, University of Bari, Bari, Italy (1) - Respiratory Diseases, University of Bari, Bari, Italy (2) - Veterinary Medicine, University of Bari, Bari, Italy (3) - Hygiene, University of Bari, Bari, Italy (4)

WMSDs and Occupational Health Agricultural machinery injuries in Finland 2004-2014 Risto Rautiainen, Jarkko Leppälä, Matts Nysand, Ari Ronkainen, Natural Resources Institute (Luke), Finland Common risk factors for agricultural injury Rohan Jadhav, Gleb Haynatzki, Chandran Achutan, Shireen Rajaram, Risto Rautiainen, University of Nebraska Medical Center, College of Public Health, Omaha, United States

Keynote lectures- 10th September 2015 The IARC Monographs, evaluations of the carcinogenicity of pesticides and on-going research Kurt Straif, IARC, WHO, Lyon, France UV induced Skin Cancer and Eye effects: neglected occupational risks! Swen Malte John (1) , Fabriziomaria Gobba (2), Dept of Dermatology, University of Osnabrueck, Osnabrueck, Germany (1), Chair of Occupational Medicine, University of Modena and Reggio Emilia, Modena, Italy (2)

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Biological monitoring of Pesticides Exposure in Rural Areas Blood Cholinesterase Activities over Two Years among Latino Farmworkers in the United States: Pesticide Exposure Evidence and Health Implications Sara Quandt (1) - Carey Pope (2) - Haiying Chen (1) - Thomas Arcury (1), Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC, United States (1) – Oklahoma, State University, Oklahoma State University, Stillwater, OK, United States (2) Comparison of persistent symptoms and cholinesterase levels in laborers in three stages of the agricultural process Martha Edilia Palacios Nava (1) - Guadalupe Silvia García de la Torre (1), Public Health Department, Faculty of Medicine, Universidad Nacional Autónoma de México, México D.F., Mexico (1) Health effects related to pesticide exposure and blood cholinesterase activity among elderly farmers in northeastern Thailand Thitirat Nganchamung, Wattasit Siriwong College of Public Health Science, Chulalongkorn University, Bangkok, Thailand Urine and hair specimens for biomonitoring short and long term penconazole exposure Silvia Fustinoni (1) - Rosa Mercadante (1) - Elisa Polledri (1) - Federico Maria Rubino (2) - Stefan MandicRajcevic (2) - Claudio Colosio (2) - Angelo Moretto (3), Department of Clinical Sciences and Community Health, University of Milano and Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy (1) - Department of Health Sciences, University of Milan, San Paolo, Hospital Unit, and International Centre for Rural Health, milan, Italy (2) - Department of Biomedical and Clinical Sciences, University of Milano, and International Centre for Pesticides and Health Risks Protection (ICPS), ), Luigi Sacco Hospital, Milan, Italy (3) Biological Monitoring on Green house workers in Yazd Province, Yazd, Iran S. Bakand, Y. Dehghani, MR. Gohari, MH. Mosadegh, SJ. Mirmohammadi, M. Rafiei, Health Faculty, Iran University of Medical Sciences,Tehran- Iran

Psychosocial health risk & workforce ageing Health promotion for aged rural workers. The European study Prohealth65+ Magnavita N1, Poscia A1, Moscato U1, Ricciardi W1, Golinowska S2. Department of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy (1); Institute for Public Health, Jagiellonian University, Krakow, Poland (2) Emerging issues related to workfoce aging and the EU ECapacit∞ Project Maryam Sokooti (1), Piotr Sakowski, Claudio Colosio (1) on behalf of the whole E-capacit8 Consortium. International Centre for Rural Health of the University Hospital S, Paolo, Milano and Department of Health Sciences of the University of Milano (1), Nofer Institute of Occupational Medicine, Lodz, Poland (2)

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Alcohol-related morbidity in a rural area in Germany Katharina Lau & Hans-Joachim Hannich, Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany Mentally challenging for farmers to apply advanced technology and automated systems? Christina Lunner Kolstrup (PhD) and Torsten Hörndahl (lecturer) Department of Work Science, Business Economics & Environmental Psychology, Swedish University of agricultural Sciences, Alnarp, Sweden- Department of Biosystems and Technology, Swedish University of agricultural Sciences, Alnarp, Sweden

Environment Safety, People Health Protection and Welfare Poisonous bites and stings: a natural risk in the natural environment Andrea Giampreti (1) - Marta Crevani (1) - Francesca Chiara (1) - Giulia Scaravaggi (1) - Azzurra Schicchi (1) Eleonora Buscaglia (1) - Davide Lonati (1) - Sarah Vecchio (1) - Valeria Margherita Petrolini (1) – Carlo Alessandro Locatelli (1), Maugeri Foundation, Maugeri Foundation - University of Pavia, Pavia, Italy (1) Acute poisonings in farmers and fishers in Italy: a poison control center based 5 years case series /observation Davide Lonati (1) - Marta Crevani (1) - Sarah Vecchio (1) - Andrea Giampreti (1) - Valeria Margherita Petrolini (1) - Eleonora Buscaglia (1) - Francesca Chiara (1) - Giulia Scaravaggi (1) - Azzurra Schicchi (1) - Carlo Alessandro Locatelli (1), Maugeri Foundation, Maugeri Foundation - University of Pavia, Pavia, Italy (1)

