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Kaneda Y, Ozaki A, Murakami M, Sawano T, Nomura S, Bhandari D, Saito H, Tsubokura M, Yamaoka K, Nakata Y, Tsukada M, Ohira H. Health Information Seeking on the Internet Among Patients With and Without Cancer in a Region Affected by the 2011 Fukushima Triple Disaster: Cross-Sectional Study. JMIR Cancer 2024; 10:e49897. [PMID: 39167438 PMCID: PMC11375390 DOI: 10.2196/49897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 03/21/2024] [Accepted: 05/31/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Health information seeking via the internet among patients with cancer in disaster-affected areas is underresearched. OBJECTIVE This study aims not only to assess the extent and means of web-based health information seeking among patients with cancer living in the disaster-affected area of the 2011 Fukushima triple disaster but also to compare these patterns with those without cancer, identifying distinct and shared factors influencing their web-based health information behaviors. METHODS We surveyed 404 patients (263 with and 141 without cancer) from the surgery department outpatient office at Minamisoma Municipal General Hospital, from October 2016 to January 2017. The survey included self-administered questions on internet and digital device use. Descriptive analyses were performed to examine the use patterns of digital devices and the internet and their impact on health information seeking across different age groups of patients with and without cancer. Multivariable logistic regression was used to examine factors associated with web-based health information seeking, stratifying by cancer diagnosis. RESULTS The proportion of participants who sought health information on the internet was comparable between patients with cancer and patients without cancer (19% vs 17.4%; P=.71). Digital device use varied significantly with age, with peak smartphone use occurring among the youngest cohorts for both groups. Multivariable logistic regression revealed that patients with cancer using smartphones or tablets daily were significantly more likely to gather web-based health information (odds ratio [OR] for smartphones 3.73, 95% CI 1.58-8.80; OR for tablets 5.08, 95% CI 1.27-20.35). Trust in institutional websites also significantly influenced web-based health information gathering among patients with cancer (OR 2.87, 95% CI 1.13-7.25). Conversely, among patients without cancer, unemployment was associated with a lower likelihood of seeking web-based health information (OR 0.26, 95% CI 0.08-0.85), whereas trust in both institutional and personal websites significantly increased this likelihood (OR for institutional websites 6.76, 95% CI 2.19-20.88; OR for personal websites 6.97, 95% CI 1.49-32.58). CONCLUSIONS This study reveals that a small proportion of both patients with cancer and patients without cancer engage in health information seeking via the internet, influenced by age, digital device use, and trust in institutional websites. Given the growing prevalence of digital literacy, strategies to enhance accessible and reliable web-based health information should be developed, particularly for patients with cancer in postdisaster settings. Future efforts should focus on tailored health communication strategies that address the unique needs of these populations.
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Affiliation(s)
- Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Japan
- Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
- Department of Thyroid and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University, Fukushima, Japan
- Center for Infectious Disease Education and Research, Osaka University, Suita, Japan
| | - Toyoaki Sawano
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shuhei Nomura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Japan
- Keio University Global Research Institute (KGRI), Tokyo, Japan
| | - Divya Bhandari
- Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Internal Medicine, Soma Central Hospital, Soma, Japan
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazue Yamaoka
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
- Tetsuyu Clinical Research Center, Tetsuyu Healthcare Holdings Pte Ltd., Tokyo, Japan
| | - Yoshinori Nakata
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Manabu Tsukada
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
| | - Hiromichi Ohira
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
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Nonaka S, Odaka M, Takada A, Senoo Y, Sawano T, Ozaki A, Murakami M, Yoshida M, Uchi Y, Onoda K, Oikawa T, Tsubokura M. Primary care clinic visits in formerly evacuated areas due to radiation disaster following the Great East Japan Earthquake: A retrospective descriptive study. Medicine (Baltimore) 2024; 103:e37942. [PMID: 38701284 PMCID: PMC11062722 DOI: 10.1097/md.0000000000037942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
Radiation disasters pose distinctive medical challenges, requiring diverse care approaches. Beyond radiation exposure assessment, addressing health impacts due to lifestyle changes, especially among vulnerable populations, is vital. Evacuation orders issued in radiation-affected areas introduce unique healthcare dynamics, with their duration significantly influencing the recovery process. Understanding evolving patient demographics and medical needs after lifting evacuation orders is crucial for post-disaster care planning. Minamisoma Municipal Odaka Hospital, located 13 to 20 km from Fukushima Daiichi Nuclear power plant in a post-evacuation zone, was greatly affected by the Great East Japan Earthquake and subsequent radiation disaster. Data were retrospectively collected from patient records, including age, gender, visit date, diagnoses, and addresses. Patient records from April 2014 to March 2020 were analyzed, comparing data before and after the July 2016 evacuation order lift. Data was categorized into pre and post-evacuation order lifting periods, using International Classification of Diseases, Tenth Edition codes, to identify the top diseases. Statistical analyses, including χ-square tests, assessed changes in disease distributions. Population data for Odaka Ward and Minamisoma City fluctuated after lifting evacuation orders. As of March 11, 2011, Odaka Ward had 12,842 residents (27.8% aged 65+ years), dropping to 8406 registered residents and 2732 actual residents by April 30, 2018 (49.7%). Minamisoma City also saw declines, with registered residents decreasing from 71,561 (25.9%) to 61,049 (34.1%). The study analyzed 11,100 patients, mostly older patients (75.1%), between 2014 and 2020. Post-lifting, monthly patient numbers surged from an average of 55.2 to 213.5, with female patients increasing from 33.8% to 51.7%. Disease patterns shifted, with musculoskeletal cases declining from 23.8% to 13.0%, psychiatric disorders increasing from 9.3% to 15.4%, and trauma-related cases decreasing from 14.3% to 3.9%. Hypertension (57.1%) and dyslipidemia (29.2%) prevailed post-lifting. Urgent cases decreased from 1.3% to 0.1%. This study emphasizes the importance of primary care in post-evacuation zones, addressing diverse medical needs, including trauma, noncommunicable diseases, and psychiatric disorders. Changing patient demographics require adaptable healthcare strategies and resource allocation to meet growing demands. Establishing a comprehensive health maintenance system tailored to these areas' unique challenges is crucial for future disaster recovery efforts.
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Affiliation(s)
- Saori Nonaka
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
- Department of General Medicine, Taito Hospital, Japan Association for Development of Community Medicine, Tokyo, Japan
| | - Masaaki Odaka
- Clinic Director, Odaka Clinic Affiliated with Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Akemi Takada
- Department of Nursing, Odaka Clinic Affiliated with Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Yuki Senoo
- Department of Internal Medicine, Higashi-Totsuka Memorial Hospital, Kanagawa, Japan
| | - Toyoaki Sawano
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
- Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan (current address)
| | - Makoto Yoshida
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuna Uchi
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Katsuko Onoda
- Department of Nursing, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Tomoyoshi Oikawa
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
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Ayoub A, Wainwright HM, Sansavini G, Gauntt R, Saito K. Resilient design in nuclear energy: Critical lessons from a cross-disciplinary analysis of the Fukushima Dai-ichi nuclear accident. iScience 2024; 27:109485. [PMID: 38571761 PMCID: PMC10987892 DOI: 10.1016/j.isci.2024.109485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/21/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
This paper presents a multidisciplinary analysis of the Fukushima Dai-ichi Nuclear Power Plant accident. Along with the latest observations and simulation studies, we synthesize the time-series and event progressions during the accident across multiple disciplines, including in-plant physics and engineering systems, operators' actions, emergency responses, meteorology, radionuclide release and transport, land contamination, and health impacts. We identify three key factors that exacerbated the consequences of the accident: (1) the failure of Unit 2 containment venting, (2) the insufficient integration of radiation measurements and meteorology data in the evacuation strategy, and (3) the limited risk assessment and emergency preparedness. We conclude with new research and development directions to improve the resilience of nuclear energy systems and communities, including (1) meteorology-informed proactive venting, (2) machine learning-enabled adaptive evacuation zones, and (3) comprehensive risk-informed emergency planning while leveraging the experience from responses to other disasters.
