The Fukushima Nuclear Accident Affected Mothers’ Depression but Not Maternal Confidence

The Fukushima nuclear power plant accident caused widespread radiation contamination. Mothers of young children were at risk of negative emotional and mental health consequences. Using data from 2 independent prefecture-wide surveys of pregnant women, we examined the associations of disaster-related stressors with both maternal self-confidence and depressive symptoms. Two postal surveys were conducted targeting women who registered their pregnancies in Fukushima Prefecture (n = 6686 in 2012 and n = 6423 in 2013). The proportions of mothers with lower self-confidence in child rearing and with depressive symptoms were 53% and 25% in 2012 and 55% and 24% in 2013, respectively. After adjusting for maternal and infant characteristics, evacuation and concern about radiation were significantly associated with depressive symptoms but not lower maternal confidence, although these 2 outcomes were significantly associated. Mothers in Fukushima showed resilience in parenting, whereas their experiences and concerns in the aftermath of nuclear disaster were associated with depressive symptoms.

Pregnancy and Birth Survey of the Fukushima Health Management Survey

The Pregnancy and Birth Survey was started by Fukushima Medical University as part of the Fukushima Health Management Survey in 2011 in order to assess the physical and mental health of mothers and provide parenting support (telephone counseling) for those in need. The present study reviewed the major findings from 4 annual surveys conducted from 2011 to 2014. Overall proportions of preterm deliveries, low birth weight infants, and congenital anomalies in the first year were almost the same as those in national surveillance data. The prevalence of depressive symptoms among the mothers held steady at about 25% over the 4 years. Regarding the content of parenting counseling, the proportion of mothers who voiced concerns about radiation decreased each year. This survey should be continued to provide support to mothers in Fukushima.

Fukushima Mothers’ Concerns and Associated Factors After the Fukushima Nuclear Power Plant Disaster

This study aimed to clarify the frequency of and temporal changes in the content of mothers’ free written opinions obtained in the Fukushima Health Management Survey Pregnancy and Birth Survey from 2011 to 2013. A self-administered questionnaire was mailed to women who delivered babies in Fukushima Prefecture. The questionnaire asked about maternal and child health. Expression of mothers’ concerns about radiation decreased over time. Common to the top 5 codes across the 3 years were “radiation effect on fetus and infant” and “information provision including survey results.” Participants who wrote free opinions were significantly more likely to be aged ≥30 years and to have depressive symptoms. Our descriptive analysis of the qualitative data showed a clear shift in mothers’ concerns from radiation-related issues to their own physical and mental health. Mothers who expressed concerns were more likely to report negative physical and mental health.

Changes of Posttraumatic Stress Responses in Evacuated Residents and Their Related Factors

The longitudinal posttraumatic stress responses and resilient factors after the Fukushima Daiichi Nuclear Power Plant are yet unknown. Here we attempted to quantify the patterns of the course of posttraumatic stress disorder (PTSD) symptoms and we explored the factors associated with psychological recovery. The subjects were 12 371 residents in the municipalities categorized as the forced evacuated area. We categorized the subjects’ PTSD symptoms into 4 groups: Chronic, Resistant, Recovered, and Non-recovered. We applied a logistic regression to clarify the factors related to psychological recovery. We observed that laughter showed significant odds ratio in the Recovered group and the Resistant group. Meanwhile, elderly residents and those with poor living circumstances showed significant odds ratios for the Recovered group and the Resistant group. Laughter in daily life was associated with the psychological health in the evacuation area.

The impact of evacuation on the incidence of chronic kidney disease after the Great East Japan Earthquake: The Fukushima Health Management Survey

Background

About 146,000 people were forced into long-term evacuation due to the nuclear power plant accident caused by the Great East Japan Earthquake in 2011. Disaster is known to induce hypertension in survivors for a certain period, but it is unclear whether prolonged disaster stress influences chronic kidney disease (CKD). We conducted an observational cohort study to elucidate the effects of evacuation stress on CKD incidence.