Modelling exposure to pesticide in Rural Areas Matphyto: a French program for retrospective pesticide exposure assessment by using CEM Johan Spinosi (1) - Laura Chaperon (2) - Céline Gentil (3) - Matthieu Gouy (4) - Mounia El Yamani (1), French Institute for Public Health Surveillance, -, Saint-Maurice, France (1) - Umrestte, University Claude Bernard Lyon 1, Lyon, France (2) - French Institute for Public Health Surveillance, -, Fort de France, Martinique (3) French Institute for Public Health Surveillance, -, Saint-Denis, Reunion (4) CIA: a new tool to assess retrospective occupational exposure to pesticides in France Laura Chaperon (1) - Johan Spinosi (2) - Laurent Perrier (1) - Mounia El Yamani (2), Umrestte, University Claude Bernard Lyon 1, Lyon, France (1) - French Institute for Public Health Surveillance, - Saint-Maurice, France (2) Biological Monitoring for Pesticide Risk Assessment in Farmers and Rural Population with a Tiered Protocol Federico Maria Rubino - Stefan Mandic-Rajcevic - Claudio Colosio, Department of Health Sciences and International Centre for Rural Health, Università degli Studi di Milano, Milano, Italy From Field Studies to Scenario-Based Risk Assessment: an Online Pesticide Risk Assessment Platform Stefan Mandic-Rajcevic - Federico Maria Rubino - Claudio Colosio, International Centre for Rural Health, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy

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Education for Basic Occupational Health in Agriculture (2) Education for Basic Occupational Health in Agriculture: a round table Van der Laan G and Van Dijk F

Noise, Vibration, Dust, Endotoxin, Microorganism Risk from vibration and noise on agricultural tractors Peretti A, Bonimini F, Pessina D, Giordano D, Gibin M, Colosio C, Mucci N M, Nuccio M, Pasqua di Bisceglie A

Chemicals and agrochemicals in rural areas Problematic of the pesticides use by the gardeners in Burkina Faso Antoine Vikkey HINSON (1) - Sandrine M. SANON LOMPO (2) - Hervé LAWIN (3) - Paul AYELO (4) Benjamin FAYOMI (4), Unity of Teaching and Research in Occupational Health:, University of Abomey-Calavi, Cotonou, Benin (1) - Unity of Training and Research in Health Science, Public Health department: University of Ouagadougou, University of Ouagadougou, Ouagadougou, Burkina Faso (2) - Faculty of medicine of Porto-Novo, Univeristy of Porto Novo, Porto Novo, Benin (3) - Unity of Teaching and Research in Occupational Health: University of Abomey-Calavi, University of Abomey Calavi, Cotonou, Benin (4) Investigating the impacts of endocrine disrupting compounds on sperm health: A new potential effect biomarker Melissa J. Perry, ScD, MHS, Professor and Chair, Department of Environmental and Occupational Health, George Washington University, Washington DC, USA, Milken Institute School of Public Health, The George Washington University, Washington DC, United States Pesticides intoxication Sarah Vecchio - Marta Crevani - Andrea Giampreti - Valeria Margherita Petrolini- Eleonora Buscaglia Francesca Chiara - Giulia Scaravaggi - Azzurra Schicchi - Davide Lonati - Carlo Alessandro Locatelli Maugeri Foundation, Maugeri Foundation - University of Pavia, Pavia, Italy Industry Point of View on Endocrine Disruptors E. Vassallo Pesticide immunotoxicity: from in vivo evidence to mechanistic understanding Emanuela Corsini, Laboratory of Toxicology, DiSFeB, Università degli Studi di Milano, Milan, Italy The Effectiveness of an Educational Intervention to Improve Knowledge and Perceptions for Reducing Organophosphate (OP) Pesticides Exposure among Indonesian Farmworkers Suratman Suratman - Kirstin Ross - Kateryna Babina - John Edwards Health and Environment Group, School of the Environment, Faculty of Science and Engineering, Flinders University, Adelaide, Australia (1)