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Affiliation(s)
- Ali Ayoub
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | - Haruko M. Wainwright
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | - Giovanni Sansavini
- Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
| | - Randall Gauntt
- Severe Accident Analysis Department, Sandia National Laboratories, Albuquerque, NM, USA
| | - Kimiaki Saito
- Fukushima Environmental Safety Center, Japan Atomic Energy Agency, Fukushima, Japan
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Mohammadi M, Jafari H, Etemadi M, Dalugoda Y, Mohtady Ali H, Phung H, Ahmadvand A, Dwirahmadi F, Barnes P, Chu C. Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence. Disaster Med Public Health Prep 2023; 17:e537. [PMID: 37994107 DOI: 10.1017/dmp.2023.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Forcibly displaced populations are among the most vulnerable groups in disasters. They experience poorer health conditions compared with nondisplaced individuals. However, a clear picture is lacking regarding the overall health problems encountered by disaster-induced mid- to long-term displaced people. This study investigated these disorders prevalence and identified their correlates among long-settled displaced populations worldwide. The current scoping review follows the PRISMA-ScR guidelines; a systematic search was conducted on PubMed, Web of Science, and CINAHL and included original peer-reviewed studies, commentary, reviews, and grey literature published in English between January 1990 to June 2022. In the thematic and content analysis, the authors applied the narrative review approach to identify themes and sub-themes. Forty-eight documents were identified as fully relevant to this study. The largest number of published papers were from Asia, followed by the Middle East, the United States, and Europe. IDPs in developed countries were the most researched populations. Human-made disasters were addressed by 89% of the included studies. The four main thematic categories included were "physical health," "mental health," "inadequate facilities," and "lack of healthy behaviour." The worsening of noncommunicable diseases had the highest prevalence, followed by communicable diseases. Due to their condition, forcibly displaced migrants face a triple burden of communicable diseases and noncommunicable diseases such as mental health issues. Health-related research and policy need to consider the links among disasters, health problems, and forced migration as a determinant of health in the new era of climate change-driven displacements.
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Affiliation(s)
- Mahan Mohammadi
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Hamid Jafari
- Department of Medical Emergencies, School of Medical Sciences, Sirjan, Iran
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Manal Etemadi
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Yohani Dalugoda
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Heba Mohtady Ali
- Cities Research Institute & School of Engineering and Built Environment, Griffith University, Gold Coast, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Alireza Ahmadvand
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Febi Dwirahmadi
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Paul Barnes
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
| | - Cordia Chu
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia
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Ochi S, Mirai S, Hashimoto S, Hashimoto Y, Sekizawa Y. Impact of the COVID-19 pandemic on exercise habits and overweight status in Japan: A nation-wide panel survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001732. [PMID: 37467210 PMCID: PMC10355423 DOI: 10.1371/journal.pgph.0001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/22/2023] [Indexed: 07/21/2023]
Abstract
A catastrophic disaster may cause distant health impacts like immobility and obesity. The aim of this research was to analyse the association of the COVID-19 pandemic and lifestyle factors -exercise habit and overweight status in the Japanese population. Nation-wide online questionnaires were conducted five times from October 2020 to October 2021. The changes in exercise habit, body mass index (BMI) and overweight status (BMI >25kg/m2) were compared between the first questionnaire and a questionnaire conducted a year later. Risk factors for losing exercise habit or becoming overweight were analysed using multiple regression. Data were obtained from 16,642 participants. In the early phase of the pandemic, people with high income and elderly females showed a higher risk for decreased exercise days. The proportion of overweight status increased from 22.2% to 26.6% in males and from 9.3% to 10.8% in females. Middle-aged males, elderly females, and males who experienced SARS-CoV-2 infection were at higher risk of becoming overweight. Our findings suggest that risks for immobility and overweight are homogeneous. Continuous intervention for elderly females and long-term intervention for males infected with SARS-CoV-2 might be especially needed. As most disasters can cause similar social transformation, research and evaluation of immobility and obesity should address future disaster preparation/mitigation plans.
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Affiliation(s)
- Sae Ochi
- Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - So Mirai
- Department of Psychiatry, Tokyo Dental College, Tokyo, Japan
| | | | - Yuki Hashimoto
- Research Department, Research Institute of Economy, Trade and Industry, Tokyo, Japan
| | - Yoichi Sekizawa
- Research Department, Research Institute of Economy, Trade and Industry, Tokyo, Japan
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Yoshida M, Sawano T, Kobashi Y, Hori A, Nishikawa Y, Ozaki A, Nonaka S, Tsuboi M, Tsubokura M. Importance of continuing health care before emergency hospital evacuation: a fatal case of a hospitalized patient in a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant: a case report. J Med Case Rep 2023; 17:37. [PMID: 36747281 PMCID: PMC9903404 DOI: 10.1186/s13256-022-03744-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/27/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND After a disaster, it is essential to maintain the health care supply levels to minimize the health impact on vulnerable populations. During the 2011 Fukushima Daiichi Nuclear Power Plant accident, hospitals within a 20 km radius were forced to make an immediate evacuation, causing a wide range of short- and long-term health problems. However, there is limited information on how the disaster disrupted the continuity of health care for hospitalized patients in the acute phase of the disaster. CASE PRESENTATION An 86-year-old Japanese man who needed central venous nutrition, oxygen administration, care to prevent pressure ulcers, skin and suctioning care of the trachea, and full assistance in the basic activities of daily living had been admitted to a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant and experienced Fukushima Daiichi Nuclear Power Plant accident. After the accident, the hospital faced a manpower shortage associated with hospital evacuation, environmental changes caused by infrastructure and medical supply disruptions, and the difficulty of evacuating seriously ill patients. As a result, antibiotics and suction care for aspiration pneumonia could not be appropriately provided to the patient due to lack of caregivers and infrastructure shortages. The patient died before his evacuation was initiated, in the process of hospital evacuation. CONCLUSIONS This case illustrates that decline in health care supply levels to hospitalized patients before evacuation during the acute phase of a radiation-released disaster may lead to patient fatalities. It is important to maintain the health care supply level even in such situations as the radiation-released disaster; otherwise, patients may experience negative health effects.
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Affiliation(s)
- Makoto Yoshida
- grid.264706.10000 0000 9239 9995Faculty of Medicine, Teikyo University, Itabashi-Ku, Tokyo, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan. .,Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan. .,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Yurie Kobashi
- grid.411582.b0000 0001 1017 9540Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan ,Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
| | - Arinobu Hori
- Department of Psychiatry, Hori Mental Clinic, Minamisoma, Fukushima Japan
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
| | - Akihiko Ozaki
- grid.507981.20000 0004 5935 0742Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima Japan
| | - Saori Nonaka
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima Japan
| | - Motohiro Tsuboi
- grid.264706.10000 0000 9239 9995Graduate School of Public Health, Teikyo University, Itabashi-Ku, Tokyo, Japan ,grid.410775.00000 0004 1762 2623Emergency and Critical Care Medicine, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima Japan ,grid.411582.b0000 0001 1017 9540Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan ,Department of Internal Medicine, Serireikai Group Hirata Central Hospital, Ishikawa District, Fukushima, Japan
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Murakami M, Nomura S. Annual prevalence of non-communicable diseases and identification of vulnerable populations following the Fukushima disaster and COVID-19 pandemic. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 84:103471. [PMID: 36465703 PMCID: PMC9707028 DOI: 10.1016/j.ijdrr.2022.103471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Disasters, pandemics, and their response measures can have secondary effects on the physical and psychological health of affected populations. Using health insurance receipt data from 2009 to 2020, we assessed changes in the prevalence of major non-communicable diseases (NCDs), including hypertension, hyperlipidemia, diabetes, and mental disorders, among affected populations before and after the Fukushima disaster and coronavirus disease (COVID-19) outbreak in Japan. Furthermore, age and sex groups with the largest increases in prevalence after these events were identified. The participants of this study were employees of large companies and their dependent family members who were insured by health insurance societies (HIS). The dataset was provided by JMDC Inc. The annual age-adjusted prevalence of each disease belonging to the HIS scheme was used to calculate the ratio of disease prevalence before and after the events. After the Fukushima disaster, hypertension, hyperlipidemia, and diabetes generally increased over a 9-year period in Fukushima Prefecture. The increase in the prevalence rate of these three NCDs and mental disorders was the highest among females aged 40-74 years compared to males and the other age groups. The prevalence of all four diseases increased after the COVID-19 outbreak in Japan, with a marked increase in males aged 0-39 years. Changes in prevalence ratios of NCDs after the COVID-19 outbreak among the areas affected by the Fukushima disaster were lower than in the whole of Japan. It is important to provide tailor-made public health support among populations in accordance with the type of disasters and pandemic.