Methods

Participants were individuals living in communities near the Fukushima nuclear power plant, aged 40–74 years without CKD as of their 2011 general health checkup (non-evacuees: n = 9780, evacuees: n = 4712). We followed new-onset CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or proteinuria] using general annual health checkup data from 2012 to 2014. Association between evacuation and CKD incidence was analyzed using the Cox proportional hazard model.

Results

Mean age of the participants at baseline was 65 years, 46.7% were men, and baseline eGFR was 75.7 ml/min/1.73 m². During the mean follow-up period of 2.46 years, CKD incidence rate was 80.8/1000 and 100.2/1000 person-years in non-evacuees and evacuees, respectively. Evacuation was a significant risk factor of CKD incidence after adjusting for age, gender, obesity, hypertension, diabetes, dyslipidemia, smoking, and baseline eGFR [hazard ratio (HR): 1.45; 95% confidence interval (CI) 1.35–1.56]. Evacuation was significantly associated with the incidence of eGFR <60 ml/min/1.73 m² (HR: 1.48; 95% CI 1.37–1.60), but not with the incidence of proteinuria (HR: 1.21; 95% CI 0.93–1.56).

Conclusion

Evacuation was a risk factor associated with CKD incidence after the disaster.

Influence of Post-disaster Evacuation on Incidence of Metabolic Syndrome

AIM

After the Great East Japan Earthquake, over 160,000 residents near the Fukushima Daiichi Nuclear Power Plant were forced to evacuate due to a nuclear accident. Health problems in these evacuees have since become major issues. We examined the association between evacuation and incidence of metabolic syndrome (METS) among residents in Fukushima.

METHODS

We conducted a cohort study among residents aged 40-74 years without METS at the time of the disaster in Fukushima. Among 20,269 residents who met the inclusion criteria before the disaster, 8,547 residents (3,697 men and 4,850 women; follow-up proportion: 42.2%) remained available for follow-up examinations after the disaster by the end of March 2013. The main outcome was incidence of METS, defined by guidelines from the Japanese committee, using data from the Comprehensive Health Check before and after the disaster. We divided participants by evacuation status and compared outcomes between groups. Using a logistic regression model, we estimated the odds ratio for incidence of METS, adjusting for potential confounders, age, gender, waist circumference, exercise habit, and alcohol consumption.

RESULTS

Incidence of METS was higher in evacuees (men 19.2%, women 6.6%) than in non-evacuees (men 11.0%, women 4.6%). Evacuees had higher body mass index, waist circumference, triglycerides, and fasting plasma glucose after the disaster than non-evacuees. We found a significant association between evacuation and incidence of METS (adjusted odds ratio 1.72, 95% confidence interval; 1.46-2.02).

CONCLUSION

This is the first study to demonstrate that evacuation after a disaster is associated with increased incidence of METS.

Diagnostic accuracy of Japanese posttraumatic stress measures after a complex disaster: The Fukushima Health Management Survey

BACKGROUND

The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) has been widely used among traumatized populations to screen people with PTSD; however, the Japanese version of the PCL has yet to be validated. We examined the diagnostic accuracy of the Japanese version PCL-Specific (PCL-S) and the abbreviated versions of the PCL-S among the evacuees of the Fukushima Daiichi Nuclear Power Plant accident.

METHODS

Fifty-one participants were recruited from an evacuee and clinical sample. The PCL-S, Impact of Event Scale-Revised (IES-R), and World Health Organization Composite International Diagnostic Interview were administered. Screening properties of the PCL-S, IES-R, and abbreviated PCL-S against PTSD diagnosis, including sensitivity, specificity, and diagnostic efficiency, were calculated. Receiver operating characteristic curves were drawn, and optimal cutoff points were examined.