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Prevention of occupational skin diseases in agriculture Contact allergy to the European Baseline Series in agricultural workers, 2009-2012 Francesca Larese Filon (1) - Buttazzo Silvia (2) - Uter Wolfgang (3), University of Trieste, Unit of Occupational Medicine, Trieste, Italy (1) - University of Trieste, Unit of Occupational Medicine, ETrieste, Italy (2) - University of Erlangen, Nürnberg Dept. of Medical Informatics, Biometry and Epidemiology, Erlangen, Germany (3) Ultraviolence: sun induced occupational skin cancer Swen Malte John, MD, PhD, Dept. Dermatology, Environmental Medicine, Health Theory, Faculty of Human Sciences, UNIVERSITY OF OSNABRUECK BACKGROUND: Skin barrier protection Swen Malte John(1) and Sanja Kezic(2) Dept. Dermatology, Environmental Medicine, Health Theory Faculty of Human Sciences, University of Osnabrueck, (1) Coronel Institute of Occupational Health , Academic Medical Centre Amsterdam, Amsterdam, Netherlands (2) Occupational exposure of workers with GENESIS-UV: dosimetric results in Germany Dr. Marc Wittlich, Head of unit radiation, Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstraße, 111, 53757 Sankt Augustin, Germany

Migration and Health Self-reported heat illness among migrant Hispanic farmworkers in North Carolina Phillip Summers (1) - Jennifer Talton (2) - Sara Quandt (3) - Thomas Arcury (1), Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, United States (1) - Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, United States (2) - Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, United States (3) Employment policies related to immigrant workers in the dairy industry: A comparative policy analysis across 10 countries Victoria Buchan - Louise Quijano, High Plains Intermountain Center for Agricultural Health and Safety, Colorado State University, Fort Collins, United States A Longitudinal Analysis of Mexican-Born Farmworkers’ Depressive Symptoms across Two Growing Seasons in North Carolina Joanne Sandberg (1) - Haiying Chen (2) - Sara Quandt (3) - Thomas Arcury (1), Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States (1) - Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States (2) - Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States (3) Living conditions, work and health of Mexican migrant farm workers Martha Edilia Palacios Nava, Public Health Department, Faculty of Medicine, Universidad Nacional Autónoma de México, México D.F., Mexico

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Migrant Workers in Swedish Agriculture – a Challenge and a Solution for Farmers and Growers Peter Lundqvist - Mozhgan Zachrison - Catharina Alwall Svennefelt, Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden

Keynote lectures - 11th September 2015 Access to Health Care – Greatest Challenge for Rural and Remote Health Ashok Vikhe Patil, International Association of Rural Health & Medicine, Pravara Institute Of Medical Sciences, Loni Bk, India A Swedish strategy for safety and health in agriculture – from zero vision of fatalities to certification of working conditions P. Lundqvist , C. Alwall Svennefelt, Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden (1) GPs and Occupational Health: the How to Achieve the dual goal of access and quality in rural health care Tanja Pekez-Pavlisko, EURIPA Interim President, WONCA Wokring Party on Rural Practice – Co-chair Impact of Globalisation on Rural Workers' Working Conditions and Occupational Health Prof. Jorma Rantanen, MD, PhD

Poster Presentation Health of the rural population Work Organization and Occupational Health and Safety in Australian and United Kingdom Horticulture Active search of occupational and work-related diseases using administrative databases: a pilot project on musculoskeletal disorders F. Beretta (1), G. Varischi (1), M. Mendola (1), E. Ariano (2), R. Pirola (2), G. Brambilla (1), C. Colosio (1) Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan – Italy (1), SPSAL Health Local Unit of Lodi, Lodi – Italy (2) Is rural a safe place to live and work? Zsuzsanna Farkas-Pall, MD, PhD, University Assistant, UNIVERSITY OF ORADEA, University Of Oradea, ORADEA, Romania A preliminary survey involving the elderly living alone in a mountainous area for the difficulty of shopping, their economic situations, diet, and nutritional intake Tatsumi HAYASHI (1), Yoshiharu FUKUDA (2) , Midori ISHIKAWA (3) and Nobuko MURAYAMA (4) Kyushu Nutrition Welfare University, Dept. of Food and Nutrition (1), Graduate School of Public Health, Teikyo University (2), National Institute of Public Health, Dept. of Health Promotion (3), University of NIIGATA PREFECTURE, Dept. of Health and Nutrition (4)