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Affiliation(s)
- Michio Murakami
- Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
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Ohira T, Nakano H, Okazaki K, Hayashi F, Nagao M, Sakai A, Hosoya M, Shimabukuro M, Takahashi A, Kazama JJ, Hashimoto S, Kawasaki Y, Satoh H, Kobashi G, Yasumura S, Ohto H, Kamiya K. Trends in Lifestyle-related Diseases and Their Risk Factors After the Fukushima Daiichi Nuclear Power Plant Accident: Results of the Comprehensive Health Check in the Fukushima Health Management Survey. J Epidemiol 2022; 32:S36-S46. [PMID: 36464299 PMCID: PMC9703921 DOI: 10.2188/jea.je20210386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/21/2021] [Indexed: 12/07/2022] Open
Abstract
Residents were forced to evacuate owing to the radiation released after the Fukushima Nuclear Power Plant (NPP) accident following the Great East Japan Earthquake on 11/03/2021; thus, their lifestyles drastically changed. The Comprehensive Health Check (CHC) of the Fukushima Health Management Survey (FHMS) was performed to evaluate health statuses and prevent lifestyle-related diseases in evacuation area residents. The first part of the CHC survey is a retrospective analysis of pre- and post-disaster data on health check-ups of evacuation area residents. The second part is a cross-sectional, prospective analysis of post-disaster (fiscal year (FY) 2011-2017) data on health check-ups. Subjects were men and women living in 13 municipalities in areas surrounding the NPP in Fukushima Prefecture. Post-disaster (FY 2011-2012) overweight, hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome, liver dysfunction, hyperuricemia, polycythemia and atrial fibrillation cases increased from the pre-disaster (FY 2008-2010) levels. This tendency was strongest among residents who were forced to evacuate. Proportion of overweight people remained unchanged, the prevalence of liver dysfunction decreased and the proportion of people with treated hypertension and dyslipidemia increased during FY 2011-2017. Meanwhile, the prevalence of diabetes mellitus and mean levels of HbA1c increased. Furthermore, Evacuees showed higher risks of diabetes mellitus, dyslipidemia, chronic kidney diseases and liver dysfunction than non-evacuees. Therefore, residents in the evacuation area, especially evacuees, are at high risk of developing lifestyle-related diseases, especially cardiovascular diseases; therefore, it is necessary to observe health statuses and implement measures to prevent lifestyle-related diseases.
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Affiliation(s)
- Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junichiro J. Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Endocrinology, Metabolism, Diabetology and Nephrology, Fukushima Medical University Aizu Medical Center, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Diabetes and Metabolism, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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The long term participation trend for the colorectal cancer screening after the 2011 triple disaster in Minamisoma City, Fukushima, Japan. Sci Rep 2021; 11:23851. [PMID: 34903779 PMCID: PMC8668878 DOI: 10.1038/s41598-021-03225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022] Open
Abstract
Colorectal cancer (CRC) screening is a well-established cancer screening method, and its effectiveness depends on maintaining a high participation rate in the target population. In this study, we analyzed the trends in CRC screening participation rates over 10 years in Minamisoma City, where residents were forced to evacuate after the 2011 triple disaster in Fukushima, Japan. The immunochemical fecal occult blood test is provided as municipal CRC screening. We calculated the annual CRC screening participation rate and analyzed the factors associated with participation in screening. Overall, 4069 (12.3%) and 3839 (11.7%) persons participated in CRC screening in 2009 and 2010, respectively; however, the number decreased significantly to 1090 (3.4%) in 2011 when the earthquake occurred. Over the following 3 years, the rate gradually recovered. Multivariable logistic analysis showed that age < 65 years, living alone, and evacuation were significant associated factors for non-participation after 2011 (p < 0.05). In conclusion, the CRC screening participation rate decreased significantly during the Great East Japan Earthquake but recovered over the next 3 years. Further analysis of factors preventing CRC screening participation and research on the long-term effects of its post-disaster decline are important to consider in assessing the need for intervention in post-disaster cancer screening.
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10
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Ozaki A, Murakami M, Nomura S, Sawano T, Tsubokura M, Ono K, Takebayashi Y, Tsukada M, Yamaoka K, Nakata Y, Ohira H. Overall health information exposure, its barriers and impacts on attitude toward healthcare among cancer patients. The long-term aftermath of the 2011 triple disaster in Fukushima, Japan: A single institution cross-sectional study. Health Informatics J 2021; 27:1460458221996420. [PMID: 33878956 DOI: 10.1177/1460458221996420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients-5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.
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Affiliation(s)
- Akihiko Ozaki
- Minamisoma Municipal General Hospital, Japan.,Jyoban Hospital of Tokiwa Foundation, Japan
| | | | - Shuhei Nomura
- Minamisoma Municipal General Hospital, Japan.,The University of Tokyo, Japan.,Keio Univeristy, Japan
| | - Toyoaki Sawano
- Minamisoma Municipal General Hospital, Japan.,Sendai Open Hospital, Japan.,Fukushima Medical University, Japan
| | - Masaharu Tsubokura
- Minamisoma Municipal General Hospital, Japan.,Fukushima Medical University, Japan
| | - Kyoko Ono
- National Institute of Advanced Industrial Science and Technology, Japan
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11
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Keasley J, Oyebode O, Shantikumar S, Proto W, McGranahan M, Sabouni A, Kidy F. A systematic review of the burden of hypertension, access to services and patient views of hypertension in humanitarian crisis settings. BMJ Glob Health 2021; 5:bmjgh-2020-002440. [PMID: 33168520 PMCID: PMC7654140 DOI: 10.1136/bmjgh-2020-002440] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Globally, a record number of people are affected by humanitarian crises caused by conflict and natural disasters. Many such populations live in settings where epidemiological transition is underway. Following the United Nations high level meeting on non-communicable diseases, the global commitment to Universal Health Coverage and needs expressed by humanitarian agencies, there is increasing effort to develop guidelines for the management of hypertension in humanitarian settings. The objective was to investigate the prevalence and incidence of hypertension in populations directly affected by humanitarian crises; the cascade of care in these populations and patient knowledge of and attitude to hypertension. METHODS A literature search was carried out in five databases. Grey literature was searched. The population of interest was adult, non-pregnant, civilians living in any country who were directly exposed to a crisis since 1999. Eligibility assessment, data extraction and quality appraisal were carried out in duplicate. RESULTS Sixty-one studies were included in the narrative synthesis. They reported on a range of crises including the wars in Syria and Iraq, the Great East Japan Earthquake, Hurricane Katrina and Palestinian refugees. There were few studies from Africa or Asia (excluding Japan). The studies predominantly assessed prevalence of hypertension. This varied with geography and age of the population. Access to care, patient understanding and patient views on hypertension were poorly examined. Most of the studies had a high risk of bias due to methods used in the diagnosis of hypertension and in the selection of study populations. CONCLUSION Hypertension is seen in a range of humanitarian settings and the burden can be considerable. Further studies are needed to accurately estimate prevalence of hypertension in crisis-affected populations throughout the world. An appreciation of patient knowledge and understanding of hypertension as well as the cascade of care would be invaluable in informing service provision.
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Affiliation(s)
- James Keasley
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - William Proto
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Amar Sabouni
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Farah Kidy
- Warwick Medical School, University of Warwick, Coventry, UK
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12
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Nomura S, Murakami M, Ozaki A, Sawano T, Leppold C, Nishikawa Y, Saito H, Oikawa T, Tsubokura M. Comparative risk assessment of non-communicable diseases by evacuation scenario- a retrospective study in the 7 years following the Fukushima Daiichi nuclear power plant accident. Glob Health Action 2021; 14:1918886. [PMID: 34058969 PMCID: PMC8172221 DOI: 10.1080/16549716.2021.1918886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: As a result of the Fukushima Daiichi nuclear power plant accident, many residents evacuated and were exposed to changes in their living environment and socioeconomic status, and to persistent stressors. Past studies have suggested the potential for these circumstances to contribute to long-term changes to population health.Objective: The objective of this study was to gain a better understanding of long-term health effects of evacuation, by evaluating the risk of non-communicable diseases among evacuees from Minamisoma City (one of the closest municipalities to the power plant) until 2017.Methods: The study evaluated data from annual health check-ups for residents aged 40-74 years covered by National Health Insurance (who are largely self-employed) from 2010 to 2017 administered by Minamisoma City. Diabetes, hyperlipidemia, and hypertension were defined from the results of blood sampling. Annual changes in age-adjusted prevalence were estimated by evacuation scenario. We also performed an inverse-probability weighting (IPW) analysis to adjust for baseline covariates in 2010 and estimated the differences in the risk of diabetes, hyperlipidemia, and hypertension by evacuation scenario as of the 2017 health check-up in reference to the no-evacuation group.Results: A total of 1,837 individuals were considered in this study. Regardless of evacuation scenario, there was statistical evidence suggesting an upward and a downward trend in diabetes and hypertension from 2010 to 2017, respectively, while hyperlipidemia showed no remarkable change. IPW analyses demonstrated that disease risks in 2017 did not differ significantly among people with different evacuation scenarios.Conclusions: Region-specific factors played an important role in the health effects of the evacuation. Our findings have important implications for the need of an assessment of the health effects of evacuations in more localized manner. Further research in this area will strengthen the communities' preparedness for future disasters that require mass evacuation.