RESULTS

The sensitivity, specificity, and diagnostic efficiency of the PCL-S were 66.7%, 84.9%, and 79.2%, respectively (at 52, the area under the curve was 0.83). The cutoff point method for the PCL-S performed better than did the symptom cluster method. The screening properties of the abbreviated versions were comparable with those of the full version.

CONCLUSIONS

The Japanese version of the PCL-S showed moderate diagnostic accuracy and improved performance over the IES-R for PTSD diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The Japanese version of the PCL-S was a reliable and valid measure, and its diagnostic accuracy was reasonable for both full and abbreviated versions.

Effect of evacuation on liver function after the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey

Background

The Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident caused residents to switch from their normal lives to lives focused on evacuation. We evaluated liver function before and after this disaster to elucidate the effects of evacuation on liver function.

Methods

This study was a longitudinal survey of 26,006 Japanese men and women living near the Fukushima Daiichi Nuclear Power Plant. This study was undertaken using data from annual health checkups conducted for persons aged 40–90 years between 2008 and 2010. Follow-up examinations were conducted from June 2011 to the end of March 2013, with a mean follow up of 1.6 years. Changes in liver function before and after the disaster were compared among evacuees and non-evacuees. We also assessed groups according to alcohol drinking status.

Results

The prevalence of liver dysfunction significantly increased in all participants from 16.4% before to 19.2% after the disaster. The incidence of liver dysfunction was significantly higher in evacuees than in non-evacuees. Multivariate logistic regression analysis showed that evacuation was significantly associated with liver dysfunction among residents.

Conclusions

This is the first study to show that evacuation due to the Fukushima Daiichi nuclear power plant disaster was associated with an increase in liver dysfunction.

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Prevalence of liver dysfunction increased after the Great East Japan Earthquake.

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The change in prevalence of liver dysfunction was greatest in evacuees.

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Evacuation is one risk factor associated with liver dysfunction.

Persistent prevalence of polycythemia among evacuees 4 years after the Great East Japan Earthquake: A follow-up study

We previously reported that the lifestyle of evacuees significantly increased the prevalence of polycythemia compared with non-evacuees at an average of 1.6 years (2011–2012) from the previous annual health checkup before the Great East Japan Earthquake (GEJE). Here we analyzed how the prolonged evacuation affected the prevalence of polycythemia an average of 2.5 years (2013–2014) after the previous data. Subjects were individuals aged 40–90 years living in the vicinity of the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture who had attended the annual health checkups since 2008. The prevalence of polycythemia and changes in its defining factors of red blood cell count (RBC), hemoglobin (Hb) level, hematocrit (Ht) level were compared between before and after the GEJE in 7713 individuals (3349 men and 4364 women) receiving follow-up examinations both 2011–2012 and 2013–2014. RBC, Hb levels and Ht levels in 2011–2012 were higher among evacuees than non-evacuees in both men and women. However, all levels in 2013–2014 were on the decline from those in 2011–2012. On the other hand, among evacuees, Hb and Ht levels continued to be higher than before the GEJE in both men and women evacuees. The prevalence of polycythemia, which was diagnosed if one of the defining factors was beyond the standard value, was significantly higher among evacuees than non-evacuees regardless of the presence or the absence of overweight/obesity, smoking, and hypertension. Therefore, prolonged evacuation is a cause of polycythemia even 3 to 4 years after the GEJE and regular health management of evacuees is important.

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Evacuation after the Great East Japan Earthquake (GEJE) causes polycythemia.

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Evacuation is an independent factor of polycythemia.

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Prevalence of polycythemia among evacuees persists even after 4 years of the GEJE.