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Effects of oral exercise on oral function and oral health related quality of life of the elderly Kim Ju-Young (1), Hwang Tae-Yoon (2), Lee Kyeong-Soo (2), Department of Community Health Services, Cheongsong-gun Health Center, Gyeongsangbuk-do, Korea, Republic Of (1) Department of Preventive Medicine & Public Health, Yeungnam University, Daegu, Korea, Republic Of (2) Self- and familial awareness of hepatitis status among hepatitis B and hepatitis C carriers in Korean rural areas Kweon Sun-Seog (1), Shin Min-Ho and Choi (2) Jin-Su (2), Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Jeonnam, Korea, Republic Of (1), Department of Preventive Medicine, Chonnam National University, Gwangju, Republic Of Korea (2) Is it possible to eliminate MERS ? – From the experience of brucellosis control in South Korea Kwan Lee, Department of Preventive Medicine, Dongguk University College of Medicine, South Korea The Effect of Health Education Program on Dysipidemia of Male Workers Mi Sook Lee, Jun Ho Shin, Kyeong-Soo Lee, Presenting author: Jun Ho Shin, Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 501-746, South Korea Korean Industrial Health Association Branch of Gyeongsangbuk-do Province, 28 Gongdan-ro, Jinryangeup, Gyeongsan City, Gyeongbuk-do , South Korea (1), Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 501-746, South Korea (2), Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170, Hyeonchoongro, Nam-gu, Daegu 705-035, South Korea (3) The Effects of School-based Fissure Sealant Program for Preventing Dental Decay in the Permanent Teeth of Schoolchildren in Rural and Urban Areas Mae Sook Jun (1), Worl-Sun Seo (2), (3), Kyeong-Soo Lee (4), Tae-Yoon Hwang (4), Chang Suk Kim(5), Mi-Kyung Kim (6), Presenting author: Worl-Sun Seo(Ph. D. candidate), Department of Public Health, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 712-749, South Korea, Division. of Dental Hygiene, Gimcheon City Public Health Center, Gyeongsangbuk-do Province, South Korea (1), Dept. of Public Health, Yeungnam Univ. 280 Daehak-ro, Gyeongsan City, Gyeongbuk-do 712-749, South Korea (2), Dept. of Public Health, Graduate School, Yeungnam University, South Korea (3), Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170, Hyeonchoong-ro, Nam-gu, Daegu 705-035, South Korea (4), Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea (5), Gimcheon Medical Center, 24 Moam-gil, Gimcheon City, Gyeongsangbuk-do 740-010, South Korea (6) Trend in colorectal cancer incidence in Chungnam province, South Korea (2000-2011) Nam Hae Sung and Kim Soon Young, Department of Preventive Medicine and Public Health, School of Medicine, Chungnam National University, Hospital/Chungnam National University, Daejeon, Korea, Republic Of Presenting author: Nam Hae Sung Experience with radionuclide therapy for malignant tumors at a rural community hospital Okae Shunji, Matsushima Masaya, Kato Maki and Furuhashi Naohiro, Department of Radiology, Anjo Kosei Hospital, Anjo, Japan Eliminating asbestos-related diseases in Albania Shamet Qejvani (1), Romeo Hanxhari (2), Melissa J. Perry (1), George Washington University, Washington DC, USA (1), University of Tirana, Tirana, Albania (2)

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Cancer risk in rural areas Galapce M Saljamovska, Hospital respiratori disease –Oteshevo R Makedonia Polymyalgia Rheumatica (PMR): Clinical, laboratory, and immunofluorescence findings in the elderly in Japan Shintani S, Kobayashi Z, Tomimitsu H. Department of Neurology, JA Toride Medical Center, Toride City, Ibaraki, Japan Changes in elderly prostatic cancer patients: A single rural community hospital experience Takehiko Okamura, Hidetoshi Akita, Kenji Yamada, Yasuhiko Hirose, Takahiro Kobayashi, Yutaro Tanaka, Department of Urology, J.A. Aichi Anjo Kosei Hospital, Anjo, Japan Regional Variation of Chronic Periodontal Care Services in South Korea Young Ju Yoon (1), Kyeong-Soo Lee (2), Tae Yoon Hwang (2), Chang-Suk Kim (3), Presenting author: Young Ju Yoon, Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea, Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea (1), Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170 Hyeonchoong-ro, Nam-gu, Daegu 705-035, South Korea (2), Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea (3)

Environmental and occupational risk assessment and prevention From safety to productivity: an ergonomic study on milking activities Michele Addesa, Federica Masci, Claudio Colosio. Department of Health Sciences of the University of Milan and International Centre for Rural Health of the S. Paolo Hospital of Milano Industrialized milking parlors operations: analysis of worker’s wrist postures. AUTHORS: Faucon B. 1, Masci F. 2, Pasquereau P. 1, Colosio C. 1, Garigou A. 1, 1 IUT de Bordeaux Département HSE University of Bordeaux – Bordeaux – France, 2 Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan - Italy Matphyto program in France's overseas departments: crop exposure matrices for retrospective pesticides exposure assessment in the French West Indies and Reunion Island Gouy M (1), Gentil C (1), Chaperon L(2), Spinosi J (1), El Yamani M (1), French Institute for Public Health Surveillance, -, Fort de France, Martinique Umrestte, University Claude Bernard Lyon 1, Lyon, France (2) ATV mortality in the United States, 2011-2013 Elise Lagerstrom M.S., David Gilkey, PhD., John Rosecrance, PhD., Sheryl Magzamen, PhD., Lorann Stallones, PhD. Colorado State University, Colorado State University, Fort Collins, United States Pesticide exposure and health-risk profiles for re-entry activities in mountain vineyards Mattè M. (1), Rubino F.M. (2), Mandic-Rajcevic S. (3) and Colosio C. (3), Dipartimento di Prevenzione, Azienda Provinciale per i Servizi Sanitari, Trento, Italy (1), LaTMA Laboratory for Analytical Toxicology and Metabolomics, Department of Medicine, Surgery and Dental Sciences, University of Milan, San Paolo University Hospital, Milan, Italy (2), International Centre for Rural Health, San Paolo University Hospital, Milan, Italy (3)