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Affiliation(s)
- Shuhei Nomura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Toyoaki Sawano
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Claire Leppold
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan.,Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Tomoyoshi Oikawa
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
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13
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Wang J, Garg S, Landes RD, Liu L, Fu Q, Seng J, Boerma M, Thrall K, Hauer-Jensen M, Pathak R. Differential Recovery of Small Intestinal Segments after Partial-Body Irradiation in Non-Human Primates. Radiat Res 2021; 196:204-212. [PMID: 34043805 DOI: 10.1667/rade-20-00272.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/06/2021] [Indexed: 11/03/2022]
Abstract
In the event of a radiological attack or accident, it is more likely that the absorbed radiation dose will be heterogeneous, rather than uniformly distributed throughout the body. This type of uneven dose distribution is known as partial-body irradiation (PBI). Partial exposure of the vital organs, specifically the highly radiosensitive intestines, may cause death, if the injury is significant and the post-exposure recovery is considerably compromised. Here we investigated the recovery rate and extent of recovery from PBI-induced intestinal damage in large animals. Rhesus macaques (Macaca mulatta) were randomly divided into four groups: sham-irradiated (0 Gy), 8 Gy PBI, 11 Gy PBI and 14 Gy PBI. A single dose of ionizing radiation was delivered in the abdominal region using a uniform bilateral anteroposterior and posteroanterior technique. Irradiated animals were scheduled for euthanasia on days 10, 28 or 60 postirradiation, and sham-irradiated animals on day 60. Intestinal structural injuries were assessed via crypt depth, villus height, and mucosal surface length in the four different intestinal regions (duodenum, proximal jejunum, distal jejunum and ileum) using H&E staining. Higher radiation doses corresponded with more injury at 10 days post-PBI, and faster recovery. However, at 60 days post-PBI, damage was still evident in all regions of the intestine. The proximal and distal ends (duodenum and ileum, respectively) sustained less damage and recovered more fully than the jejunum.
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Affiliation(s)
- Junru Wang
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sarita Garg
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Reid D Landes
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Liya Liu
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Qiang Fu
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - John Seng
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Marjan Boerma
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Martin Hauer-Jensen
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Rupak Pathak
- Division of Radiation Health, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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14
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Moriyama N, Nakayama C, Orui M, Kuroda Y, Iwasa H, Horiuchi T, Nakayama T, Sugita M, Yasumura S. Associated factors related to participation in general health checkup and survey of the effect of low-dose radiation exposure on health of residents of Fukushima Prefecture after the Fukushima Daiichi nuclear power plant accident. Prev Med Rep 2020; 20:101214. [PMID: 33083209 PMCID: PMC7553339 DOI: 10.1016/j.pmedr.2020.101214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 08/05/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
The Fukushima Daiichi nuclear power plant accident caused radioactive contamination of the surrounding area. In addition to annual health checkups, a survey of the effects of low-dose radiation exposure on health among Fukushima Prefecture residents after the accident has been conducted. Despite health literacy (HL) being recognized as essential to health, its association with participation in these checkups and the survey remains unknown. We aimed to describe the HL status of the Fukushima Prefecture residents and to verify the hypothesis that HL is associated with participation in both checkup and survey. In a cross-sectional study, a questionnaire was sent to 2000 randomly sampled Fukushima Prefecture residents; data from 770 individuals were analyzed. Communicative and critical HL were measured using a 5-point scale. Factors associated with participation were examined using logistic regression. The survey's valid response rate was 38.5%. The average HL score was 3.11 ± 0.81. HL was not associated with checkup or survey participation. Checkup participation was negatively associated with radiation anxiety (odds ratio 0.93, 95% confidence interval 0.86-0.99, p = 0.03). The HL of Fukushima Prefecture residents after the accident was relatively lower than that of the Japanese general population, which may be attributed to difference in educational background. The complexities involved in understanding the effects of radiation on the health of residents could explain why no association between HL and participation in a health checkup and survey was observed. Future studies with a longitudinal design should clarify causality between anxiety and checkup participation.
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Affiliation(s)
- Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Chihiro Nakayama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masatsugu Orui
- Sendai City Mental Health and Welfare Center, Sendai, Japan
| | - Yujiro Kuroda
- Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Hajime Iwasa
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Teruko Horiuchi
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | | | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
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15
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Takahashi S, Yonekura Y, Tanno K, Shimoda H, Sakata K, Ogawa A, Kobayashi S. Increase in Body Weight Following Residential Displacement: 5-year Follow-up After the 2011 Great East Japan Earthquake and Tsunami. J Epidemiol 2020; 31:328-334. [PMID: 32536638 PMCID: PMC8021881 DOI: 10.2188/jea.je20190333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have linked residential displacement as a result of the 2011 East Japan Earthquake to increases in body weight. However, no study has examined longer-term trajectories of body weight among displaced survivors. We compared body weight change between survivors relocated to temporary housing (TH) group versus other types of accommodation for up to 5 years after the Great East Japan Earthquake. METHODS Longitudinal follow-up was conducted from 2011 to 2015 in a cohort of 9,909 residents of 42,831. We compared trends in body weight in the TH group (n = 3,169) and the non-TH group (n = 6,740) using a mixed linear regression model stratified by sex (mean age, 61.0 years old; male, 38.9%). RESULTS In age-adjusted analysis, the body weight in the 2011 survey was not significantly different between two groups for either sex. In men, the TH group significantly increased body weight compared to the non-TH group since 2012. In women, body weight sharply increased in the TH group while body weight did not change in the non-TH group during survey time points. The interaction of living conditions and survey years was statistically significant in both sexes (men; F-value, 6.958; P < 0.001: women; F-value, 19.127; P < 0.001). CONCLUSION Survivors relocated to temporary housing had an increased risk of weight gain. The weight gain in this group is a potential risk factor for metabolic syndrome in the post-disaster period.
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Affiliation(s)
- Shuko Takahashi
- Division of Medical Education, Iwate Medical University.,Takemi Program in International Health, Harvard T.H. Chan School of Public Health.,Department of Health and Welfare, Iwate Prefecture
| | | | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University
| | - Haruki Shimoda
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University
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16
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Effect of temporary housing on incidence of diabetes mellitus in survivors of a tsunami-stricken area in 2011 Japan disaster: a serial cross-sectional RIAS study. Sci Rep 2020; 10:15400. [PMID: 32958796 PMCID: PMC7505964 DOI: 10.1038/s41598-020-71759-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/17/2020] [Indexed: 12/25/2022] Open
Abstract
The association between incidence of diabetes mellitus (DM) and living conditions has not been studied after natural disasters. We compared the incidence of DM between individuals living in temporary housing (TH) and those living in other types of accommodation (non-TH) five years after the 2011 Great East Japan Earthquake. Longitudinal follow-up was conducted from 2011 to 2015 in a cohort of 7,491 residents of coastal communities in Iwate Prefecture directly impacted by the 2011 disaster (mean age, 61.6 years; men, 36.0%). We calculated the odds ratio of new onset of DM in the TH group (n = 2,372) compared with the non-TH group (n = 5,119) using discrete-time logit models stratified by sex and age classes (64 years or younger and older than 65 years). The TH group showed a significantly higher odds ratio (OR) for DM in men aged 64 years or younger (OR [95% confidence interval (CI)], 1.71 [1.03–2.85]; P-value = 0.040). In women, living conditions were not significantly associated DM. Survivors relocated to TH appeared to be at an increased risk of new onset DM.