[The effect of telephone support to evacuees with risks of hypertension and diabetes mellitus after a disaster: the Fukushima Health Management Survey]

Objectives　Fukushima Medical University has been conducting the Fukushima Health Management Survey "Mental Health and Lifestyle Survey" annually as part of the health care of evacuees following the Fukushima Daiichi nuclear power plant accident.　This study aimed to clarify the effects of telephone support performed by nurses or public health nurses. In particular, we investigated the response rates for questionnaire of the following year and the recommended effect of medical support for evacuees with risks of hypertension and diabetes mellitus in the fiscal year 2011 (FY2011).Methods　The study population included evacuees (1,620 people) with risks of hypertension and diabetes mellitus in FY2011. We compared the participants' responses to the FY2012 survey and medical results based on those who received telephone support and those who did not.Results　Evacuees who have received telephone support (telephone supporters) comprised 1,078 people. Evacuees who did not receive telephone support (non-telephone supporters) comprised 542 people.　Telephone supporters consisted of more people from outside Fukushima prefecture (P=0.001), with above high school education (P<0.001), and who were unemployed (P<0.001) compared to non-telephone supporters.　For the FY2012 survey, 616 telephone supporters responded (57.1%), while 248 non-telephone supporters responded (45.8%). The response rate of telephone supporters was significantly higher compared to non-telephone supporters for the FY2012 questionnaire (P<0.001).　In addition, 184 (29.9%) telephone supporters and 68 (27.4%) non-telephone supporters underwent the medical examination.　In the multivariate analysis, responses to the FY2012 questionnaire were significantly associated with receiving telephone support (P=0.016).Conclusion　Telephone supporters had higher response rates for the questionnaire the following year compared to non-telephone supporters. Therefore, telephone support was effective in increasing the questionnaire response rate during the following year.

[The Unit Use Situation and Problems of the Examination of Blood Count in Fukushima]

In comprehensive health check performed in Japan, many errors have been found that were caused by man- ually transcribing family doctor's reports or commissioned health check company's reports to Medical Examina- tion Record and Results Report. Since those errors included unit's error of blood tests that caused digits differ- ences, we hereby present the result of an investigation on current situation of blood test reporting units in Japan. Results showed that, in prefectural medical institutions, only a few facilities used international units in reporting units of blood tests. However, most of the domestic or overseas quality control programs used in- ternational units, except for that conducted by the Japan Medical Association. We consider that it might be possible to prevent medical malpractices caused by erroneous judgment on health check results, by unifying the blood test reporting units upon sharing patients' information among medical facilities. [Letter].

Residence-related factors and psychological distress among evacuees after the Fukushima Daiichi nuclear power plant accident: a cross-sectional study

BACKGROUND

Relocation following a disaster can impact the psychological well-being of evacuees. This study investigated the associations between residence-related factors and psychological distress among evacuees living in temporary housing after the Fukushima Daiichi Nuclear Power Plant accident.

METHODS

Data from 525 participants living in temporary housing were collected. Associations between residence-related factors (frequent relocation, dissatisfaction with the residence, and plan to move to permanent housing) and psychological distress were measured. The psychological distress of evacuees was measured using the Japanese version of the 6-item Kessler scale (K6). We used a cut-off score of five to identify cases with psychological distress, the basis of Kessler's 6 items for psychological distress.

RESULTS

Multivariate logistic regression analysis (n = 418) showed that frequent relocation (OR = 2.05, 95% CI: 1.14-3.66, p = 0.016) and dissatisfaction with the residence (OR = 2.48, 95% CI: 1.60-3.83, p < 0.001) was significantly associated with psychological distress. After stratifying by gender, dissatisfaction with the residence was associated with psychological distress, and a plan to move to permanent housing was significantly associated with psychological distress in women (OR = 1.93, 95% CI: 1.03-3.63, p = 0.041).

CONCLUSIONS

Frequent relocation and dissatisfaction with the residence were associated with psychological distress among evacuees following the Fukushima nuclear disaster. Evacuees should be provided with comfortable living spaces, and steps should be taken to reduce repeated relocation of evacuees. Thus, particular attention should be paid to women with a plan to move to permanent housing within this context.