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Characterization of exposure to vibrations in different agricultural tractors Ninfa Monica Mucci (1), Michele Nuccio (1), Domenico Pessina (2), Davide Giordano (2), Alessandro Peretti (3), Francesco Bonomini (4), Federica Masci (1), Claudio Colosio (1). Department of Health Sciences of the University of Milan and International Centre for Rural Health of the S.Paolo Hospital of Milano (1), Department of Environmental and Agronomic Sciences of the University of Milan (2), Post Graduate School of Occupational Health, University of Padua (3), Free Engineer, Padua (4) Characterization of noise in three different types of wheeled tractors Michele Nuccio (1) Ninfa Monica Mucci (1), Domenico Pessina (2),Davide Giordano (2), Marco Gibin (2), Federica Masci (1) , Claudio Colosio (1), 1 Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan – Italy, 2 Department of Agronomic and Environmental Sciences, University of Milano Toolbox talks: development of a dairy training curriculum Foos R (1), Rosecrance J (1), Rovai M (2), HICAHS, Colorado State University, Fort Collins, United States (1), HICAHS, South Dakota State University, Fort Collins, United States (2) Assessment of noise annoyance on the workers in Olfin Factory, Mahshahr port, Iran Dr. Masoud Rafiei (1), Dr. Afshin Takdastan (2), Dr. Roksana Mirkazemi (3), Prisa Ghanberi (4), Member of Ahvaz Joundishapour University of Medical Sciences, (Retired), Ahvaz, Iran and Corresponding Author, [email protected] (1), Member of Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran (2), Head of Hooman Research Institute, Tehran, Iran (3), M.Sc. of Environment pollution, research and sciences for Khuzestan Azad centre, Ahvaz, Iran (4) Assessment of agricultural pesticide exposure by Pesticide Exposure Examination Survey among Korean agricultural workers Sangchul Roh (Center for farmer’s health & safety, Dankook University Hospital), Shin Ah Kim (Center for farmer’s health & safety, Dankook University Hospital), Jee Young Lee (Center for farmer’s health & safety, Dankook University Hospital), Myung Seon Yeon (Center for farmer’s health & safety, Dankook University Hospital), Hye Yoon Choi (Center for farmer’s health & safety, Dankook University Hospital) Yunkeun Lee (Wonjin Institute for Occupational and Environmental Health), Jaeseok Song (Dep. Of preventive medicine, Catholic Kwandong University), Hongsoon Choi (Dep. Of preventive medicine, Catholic Kwandong University), Jeongbae Rhie (Center for farmer’s health & safety, Dankook University Hospital)

Health and safety policies in rural areas People’s Attitude Toward Eating Habits and Health in Japanese Rural Area - Analysis of Survey Results and Their Commitment to Agriculture Tomihiro HAYAKAWA (1), Masashi SUGIURA (1), Sinya KOBAYASHI (1), Sachiko SUZUKI (1), Jiro IWASAKI (2), Akira HADA (3), Aichi Koseiren (prefectural federation of agricultural Cooperatives for health and welfare) Asuke Hospital, Aichi, Japan (1), Ibaraki Koseiren JA Toride Medical Center (2), Department of Public Health, Chiba University Graduate School of Medicine (3)

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Legal, statutory and institutional framework of the management of pesticides in Benin: which impact on the users behaviors? Hinson A V, Dossou F, Lawn H, Ayelo P, Fayomi P, Unity of Teaching and Research in Occupational Health:, University of Abomey-Calavi, Cotonou, Benin Mid-career change of medical doctors in Japan - Specialists to GeneralistKato Takuma (1) and Ikegami Naoki (2), Department of Global Health, Deputy Medical Director, School of Medicine, PhD candidate, Saku Central Hospital,Keio University, Keio University, Saku (1), Professor Emeritus, Keio University, Tokyo (2) The possibility of verbal autopsy to clarify the causes of death in the HIV positive patients and to improve the services in rural setting in Zambia Kato Takuma, Department of Global Health, Saku Central Hospital, Saku Differences in the number of elderly individuals newly certified to require long-term care between basic checklist respondents and non-respondents Katsura T (1), Fujimoto M (1), Shizawa M (2), Usui K (2), Hoshino A (2), GRADUATE SCHOOL OF MEDICINE DEPARTMENT OF HUMAN HEALTH SCIENCES, KYOTO UNIVERSITY, KYOTO, Japan (1), GRADUATE SCHOOL OF NURSING DEPARTMENT OF COMMUNITY HEALTH NURSING, KYOTO PREFECTURAL UNIVERSITY OF MEDICINE, KYOTO, Japan (2) The status of safety and health in agriculture of South Korea Kyungsuk Lee, Hyeseon Chae, Hyocher Kim, Dept. of Agricultural Engineering, National Academy of Agricultural Science, RDA, Presenting author: Kyungsuk Lee, Dept. of Agricultural Engineering, National Academy of Agricultural Science, RDA 310 Nongsaengmyeong-ro, Wansan-gu, Jeonju-si,, Jellabuk-do, South Korea A Health Promotion Strategy for Rapidly Aging Communities: The Activities of the Awata Health and Community Development Association’s “Campaign for Improved Health” Miho Shizawa (1), (2), Akiko Hoshino (1), Kanae Usui (1), Mika Nishizawa(1), Megumi Fujimoto(2), Rikuya Hosokawa(2), Toshiki Katsura(2), KYOTO PREFECTURAL UNIVERSITY OF MEDICINE (1), KYOTO UNIVERSITY (2)