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17
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Nail Wound and Cellulitis Following Typhoon Hagibis in Fukushima, Japan. Disaster Med Public Health Prep 2020; 15:540-542. [PMID: 32487277 DOI: 10.1017/dmp.2020.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Chung YS, Harada KH, Igari K, Ishizuka J, Koizumi A. The incidence of diabetes among the non-diabetic residents in Kawauchi village, Fukushima, who experienced evacuation after the 2011 Fukushima Daiichi nuclear power plant disaster. Environ Health Prev Med 2020; 25:13. [PMID: 32384869 PMCID: PMC7210664 DOI: 10.1186/s12199-020-00852-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/01/2020] [Indexed: 12/22/2022] Open
Abstract
Objectives After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village. Methods Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: “Diabetes (DM)” (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5% or hospital visit for DM or usage of diabetic medication), “Borderline DM” (126 mg/dL > FBG ≥ 110 mg/dL or 6.5% > HbA1c ≥ 6.0%, and without hospital visit, and without diabetic medication), and “Normoglycemic” (FBG < 110 mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9 years in Kawauchi village and 3.6 years in Ono town. Results Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village. Conclusions The current results confirmed that diabetes incidence was increased 6 years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority.
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Affiliation(s)
- Yun-Shan Chung
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Kouji H Harada
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan.
| | - Keiko Igari
- Yufune Healthcare Center, Kawauchi Village Office, Fukushima, 979-1202, Japan
| | - Jinrou Ishizuka
- Medical Corporation Ishizuka Clinics, Ono Town, Fukushima, 963-3401, Japan
| | - Akio Koizumi
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan.,Public Interest Corporation Kyoto Hokenkai, Nakagyo-ku, Kyoto, 616-8141, Japan
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19
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Ozaki A, Elstow L, Murakami M, Tsubokura M, Abeysinghe S. Lessons learned from Fukushima, Japan: in what ways can the social sciences help to mitigate some of the health impacts of disaster? QJM 2020; 113:237-238. [PMID: 31250020 DOI: 10.1093/qjmed/hcz165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - L Elstow
- Department of Sociology, Lancaster University, Lancaster, UK
| | | | - M Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - S Abeysinghe
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
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20
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Goniewicz K, Misztal-Okońska P, Pawłowski W, Burkle FM, Czerski R, Hertelendy AJ, Goniewicz M. Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051779. [PMID: 32182947 PMCID: PMC7084892 DOI: 10.3390/ijerph17051779] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022]
Abstract
Medical facilities, while providing both essential and demanding health care to society’s most vulnerable populations, also belong to the most demanding category of risk to human life if and when a crisis event occurs within its walls. The development of a safe evacuation plan for these facilities is extremely complicated, as the evacuation of medical facilities is much more complex than for other critical infrastructure. In this category, the evacuated patients constitute a specific risk group requiring specialized medical care. Hospitalized persons may be dependent on life-saving measures, are unconscious or immobile, are significantly restricted in movement or mentally unbalanced, being dependent on the continued assistance of trained third parties. Additionally, the medical transport of evacuated patients becomes more difficult due to the limited capacity of ambulances and available health care facilities to transport them to, which are increasingly limited due to their overcrowded census. The study aimed to analyze the requirements which are placed on hospitals in Poland to ensure the safety of patients in case of an evacuation. The research method used in the paper was retrospective analysis and evaluation of the media and literature. We have found, that Polish law imposes an obligation on the administrator of a medical facility to ensure the safety of both patients and employees. The regulations cover issues of technical conditions to be met by buildings and their location, prevention, and fire protection requirements, and the determination of which staff is responsible for the evacuation. However, available documents fail to describe what the hospital evacuation process itself should entail under emergency evacuation. Taking into account the complexity of the hospital evacuation process, health care facilities should have a well-developed plan of action that must be implemented at least once a year in the form of facility-wide training. Evacuation drills should not be avoided. Only trained procedures offer the possibility of later analysis to identify and eliminate errors and provide the opportunity to acquire skill sets and habits which promote the behaviors expected in real-life emergencies.
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Affiliation(s)
- Krzysztof Goniewicz
- Department of Aviation Security, Polish Air Force Academy, 08-521 Dęblin, Poland;
- Correspondence:
| | - Patrycja Misztal-Okońska
- Department of Emergency Medicine, Medical University of Lublin, 20-059, Lublin, Poland; (P.M.-O.); (W.P.); (M.G.)
| | - Witold Pawłowski
- Department of Emergency Medicine, Medical University of Lublin, 20-059, Lublin, Poland; (P.M.-O.); (W.P.); (M.G.)
| | - Frederick M. Burkle
- Harvard Humanitarian Initiative, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Robert Czerski
- Department of Aviation Security, Polish Air Force Academy, 08-521 Dęblin, Poland;
| | - Attila J. Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL 33174, USA;
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-059, Lublin, Poland; (P.M.-O.); (W.P.); (M.G.)
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21
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Takebayashi Y, Hoshino H, Kunii Y, Niwa SI, Maeda M. Characteristics of Disaster-Related Suicide in Fukushima Prefecture After the Nuclear Accident. CRISIS 2020; 41:475-482. [PMID: 32141328 PMCID: PMC8208296 DOI: 10.1027/0227-5910/a000679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Abstract.Background:
Suicide is a major concern after the 2011 earthquake and
nuclear accident in Fukushima. Aims: This study
delineates characteristics of the disaster-related suicides
in Fukushima. Method: Data
provided by the Fukushima Prefectural Police and data
published by the Fukushima or Japanese Government were
analyzed. Numbers of disaster-related suicides and evacuees
were compared among the three prefectures affected. Age,
sex, occupation, and means for disaster-related suicides in
Fukushima were compared with overall suicides in Fukushima
or Japan. History of medical treatment, changes in job and
family structure after the disaster, and signs of
contemplation were examined within the disaster-related
suicides of Fukushima. Results: While
other prefectures have experienced a drop in
disaster-related suicides, Fukushima has not.
Age-standardized disaster-related suicide rates were
remarkably higher in men than in women. Moreover,
disaster-related suicide rates in Fukushima were higher in
women in their 50s and 80s as compared with overall suicide
rates in Fukushima or Japan. Limitations: No detailed comparisons were made between disaster-related and non-disaster-related suicides. Conclusion: Disaster-related suicide rates were higher in men than in women. Also, it was found that the disaster-related suicide rates of elderly women were higher compared with overall suicide rates in Japan and Fukushima. In addition, many who died by suicide showed signs of contemplation before the attempt and had started psychiatric treatment. Improvement of suicide risk assessment skills for mental health professionals and gatekeeper training among residents will be essential to prevent disaster-related suicides.
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Affiliation(s)
- Yoshitake Takebayashi
- Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Hoshino
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuto Kunii
- Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Shin-Ichi Niwa
- Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Masaharu Maeda
- Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Sawano T, Kambe T, Seno Y, Konoe R, Nishikawa Y, Ozaki A, Shimada Y, Morita T, Saito H, Tsubokura M. High internal radiation exposure associated with low socio-economic status six years after the Fukushima nuclear disaster: A case report. Medicine (Baltimore) 2019; 98:e17989. [PMID: 31764810 PMCID: PMC6882598 DOI: 10.1097/md.0000000000017989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Managing the health of vulnerable groups is an important component of health care. Given the long-term burden of radiation-release incidents among those exposed, managing the health of vulnerable groups following a nuclear disaster is very important. However, there is limited information available concerning the long-term management of the health effects of radiation exposure in vulnerable groups following nuclear disasters. After the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, Minamisoma City launched internal radiation exposure monitoring program for local residents, using whole body counter (WBC) units. In 2017, a man of low socio-economic status (SES), was found to have the highest level of internal contamination detected in a person living in the Soma District in recent years. This report describes the case so that the lessons learned can be applied in future nuclear disaster settings. PATIENT CONCERNS A 77-year-old Japanese man, who had been homeless for 2 months and had been staying in the exclusion zone of Minamisoma City, was brought to our hospital. He had become homeless because a lack of communication between social support services had led to his eviction from leased housing after free housing support for evacuees was terminated. DIAGNOSES He was admitted with a diagnosis of dehydration and malnutrition. A WBC unit was used to assess his body burden of radioactive cesium. This revealed levels of Cs-134 and Cs-137 of 538 Bq/body and 4,993 Bq/body, respectively. INTERVENTION He received intravenous fluid therapy and health monitoring. The paperwork required for him to receive public income support was processed during hospitalization. OUTCOME He was discharged to public housing after 9 days, and municipal workers started visiting him regularly after his discharge. LESSONS A high level of internal radiation contamination may occur after a nuclear disaster. This may be associated with a decline in social support, poverty, and social isolation, and may have more impact on people in poor health than on the general population. It would be useful to strengthen linkages between local government and welfare service providers to increase social support for vulnerable groups requiring health care, not only following disasters, but also under normal circumstances.