Evacuation after the Great East Japan Earthquake was associated with poor dietary intake: The Fukushima Health Management Survey

Background

Few studies have investigated the relationship between living arrangements and dietary intake among evacuees after disasters.

Objectives

To examine the relationship between living arrangements and dietary intake using the data of a large-scale cohort survey of evacuees after the Great East Japan Earthquake in 2011.

Methods

73,433 residents in evacuation zones responded to the Fukushima Health Management Survey questionnaire. Subjects were excluded if they did not report their living conditions or were missing more than three pieces of information about dietary intake. The data of 52,314 subjects (23,149 men and 29,165 women ≥15 years old) were used for the analyses. Evacuees' living arrangements were characterized into three categories: evacuation shelters or temporary housing, rental houses or apartments, or a relative's home or their own home. Dietary intake was characterized in terms of grains, fruits and vegetables, meat, soybean products, dairy products, and fish. Daily consumption of the third quartile (Q3) or higher for each food group was defined as ‘high consumption’. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression analyses.

Results

Modified Poisson regression analyses showed that, compared with respondents living in a relative's home or their own home, the PRs and 95% CIs for the people living in rental apartments of high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products were 0.69 (95% CI, 0.61–0.77), 0.82 (95% CI, 0.73–0.91), 0.89 (95% CI, 0.83–0.94), and 0.83 (95% CI, 0.74–0.93) respectively. The corresponding PRs and 95% CIs for people living in evacuation shelters or temporary housing were 0.83 (95% CI, 0.78–0.88), 0.90 (95% CI, 0.86–0.95), 0.94 (95% CI, 0.91–0.97), and 0.91 (95% CI, 0.86–0.96) for high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products, respectively.

Conclusion

The present study suggests that, after the earthquake, living in non-home conditions was associated with poor dietary intake of fruits and vegetables (non-juice), meat, soybean products, and dairy products, suggesting the need for early improvements in the provision of balanced meals among evacuees living in non-home conditions.

The effect of a behavioral activation program on improving mental and physical health complaints associated with radiation stress among mothers in Fukushima: a randomized controlled trial

BACKGROUND

Mothers living with small children in Fukushima prefecture may experience radiation anxiety and related symptoms after the Fukushima Dai'ich Nuclear Power Plant Accident. A behavioral activation (BA) program was developed to improve their psychosomatic symptoms. The purpose of this randomized controlled trial was to examine the effectiveness of a BA program for improving psychological distress and physical symptoms among mothers with preschool children in Fukushima-prefecture 3 years after the Fukushima Daiichi Nuclear Power Plant accident.

METHODS

Participants were recruited from mothers living with a preschool child(ren) in Fukushima city and surrounding areas though a newspaper advertisement, posters, and flyers. Participants allocated to the intervention group received a newly developed group-based BA program, which consisted of two 90- min lessons with a 1-week interval. Psychological distress and physical symptoms as a primary outcome, and radiation anxiety and positive well-being (liveliness and life satisfaction) as a secondary outcome, were measured at baseline, 1- and 3-month follow-ups.

RESULTS

Participants were randomly allocated to either an intervention or a control group (18 and 19, respectively). The BA program showed a marginally significant intervention effect on psychological distress (p = 0.051) and physical symptoms (p = 0.07) at 1-month follow-up, while the effect became smaller at 3-month follow-up. The effect sizes at 1-month were medium to large (-0.72 and -0.56, respectively). There was a significant intervention effect on increasing liveliness at 3-month follow-up (p = 0.02); and there were marginally significant effects on life satisfaction at 1- and 3-month follow-ups (both p = 0.09).

CONCLUSIONS

This BA program may be effective for improving psychological distress, physical symptoms, and well-being, at least for a short duration, among mothers with preschool children after the nuclear power plant accident in Fukushima, while a further large-scale study is needed.

TRIAL REGISTRATION

The UMIN Clinical Trials Registry (UMIN-CTR; ID =  UMIN000014081 ). Registered 27 May 2014.