Improving the health of aged rural workers Quality of Life of elderly people on a remote island: a comparison between urban and rural areas Hamano K., The Graduate School, St. Mary's College, 422 Tsubukuhonmachi Kurume Fukuoka Pref., Japan Participatory Action Oriented Training for Improvement of Health and Safety of Korean Farmers Jin-Seok Kim, Seong-Yong Yoon, Seong-Yong Cho, Kuck-Hyun Woo, Dept. of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital,South Korea, Presenting author: Jin-Seok Kim, Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, Korea

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Gender Differences in the Occurrence of Nonfatal Agricultural Injuries among Farmers in Fukuoka, Japan Momose Y (1), Suenaga T (2), Faculty of Medicine, Fukuoka University, Fukuoka, Japan (1), Faculty of Medicine, Kurume University, Kurume, Japan (2) Development and Application of Participatory Mapping for Healthy Agricultural Village Ki Soo Park, Jin Seok Kim, Department of Preventive Medicine, Gyeongsang National University, School of Medicine and Institute of Health Sciences, Jinju, Korea, Department of Occupational Medicine, Soonchunhyang University Gumi Hospital Factors Affecting Four-year Score Change of Frailty, Depression, Cognitive Function and QOL in Rural Elderly: A Retrospective Study Seon Hee Kim (1), Kyeong-Soo Lee (2), Tae-Yoon Hwang (2), Chongsong-gun Public Health Center, Gyeongsanbuk-do Province, South Korea (1), Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170 Hyeo choong-ro, Nam-gu, Daegu 705-035, South Korea (2), Presenting author: Kyeong-Soo Lee, Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170 Hyeon choong-ro, Nam-gu, Daegu 705-035, South Korea Alteplase (rt-PA) therapy in old Japanese patients with acute ischemic stroke Hiroyuki Tomimitsu, Kiyobumi Ohta, Zen Kobayashi, Shuzo Shintani, Department of Neurology, JA Toride Medical Center, Ibaraki, Japan

Muscle skeletal risk Ergonomic analysis of work-related hazards in older farmers: a comparison between Sweden and Italy Caffaro F (1), Micheletti Cremasco M (2), Lundqvist, Nilsson K (3), Pinzke S (3), Göransson E (3), Cavallo E (1), CNR - Italian National Research Council, IMAMOTER - Institute for Agricultural and Earth-moving Machines, Turin, Italy (1), Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy (2), Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden (3) Prevalence of Osteoporosis and related Factors using Quantitative Ultrasound among Korean Women Farm Workers Kim J H (1), Kim H D (2), Lee K S (3), Kim J G (2), Kim S Y (1), Choo H J (4), Kim H K (1), Lee S J (4), Lee C K (5) Son B C (5), Lee J T (5), Inje University Busan Paik Hospital Research Center for Fishery Safety and Health, Department of Occupational and Environmental Medicine, College of Medicine, Inje University, Busan, Korea, Republic Of (1), Inje University Busan Paik Hospital Research Center for Fishery Safety and Health, Department of Rehabilitation Medicine, College of Medicine, Inje University, Busan, Korea, Republic Of (2), National Academy of Agricultural Science, Rural Development Administration, Republic of Korea, National Academy of Agricultural Science, Rural Development Administration, Republic of Korea, Cheonju, Korea, Republic Of (3), Inje University Busan Paik Hospital Research Center for Fishery Safety and Health, Department of Radiology, College of Medicine, Inje University, Busan, Korea, Republic Of (4), Department of Occupational and Environmental Medicine, College of Medicine, Inje University, Busan, Republic Of Korea (5) Study of posture during plowing operations. Analysis of the pressures to the seat Romano E., Cutini M., Bisaglia C.