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Affiliation(s)
- Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital
- Department of Public Health, Fukushima Medical University School of Medicine
| | - Toshiyuki Kambe
- Department of Pulmonary Medicine, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Yuki Seno
- Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ran Konoe
- Department of Surgery, Minamisoma Municipal General Hospital
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Fukushima
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation
| | - Yuki Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima
| | - Tomohiro Morita
- Department of Internal Medicine, Soma Central Hospital, Fukushima
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Masaharu Tsubokura
- Department of Public Health, Fukushima Medical University School of Medicine
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma
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Moriyama N, Iwasa H, Tsubokura M, Kuroda Y, Yasumura S. Living in the Restoration Public Housing after the Great East Japan Earthquake Correlates with Lower Subjective Well-Being of Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152696. [PMID: 31357741 PMCID: PMC6696690 DOI: 10.3390/ijerph16152696] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 11/16/2022]
Abstract
We aimed to (1) describe the subjective well-being (SWB) of older residents in Fukushima Prefecture seven years and seven months after the Great East Japan Earthquake (GEJE) and examine the effect of relocation to the restoration public housing (RPH) on SWB, social capital, and health indicators; and (2) investigate the association between social capital and SWB. Questionnaires were administered to collect data of both RPH and non-RPH residents (≥65 years). Respondents' SWB was collected via the Japanese version of the World Health Organization Five Well-Being Index. Additionally, residents' social capital (trust, reciprocity, and participation), physical activity level, social network, functional health, history of chronic disease, and demographic data were collected. We analyzed 101 responses (valid response rate: approximately 34%) from RPH and 158 (53%) from non-RPH residents. SWB was lower in RPH compared to non-RPH residents but not statistically significant. Older RPH residents may demonstrate lower social capital and health indicators after the GEJE. Mistrust was found to be positively associated with low SWB in RPH residents. Future studies should examine the effectiveness of support for enhancing the trust of older RPH residents regarding, for example, the involvement of scientists-including medical professionals-in risk communications in promoting SWB.
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Affiliation(s)
- Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima Prefecture 960-1295, Japan.
| | - Hajime Iwasa
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima Prefecture 960-1295, Japan
| | - Masaharu Tsubokura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima Prefecture 960-1295, Japan
| | - Yujiro Kuroda
- Center for Integrated Science and Humanities, Fukushima Medical University, Japan
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki Prefecture 305-8560, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima Prefecture 960-1295, Japan
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Impact of evacuation on trends in the prevalence, treatment, and control of hypertension before and after a disaster. J Hypertens 2019; 36:924-932. [PMID: 29227375 DOI: 10.1097/hjh.0000000000001626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE After the Great East Japan Earthquake in 2011, the prevalence of cardiovascular disease risk factors increased in victims. We examined the trends in the prevalence, treatment, and control of hypertension before and after the disaster, as well as the impact of evacuation. METHODS Study participants were approximately 10 000 men and 12 000 women aged 40-74 years in each year from 2008 to 2014. All of the participants had lived in radiation evacuation zones prior to the Fukushima nuclear crisis. The age-standardized prevalence, treatment, and control of hypertension were calculated using the direct method. In a comparison of evacuees with nonevacuees, the proportion ratios and 95% confidence intervals for hypertension, treatment, and control were calculated by Poisson regression with robust error variance adjusted for covariates in each year after the disaster. RESULTS The age-standardized prevalence of hypertension peaked in 2012 at 48.8% in men and 39.0% in women. By 2014, the treatment and control of hypertension had increased to 66.3 and 67.1% in men, and 70.6 and 68.1% in women, respectively. The multiadjusted proportion ratios for the prevalence, treatment, and control of hypertension in any given year were 1.02-1.03, 0.99-1.05, and 0.93-1.06 in men, and 0.96-1.00, 0.99-1.05, and 1.06-1.11 in women, respectively. CONCLUSION The prevalence of hypertension peaked 1 year after the disaster, while the treatment and control of hypertension increased thereafter. These results indicate that evacuation had little to no impact on the prevalence, treatment, and control of hypertension in the population of Fukushima Prefecture.
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Clow B, Haworth-Brockman M, Boily-Larouche G, Qadar Z, Keynan Y. Looking for Evidence of Public Health's Role for Long-Term Evacuees. Front Public Health 2019; 7:15. [PMID: 30809517 PMCID: PMC6379342 DOI: 10.3389/fpubh.2019.00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/17/2019] [Indexed: 11/24/2022] Open
Abstract
Many Canadians have had personal experience of a major emergency or disaster at some point in their lifetime and close to a third of those affected were evacuated from their homes or communities. Most evacuations have lasted less than 2 weeks, but in some instances, people have been displaced for months or years. For example, hundreds of residents evacuated following flooding in Lake St. Martin, Manitoba in 2011, remain displaced today. In order to learn more about the roles and responses of public health for long-term evacuees (LTEs) in Canada, we conducted a narrative review of published English-language documents, beginning with literature specific to Canada and then expanding to include literature on other high-income countries. We found that while researchers have explored public health considerations in emergency preparedness, acute disaster management, and resettlement in these contexts there is a dearth of published evidence regarding the public health implications of prolonged evacuation and the public health responses to long-term evacuation in Canada and in other high-income countries. Because the public health needs of diverse populations of LTEs have not been fully investigated, it is likely that they are neither well-understood nor adequately addressed in public health policy and practice.
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Affiliation(s)
| | - Margaret Haworth-Brockman
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Geneviève Boily-Larouche
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Zeeshan Qadar
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Yoav Keynan
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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26
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Hasegawa M, Murakami M, Nomura S, Takebayashi Y, Tsubokura M. Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima. TOHOKU J EXP MED 2019; 248:115-123. [DOI: 10.1620/tjem.248.115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Makoto Hasegawa
- Department of Health Risk Communication, Fukushima Medical University School of Medicine
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine
| | - Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo
- Research Center for Community Health, Minamisoma Municipal General Hospital
| | - Yoshitake Takebayashi
- Department of Health Risk Communication, Fukushima Medical University School of Medicine
| | - Masaharu Tsubokura
- Department of Public Health, Fukushima Medical University School of Medicine
- Department of Radiation Protection, Minamisoma Municipal General Hospital
- Department of Radiation Protection, Soma Central Hospital
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Murakami M, Kumagai A, Ohtsuru A. BUILDING RISK COMMUNICATION CAPABILITIES AMONG PROFESSIONALS: SEVEN ESSENTIAL CHARACTERISTICS OF RISK COMMUNICATION. RADIATION PROTECTION DOSIMETRY 2018; 182:120-127. [PMID: 30165706 DOI: 10.1093/rpd/ncy140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 06/08/2023]
Abstract
Since the Fukushima disaster, medical professionals have been involved in risk communication with residents affected. This is an urgent issue, and an important aspect of global disaster preparedness is defining the essential characteristics of professional risk communication, and training medical professionals and students to conduct effective risk communication. Using a narrative of risk trade-offs between radionuclides in the diet and traffic accidents as an example, we introduce the seven essential characteristics required by medical professionals and authorities involved in risk communication: (1) risk assessment, (2) differentiating between risk acceptance and risk trade-offs, (3) understanding differences in risk quality, (4) understanding how to frame information given residents' values, (5) giving attention to coping with too-high risk, (6) building trust and (7) fully considering how information is provided. Furthermore, we introduce an example of lectures at which participants can voluntarily learn the seven essential characteristics of risk communication through group discussions.