Predictors of severe psychological distress trajectory after nuclear disaster: evidence from the Fukushima Health Management Survey

OBJECTIVES

The Fukushima Daiichi Nuclear Power Plant accident, which occurred after the Great East Japan Earthquake and Tsunami in March 2011, may have a considerable long-term impact on the lives of area residents. The aims of this study were to determine the trajectories of psychological distress using 3-year consecutive data, and to find predictive factors of severe distress that may also prove useful for public health intervention.

METHODS

Data were obtained on 12 371 residents who were registered in the municipalities categorised as complete evacuation areas for 3 years after the disaster and who completed an assessment in each of the 3 years.

RESULTS

Using group-based trajectory modelling, we identified four trajectory patterns distinguished by the levels of psychological distress, which gradually improved over time in all trajectories. Subjective sleep insufficiency, problem drinking, poor social support and perception of radiation risk 3 years after the accident were associated with the severity of psychological distress, according to the multivariate analysis.

CONCLUSIONS

The identified factors may be useful for community-based mental healthcare over the long term following a nuclear disaster.

EXTERNAL AND INTERNAL EXPOSURE TO FUKUSHIMA RESIDENTS

The Great East Japan Earthquake of 11 March 2011, caused the Fukushima Daiichi Nuclear Power Plant Accident, which resulted in the release of a large amount of radioactive materials into the environment, and there is a serious concern about the radiation effects on the health of residents living in the affected areas. The evaluation of exposure dose is fundamental for the estimation of health effects, and whenever possible, the exposure dose should be evaluated by actual measurements as opposed to estimations. Here, the outline of the exposure doses of residents estimated from surveys or obtained by measurements is described. Fukushima Health Management Survey reported the results for 460 408 residents during the first 4 months after the accident; 66.3% received doses <1 mSv, 94.9% received <2 mSv, 99.7% received <5 mSv and the maximum dose was 25 mSv. Thus, it was demonstrated that the results from personal dosemeter measurements were comparable to the estimations. The dose assessment of internal exposure of 184 205 residents conducted by Fukushima Prefecture by using whole body counter showed that 99.986% received <1 mSv, with the maximum dose being 3 mSv. Regarding exposure of the thyroid, there is not enough data for the Fukushima accident, but it is presumed that thyroid doses are much lower than those from Chernobyl. The outline of exposure doses of residents in result of the accident is still being clarified, questions and uncertainties in dose assessment remain and further efforts for more accurate dosimetry are required continuously.

Evacuation and Risk of Hypertension After the Great East Japan Earthquake

On March 11, 2011, the Great East Japan Earthquake occurred in Japan, with a nuclear accident subsequently occurring at the Fukushima Daiichi Nuclear Power Plant. The disaster forced many evacuees to change particular aspects of their lifestyles. This study assessed the hypothesis that evacuation may have increased the risk of hypertension among residents in Fukushima. A longitudinal study examined data collected from 31 252 Japanese participants aged 40 to 74 years sourced from general health checkups conducted in 13 communities between 2008 and 2010. Follow-up examinations were conducted from 2011 through 2013. A total of 21 989 participants (follow-up proportion, 70.4%) received follow-up examinations. Mean blood pressure significantly increased in both evacuees and nonevacuees after the disaster, with greater changes in blood pressure among the former. The changes in systolic and diastolic blood pressure among the evacuees and nonevacuees were +5.8/3.4 versus +4.6/2.1 mm Hg ( P <0.01/ P <0.0001) for men and +4.4/2.8 versus +4.1/1.7 mm Hg ( P =0.33/ P <0.0001) for women, respectively. Evacuation was associated with an increased risk of hypertension among men, and the age-adjusted hazard ratios of evacuation for incidence of hypertension were 1.24 (95% confidence interval, 1.11–1.39; P <0.001) for men and 1.05 (95% confidence interval, 0.94–1.17; P =0.37) for women, respectively. For men, after adjustment for confounding variables, the hazard ratio slightly decreased to 1.20, but the association was essentially unchanged. Blood pressure increased among residents, especially evacuees, in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake. Evacuation may be associated with an increased risk of hypertension among men in the 2 years after the disaster.