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A review of recent studies on the risk assessment from repetitive movements in agriculture Schillaci G., Camillieri D., Rapisarda V., Failla S., Caruso L., Romano E. Risk Factors Associated with Lumbar and Femoral Bone Fractures in postmenopausal Japanese Women Yoshiaki Somekawa, Yusuke Kohri, Atsushi Fusegi, Takanori Yoshida, Mikiko Tsugata, Umeki Hidenori. Department of Obstetrics and Gynecology, Toride Medical Center, Toride, Japan Internal fixation for displaced femoral neck fracture associated with poorly controlled diabetes mellitus Koji Suzuki.M.D., JA Toride Medical Center, JA Toride Medical Center, Ibaraki, Japan

Occupational risks assessment and prevention Fine dust aerosols toxicokinetics in organism Ibrayeva L., Laboratory of environmental and occupational diseases, RSGE “National Center of Labor Hygiene and Occupational Diseases” of the Ministry of Healthcare and Social Development, Karaganda, Kazakhstan Risk factors and children injuries while performing agricultural work in the Požega-Slavonia County, Croatia Janev Holcer N (1), Brkic Bilos I (1), Mandic-Rajcevic S (2), Mustajbegovic J (3), Croatian Institute of Public Health, Croatian Institute of Public Health, Zagreb, Croatia (1), International Centre for Rural Health and Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy, School of Medicine, Andrija Stampar School of Public Health, WHO CC for Occupational Health, University of Zagreb, Zagreb, Croatia (3) Rural-urban differences impact the number of unintentional injuries in elderly Korean adults Sun-A Kim(1), Su-Hyun Oh(1), Sun-Seog Kweon(1), Jin-Su Choi(1), Min-Ho Shin(1), Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea (1) Social capital among people with arthritis in Rural Area Ki Soo Park, Department of Preventive Medicine, Gyeongsang National University, School of Medicine and Institute of Health Sciences, Jinju, Korea

Policies and approaches for improving the access to health care in rural areas Analysis of Medical Expenses Structure for Patients on Percutaneous Coronary Intervention by Medical Security Type Mi-Kyung, Son(1), Yong-Bae, Park(1), Sok-Goo, Lee(2), Division of Planning and Budget , ChungNam National University Hospital, Daejeon, South Korea (1) Department of Preventive Medicine and Public health, Chungnam National University School of Medicine, Daejeon, South Korea (2) Current situation of severe motor and intellectual disabilities in a rural area, the Saku region of Nagano Prefecture Hosoya M, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare, Saku Central Hospital Advanced Care Center, 3400-28 Saku City, Nagano Pref., 385-0051, Japan

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Examination of support needed to continue home care in the community (1): Differences in occupations and training of staff involved in home care Takako Tsukahara (1), Kimiko Mizukami (2), Hiroyuki Beniya (3), Kawasaki University of Medical Welfare, University, kurashiki city, Japan (1), Jin-ai University, University, Echizen city, Japan (2), Orange Home Care Clinic, Hospital, fukui city, Japan (3) Examination of support needed to continue home care in the community (2): Creating a Scale of Difficulty in Continuing Home Care Kimiko Mizukami (1), Takako Tsukahara (2) , Hiroyuki Beniya (3), Jin-ai University, University, Echizen city, Japan (1), Kawasaki University of Medical Welfare, University, kurashiki city, Japan (2), Orange Home Care Clinic, Hospital, fukui city, Japan (3) Relationship between Bone Mineral Density and Remaining Teeth and Its Related Physiological Factors in Postmenopausal Women Chang-Suk Kim (1), Kyeong-Soo Lee (2), Tae Yoon Hwang (2), Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea (1), Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam Univ. 170 Hyeonchoong-ro, Nam-gu, Daegu 705-035, South Korea (2), Presenting author: Chang-Suk Kim, Dept. of Dental Hygiene, Ulsan College, 101 Bongsu-ro, Dong-gu, Ulsan 682-715, South Korea

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The NEW Lodi Declaration on Rural Health Adopted by the International Congress on Rural Health (ICRH) and the 4th International Conference Ragusa Safety Health Welfare in Agriculture Agro-Food and Forestry Systems (Ragusa SHWA)

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Whereas more than 50% of the world’s population live in rural areas, with limited or no access to primary health care, basic occupational health care, clean water and sanitation, Whereas unsustainable and unhealthy agricultural practices have influence on the rural population, with potential severe influence on the environment, wildlife, and urban population, through contaminated soil, water and food, Whereas structural system-related determinants accompanied by unsafe work behaviours causes occupational and work-related diseases and injuries, disabilities, premature deaths, loss of income, as well as human suffering and poverty in rural areas, Whereas children and women working in agriculture are especially vulnerable to occupational and environmental risks, in addition to consequences arising from the unavailability of basic health service and inadequate housing, in particular from household fuel combustion, Whereas international, national and local actions, although significant and honourable, have not been able to respond successfully to all the challenges put before them, Underlining that the achievement of the highest possible level of health for all people is impossible without improving the health of the rural population, and this is impossible without the involvement of the public sector as a whole, Taking into consideration the Declaration of the International Conference on Primary Health Care, Alma-Ata, USSR, 1978, the Global Strategy on Occupational Health for All adopted by the World Health Assembly with Resolution 49.12 from 1996 and the Global Strategy on Occupational Safety and Health adopted by the International Labour Conference in 2003, the Safety and Health in Agriculture Convention, 2001 (No. 184) of the International Labour Organisation.