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Affiliation(s)
- Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Kumagai
- Education Center for Disaster Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Education Center for Disaster Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
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Nishikawa Y, Niimura H, Ozaki A, Kimura Y, Morita T, Sawano T, Saito H, Tsubokura M. Successful institutional care for behavioral and psychological symptoms of dementia in a repopulated area after the 2011 Fukushima disaster: A case report. Clin Case Rep 2018; 6:2266-2270. [PMID: 30455934 PMCID: PMC6230616 DOI: 10.1002/ccr3.1867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/18/2018] [Accepted: 09/25/2018] [Indexed: 11/16/2022] Open
Abstract
Caregiving in a long-term facility played a key role in improvements of this patient's behavioral and psychological symptoms of dementia, which also led to a reduced caregiver burden on her family members. Considering the global population aging trend, the lesson from this case may apply to other settings beyond disasters.
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Affiliation(s)
- Yoshitaka Nishikawa
- Kawauchi Intensive Care Homes for the ElderlyFutaba‐gunJapan
- Kawauchi Village National Health Insurance ClinicFutaba‐gunJapan
- Department of Internal MedicineHirata Central HospitalIshikawa‐gunJapan
- Department of Health Informatics, School of Public HealthKyoto UniversityKyotoJapan
| | - Hidehito Niimura
- Kawauchi Village National Health Insurance ClinicFutaba‐gunJapan
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
| | - Akihiko Ozaki
- Department of Breast SurgeryJyoban Hospital of Tokiwa FoundationIwakiJapan
- Department of Epidemiology and BiostatisticsTeikyo University Graduate School of Public HealthTokyoJapan
| | - Yuko Kimura
- Kawauchi Village National Health Insurance ClinicFutaba‐gunJapan
| | - Tomohiro Morita
- Department of Internal MedicineSoma Central HospitalSomaJapan
| | - Toyoaki Sawano
- Department of SurgeryMinamisoma Municipal General HospitalMinamisomaJapan
- Department of Public HealthFukushima Medical University School of MedicineFukushimaJapan
| | - Hiroaki Saito
- Department of GastroenterologySendai Kousei HospitalSendaiJapan
| | - Masaharu Tsubokura
- Department of Internal MedicineHirata Central HospitalIshikawa‐gunJapan
- Department of Internal MedicineSoma Central HospitalSomaJapan
- Department of Public HealthFukushima Medical University School of MedicineFukushimaJapan
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Shimada Y, Nomura S, Ozaki A, Higuchi A, Hori A, Sonoda Y, Yamamoto K, Yoshida I, Tsubokura M. Balancing the risk of the evacuation and sheltering-in-place options: a survival study following Japan's 2011 Fukushima nuclear incident. BMJ Open 2018; 8:e021482. [PMID: 30056383 PMCID: PMC6067355 DOI: 10.1136/bmjopen-2018-021482] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The decision to evacuate or shelter-in-place is fundamental to emergency response, especially for a vulnerable population. While an elevated risk of mortality due to a hasty, unplanned evacuation has been well documented, there is little research on and knowledge about the health consequences of sheltering-in-place in disaster contexts. We compared hospital mortality in patients who sheltered-in-place (non-evacuees) after the incident with the baseline preincident mortality and articulated postincident circumstances of the hospital while sheltering-in-place. PARTICIPANTS We considered all 484 patients admitted to Takano Hospital (located 22 km South of the Fukushima Daiichi nuclear power plant) from 1 January 2008 to 31 December 2016. METHODS Significant differences in mortality rates between preincident baseline and three postincident groups (evacuees, non-evacuees (our major interest) and new admittees) were tested using the Bayesian survival analysis with Weibull multivariate regression and survival probability using the Kaplan-Meier product limit method. All the analyses were separately performed by the internal and psychiatry department. RESULTS After adjusting for covariates, non-evacuees in the internal department had a significantly higher mortality risk with an HR of 1.57 (95% credible intervals 1.11 to 2.18) than the baseline preincident. Of them, most deaths occurred within the first 100 days of the incident. No significant increase in mortality risk was identified in evacuees and new admittees postincident in the department, which were adjusted for covariates. In contrast, for the psychiatry department, statistical difference in mortality risk was not identified in any groups. CONCLUSIONS The mortality risk of sheltering-in-place in a harsh environment might be comparable to those in an unplanned evacuation. If sheltering-in-place with sufficient resources is not guaranteed, evacuation could be a reasonable option, which might save more lives of vulnerable people if performed in a well-planned manner with satisfactory arrangements for appropriate transportation and places to safely evacuate.
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Affiliation(s)
- Yuki Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
| | - Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Akihiko Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Fukushima, Japan
- Department of Biostatistics and Epidemiology, Teikyo University Graduate School of Public Health, Tokyo, Japan
| | | | - Arinobu Hori
- Hori Mental Clinic, Fukushima, Japan
- Department of Disaster and Comprehensive Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuki Sonoda
- Department of nursing, Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
| | - Kana Yamamoto
- Department of Internal Medicine, Ohmachi Hospital, Fukushima, Japan
| | | | - Masaharu Tsubokura
- Department of Internal Medicine, Minamisoma Municipal General Hospital, Fukushima, Japan
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan
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Murase K, Murase J, Machidori K, Mizuno K, Hayashi Y, Kohri K. Nationwide Increase in Cryptorchidism After the Fukushima Nuclear Accident. Urology 2018; 118:65-70. [PMID: 29751027 DOI: 10.1016/j.urology.2018.04.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/09/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To estimate the change of discharge rate after cryptorchidism surgery between pre- and postdisaster in Japan. Cryptorchidism cannot be diagnosed before birth and is not a factor that would influence a woman's decision to seek an abortion. Therefore, this disease is considered suitable for assessing how the Great East Japan Earthquake and the subsequent Fukushima Daiichi nuclear accident (2011) influenced congenital diseases. MATERIALS AND METHODS We obtained cryptorchidism discharge data collected over 6 years from hospitals that were included in an impact assessment survey of the Diagnosis Procedure Combination survey database in Japan and used these data to estimate the discharge rate after cryptorchidism surgery before and after the disaster. The 94 hospitals in Japan that participated in Diagnosis Procedure Combination system and had 10 or more discharges after cryptorchidism surgery within successive 6 years covering pre- and postdisaster period (FY2010-FY2015) were involved. The change in discharge rate between pre- and postdisaster was analyzed using a Bayesian generalized linear mixed model. RESULTS Nationwide, a 13.4% (95% credible interval 4.7%-23.0%) increase in discharge rates was estimated. The results of all sensitivity analyses were similar to the reported main results. CONCLUSION The discharge rate of cryptorchidism was increased nationwide. The rates of low-weight babies or preterm births, risk factors of cryptorchidism, were almost constant during the study period, and age distribution of the surgery was also not changed, which suggested that the other factors that associated with the disaster increased the incidence of cryptorchidism.
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Affiliation(s)
- Kaori Murase
- Nagoya City University Graduate School of Natural Sciences, Nagoya, Japan.
| | | | | | - Kentaro Mizuno
- Department of Pediatric Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yutaro Hayashi
- Department of Pediatric Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kenjiro Kohri
- Department of Nephro-Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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31
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Callen J, McKenna T. Saving Lives and Preventing Injuries From Unjustified Protective Actions-Method for Developing a Comprehensive Public Protective Action Strategy for a Severe NPP Emergency. HEALTH PHYSICS 2018; 114:511-526. [PMID: 29578899 DOI: 10.1097/hp.0000000000000801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
During the response to the Fukushima Daiichi nuclear power plant (FDNPP) emergency, about 50 patients died during or shortly after an evacuation when they were not provided with the needed medical support. In addition, it has been shown that during the FDNPP emergency there were increases in mortality rates among the elderly due to long-term dislocation as a result of evacuation and relocation orders and an inability to stay in areas where residents were advised to shelter for extended periods. These deaths occurred even though the possible radiation exposure to the public was too low to result in radiation-induced deaths, injuries, or a meaningful increase in the cancer rate, even if no protective actions had been taken. These problems are not unique to the FDNPP emergency and would be expected if the recommendations of many organizations were followed. Neither the International Commission on Radiological Protection (ICRP), the U.S. Nuclear Regulatory Commission (NRC) nor the U.S Environmental Protection Agency (EPA) adequately take into consideration in their recommendations and analysis the non-radiological health impacts, such as deaths and injuries, that could result from protective actions. Furthermore, ICRP, NRC, EPA, and the U.S. Department of Homeland Security (DHS) call for taking protective actions at doses lower than those resulting in meaningful adverse radiation-induced health effects and do not state the doses at which such effects would be seen. Consequently, it would be impossible for decision makers and the public to balance all the hazards both from radiation exposure and protective actions when deciding whether a protective action is justified. What is needed, as is presented in this paper, is a method for developing a comprehensive protective action strategy that allows the public, decision makers, and others who must work together to balance the radiological with the non-radiological health hazards posed by protective actions, and to counter the exaggerated fear of radiation exposure that could lead to taking unjustified protective actions and adverse psychological, sociological, and other effects.