Comparison of childhood thyroid cancer prevalence among 3 areas based on external radiation dose after the Fukushima Daiichi nuclear power plant accident: The Fukushima health management survey

The 2011 Great East Japan Earthquake led to a subsequent nuclear accident at the Fukushima Daiichi Nuclear Power Plant. In its wake, we sought to examine the association between external radiation dose and thyroid cancer in Fukushima Prefecture. We applied a cross-sectional study design with 300,476 participants aged 18 years and younger who underwent thyroid examinations between October 2011 and June 2015. Areas within Fukushima Prefecture were divided into three groups based on individual external doses (≥1% of 5 mSv, <99% of 1 mSv/y, and the other). The odds ratios (ORs) and 95% confidence intervals of thyroid cancer for all areas, with the lowest dose area as reference, were calculated using logistic regression models adjusted for age and sex. Furthermore, the ORs of thyroid cancer for individual external doses of 1 mSv or more and 2 mSv or more, with the external dose less than 1 mSv as reference, were calculated. Prevalence of thyroid cancer for the location groups were 48/100,000 for the highest dose area, 36/100,000 for the middle dose area, and 41/100,000 for the lowest dose area. Compared with the lowest dose area, age-, and sex-adjusted ORs (95% confidence intervals) for the highest-dose and middle-dose areas were 1.49 (0.36-6.23) and 1.00 (0.67-1.50), respectively. The duration between accident and thyroid examination was not associated with thyroid cancer prevalence. There were no significant associations between individual external doses and prevalence of thyroid cancer. External radiation dose was not associated with thyroid cancer prevalence among Fukushima children within the first 4 years after the nuclear accident.

Association between psychological distress and dietary intake among evacuees after the Great East Japan Earthquake in a cross-sectional study: the Fukushima Health Management Survey

OBJECTIVE

Psychological distress is generally associated with poor dietary intake, but this has never been investigated among residents after a major disaster. We attempted to reveal the associations between dietary intake and non-specific mental health distress as well as traumatic symptoms among evacuees after the Great East Japan Earthquake of 2011.

METHODS

In this cross-sectional analysis of 63 047 evacuees (27 901 men, 35 146 women) who responded to The Fukushima Health Management Survey in 2012, non-specific mental health distress was assessed using the Kessler-6 (K6) scale, while traumatic symptoms were evaluated using the Post-traumatic Stress Disorder (PTSD) Checklist-Stressor-Specific Version (PCL-S). The outcome was 'low frequency'-meaning a daily consumption in the 25th centile or less according to the food frequency questionnaire (FFQ)-of 19 targeted food items. Logistic regression analysis was used to estimate ORs and 95% CIs adjusted for demographic, lifestyle-related and disaster-related factors.

RESULTS

Of the participants, 14.7% suffered non-specific mental health distress, and 21.2% exhibited traumatic symptoms. Multivariable adjusted logistic regression analysis showed that the former were likely to have a low intake frequency of certain foods, such as rice and bread, fish, meat, vegetables or fruit (non-juice), soya bean products, milk, and yogurt or lactobacillus drinks; the latter were also likely to have a low intake frequency of certain foods, including rice and bread, fish, meat, vegetables (non-juice), milk and yogurt or lactobacillus drinks, but conversely consumed vegetable and fruit juices more often. These associations between dietary intake and non-specific mental health distress, as well as traumatic symptoms, were predominantly observed in women.

CONCLUSIONS

Psychological distress after the Great East Japan Earthquake among evacuees was associated with a low intake frequency of certain foods, and the association was predominantly observed in women.