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Recalling the outcomes of previous international deliberations on occupational health in agriculture and rural health, such as the Declaration of the First International Congress on Rural Health in the Mediterranean and Balkan Countries (Bari, Italy, 2002), the Agenda on Rural Health (Loni, India, 2002), the Declaration on Occupational and Environmental Rural Health (Belgrade, Serbia, 2004), the Lodi Declaration on Healthy Villages (Lodi, Italy, 2006), the Cartagena Declaration on Rural Health in Latin America (Cartagena de Indias, Colombia, 2009), and the Goa Declaration for Health in the Global Village (Panaji, Goa, India, 2012), Recalling the continuing appeal of spiritual and secular leaders and of scholars and scientists worldwide to a responsible stewardship of the Planet, to a shared and sustainable access to its natural and limited resources, to their preservation for future generations, We, the 250 participants from 52 countries from all continents who took part in the International Congress on Rural Health and 4th Ragusa SHWA, held here in Lodi, Italy, from September 8th to September 11th, 2015, discussed the challenges to providing adequate occupational and environmental health, food safety, public health and medical services in rural areas, and

WE DECLARE THAT: 1. We will commit ourselves to help solving occupational, environmental and public health problems and inadequacies in access to health care in rural areas, in the frame of the WHO global strategy on people centred and integrated health service; 2. We will advocate for the elimination of child labour in rural and remote areas, recognition of informal and migrant agricultural workers, and abolishment of modern slavery; 3. We call for national and international organizations, as well as individuals to work on the improvement of the scope and coverage

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of primary health care to address better the needs of rural communities inclusive needs related to health and safety at work such as agrochemical use, heavy physical work, accidents, heat stress, dehydration and kidney injuries, cancer

due to solar

radiation, biological risk factors and zoonoses; 4. We will work towards providing higher access of workers to occupational health care with the creation of basic occupational health services in rural areas wherever necessary, 5. We recognize the need for addressing occupational, environmental and public health risks in rural areas by working together with all of the stakeholders, governments, public sector a while, and industry, as well as the ministries of health, environment, labour, agriculture and other state agencies, private enterprises and workers’ organizations; 6. We underline the significance of local, regional, national and international initiatives to protect and promote the health of the rural population; 7. We encourage the following organizations: The European Rural and Isolated Practitioners Association (EURIPA), The International Association on Rural Medicine and Health (IARM), the International Commission on Occupational Health (ICOH), the WONCA Working

Party on Rural Practice, as well as the

organizations of farmers, agricultural workers, agricultural industry, and the relevant non-governmental organizations and networks, to take action to support and promote the development of Rural Health programmes; 8. We will dedicate a significant part of our scientific and professional efforts to create useful, accessible, simple and low-cost tools for occupational,

indoor

and

environmental

risk

assessment,

communication and management; 9. We call upon the governmental agencies and local authorities to ensure equal and proper access of people in villages, to information

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on public and occupational health and the environment, stimulate social and environmental justice, as well as to provide means for empowerment of rural populations to protect and promote their health, and to improve their working and living conditions. Access to health care should be treated as a basic human right. Use of ehealth and telemedicine should be promoted in rural area; 10. We congratulate our colleagues which have been working on opening reference centres at the local, national and international level for providing expertise and support to the rural population; 11. We call for the creation of interdisciplinary teams of experts from the field of human and veterinary medicine, public, occupational, and environmental health, health promotion, food safety, chemical safety, agricultural, social and human sciences, and agricultural engineering which will address the needs of the rural population; 12. We recommend introducing Occupational Health and Safety concerns in training and educational programmes in all of the abovementioned disciplines at any level, from health care providers to rural workers and population, in order to build the necessary human resources and to provide services of great quality to the rural population and agricultural workers. Specific country needs and participatory approach should be addressed; 13. We urge the agricultural sector to realize its responsibility for healthy working and housing conditions by expanding suitable measures for workers and farms and by providing financial means for scientific and educational developments to support such measures; 14. We are committed to share our practice and experience in devising, implementing and evaluating educational programs for the improvement of the health of the rural population; 15. We are committed, as citizens, to advocate peace and justice, and the pursuit of the common good as the founding of scientific and professional achievement in our own field of expertise;

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We hereby authorize the Congress Presidents, the EURIPA, IARM, ICOH

and

WONCA

Working

Party on

Rural

Practice

representatives to sign this declaration on our behalf. Submitted to the Assembly by Stefan Mandic-Rajcevic (Italy and Serbia)

Signed in Lodi, September 11th 2015 Claudio Colosio, ICRH President Giampaolo Schillaci, Ragusa SHWA President Tanja Pekez Pavlisko, President, EURIPA; Vice Chair WONCA Working Party on Rural Practice, Hans Joaquin Hannich, President, IARM and Shuzo Shintani, Secretary General, IARM Jukka Takala, President, ICOH and Gert van der Laan, Chair, the ICOH Scientific Committee on Rural Health , ICOH