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Zölzer F. Ethics of Radiological Protection—recent developments. J Public Health (Oxf) 2018; 42:183-187. [DOI: 10.1093/pubmed/fdy069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/13/2018] [Indexed: 12/15/2022] Open
Abstract
Abstract
The International Commission on Radiological Protection (ICRP) has recently reviewed the ethical foundations of its recommendations. The approach taken in its report is similar to principlism, i.e. the system of Beauchamp and Childress proposed in their ‘Principles of Biomedical Ethics.’ The commission identifies a number of ‘core values’ which have helped shape the evolution of the ICRP system of radiological protection, namely ‘Beneficence and non-maleficence’, ‘Prudence’, ‘Justice’ and ‘Dignity’. In addition, ‘procedural values’ are cited that are important for the system’s applications in practice, ‘Accountability’, ‘Transparency’ and ‘Inclusiveness (Stakeholder Participation)’. It is emphasized that these values are common to or at least acceptable for people from different cultural backgrounds, which for an endeavour as global in nature as radiological protection seems to be quite important and appropriate. Thus, the ICRP document on ‘Ethics of radiological protection’ could set a standard for other areas.
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Affiliation(s)
- F Zölzer
- Institute of Radiology, Toxicology, and Civil Protection, Faculty of Health and Social Sciences, University of South Bohemia, 37001 České Budějovice, Czech Republic
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Igarashi Y, Tagami T, Hagiwara J, Kanaya T, Kido N, Omura M, Tosa R, Yokota H. Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake. PLoS One 2018; 13:e0195684. [PMID: 29664960 PMCID: PMC5903607 DOI: 10.1371/journal.pone.0195684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 03/27/2018] [Indexed: 12/05/2022] Open
Abstract
Introduction After the accident of the Fukushima Daiichi nuclear power plant due to the Great East Japan Earthquake in March 2011, the Japanese government issued a mandatory evacuation order for people living within a 20 km radius of the nuclear power plant. The aim of the current study was to investigate long-term outcomes of these patients and identify factors related to mortality. Materials and methods Patients who were evacuated from hospitals near the Fukushima Daiichi nuclear power plant to the Aizu Chuo Hospital from 15 to 26 March, 2011 were included in this study. The following data were collected from medical records: age, sex, activities of daily life, hospital they were admitted in at the time of earthquake, distance between the facility and the nuclear power plant, reasons of evacuation and number of transfers. The patient outcomes were collected from medical records and/or investigated on the telephone in January 2012. Results A total of 97 patients (28 men and 69 women) were transferred from 10 hospitals via ambulances or buses. No patients died or experienced exacerbation during transfer. Median age of the patients was 86 years. Of the total, 36 patients were not able to obey commands, 44 were bed-ridden and 61 were unable to sustain themselves via oral intake of food. Among 86 patients who were followed-up, 41 (48%) died at the end of 2011. Multiple-regression analysis showed that non-oral intake [Hazard Ratio (HR): 6.07, 95% Confidence interval (CI): 1.94–19.0] and male sex [HR: 8.35, 95% CI: 2.14–32.5] had significant impact on mortality. Conclusion This study found that 48% of the evacuated patients died 9 months after the earthquake and they had significantly higher mortality rate than the nursing home residents. Non-oral intake and male sex had significant impact on mortality. These patients should be considered as especially vulnerable in case of hospital evacuation.
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Affiliation(s)
- Yutaka Igarashi
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
- * E-mail:
| | - Takashi Tagami
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
| | - Jun Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Takahiro Kanaya
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Norihiro Kido
- Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
| | - Mariko Omura
- Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Fukushima, Japan
| | - Ryoichi Tosa
- Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Fukushima, Japan
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
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Murakami M. Importance of risk comparison for individual and societal decision-making after the Fukushima disaster. JOURNAL OF RADIATION RESEARCH 2018; 59:ii23-ii30. [PMID: 29420739 PMCID: PMC5941137 DOI: 10.1093/jrr/rrx094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/07/2017] [Indexed: 05/14/2023]
Abstract
Risk comparison is essential for effective societal and individual decision-making. After the Fukushima disaster, studies compared radiation and other disaster-related risks to determine the effective prioritizing of measures for response. Evaluating the value of risk comparison information can enable effective risk communication. In this review, the value of risk comparison after the Fukushima disaster for societal and individual decision-making is discussed while clarifying the concept of radiation risk assessment at low doses. The objectives of radiation risk assessment are explained within a regulatory science framework, including the historical adoption of the linear non-threshold theory. An example of risk comparison (i.e. radiation risk versus evacuation-related risk in nursing homes) is used to discuss the prioritization of pre-disaster measures. The effective communication of risk information by authorities is discussed with respect to group-based and face-to-face approaches. Furthermore, future perspectives regarding radiation risk comparisons are discussed.
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Affiliation(s)
- Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, 960-1295, Japan
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Hasegawa M, Murakami M, Takebayashi Y, Suzuki S, Ohto H. Social Capital Enhanced Disaster Preparedness and Health Consultations after the 2011 Great East Japan Earthquake and Nuclear Power Station Accident. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29538320 PMCID: PMC5877061 DOI: 10.3390/ijerph15030516] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in the percentage of those who prepared for disasters and who utilized health checkups in Fukushima Prefecture, and identified the factors governing disaster preparedness and utilization of health checkups. We used the public opinion survey from 2011 to 2015 (n = 677–779 each year) on prefectural policies that is conducted every year by the Fukushima Prefecture government Public Consultation Unit. We found that the percentage of those who prepare for disasters decreased, while that for health checkups did not significantly change. With regard to disaster preparedness, experiences of disaster enhance disaster preparedness, while bonds with other local people help to maintain preparedness. For health checkups, familiarity with the welfare service was the most important factor governing such consultations. The findings suggest that social capital should be promoted in order to improve disaster preparedness. The findings also suggest that residents’ accessibility to medical and welfare services is also important in promoting the utilization of health checkups.
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Affiliation(s)
- Makoto Hasegawa
- Department of Health Risk Communication, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan.
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan.
| | - Yoshitake Takebayashi
- Department of Health Risk Communication, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan.
| | - Satoshi Suzuki
- Fukushima Prefectural Centre for Environmental Creation, 2-10 Fukasaku, Miharu-machi, Tamura-gun, Fukushima 963-7700, Japan.
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan.
- Department of Advanced Cancer Immunotherapy, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan.
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Ozaki A, Tsubokura M. Radiation Oncology and Related Oncology Fields in the Face of the 2011 “Triple Disaster” in Fukushima, Japan. Int J Radiat Oncol Biol Phys 2018; 100:845-848. [DOI: 10.1016/j.ijrobp.2017.12.285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/01/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
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Effect of Radiological Countermeasures on Subjective Well-Being and Radiation Anxiety after the 2011 Disaster: The Fukushima Health Management Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010124. [PMID: 29329263 PMCID: PMC5800223 DOI: 10.3390/ijerph15010124] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 11/16/2022]
Abstract
After the Fukushima Daiichi Nuclear Power Station accident in 2011, concerns about radiation exposure and decline in subjective well-being have been reported. To tackle these problems, various countermeasures in relation to radiation have been implemented. In this study, we comprehensively evaluated the effects of radiological countermeasures on subjective well-being (e.g., satisfaction with life (SWL) and emotional well-being) and radiation anxiety, through a questionnaire survey targeting Fukushima residents (N = 1023). Propensity scores matching was applied to evaluate significant effects of radiological countermeasures on subjective well-being and radiation anxiety. Among the radiological countermeasures, thyroid examination, whole body counter, and air dose monitoring showed the highest proportions of participation, utilization, and useful evaluation, suggesting a high degree of public attention focused on these countermeasures. The basic survey was associated with significant increases in SWL and self-rated health (SH). Thyroid examination was significantly associated with not only a reduction in radiation anxiety but also an increase of emotional stress, suggesting the importance of careful design of system and detailed communication. Food inspection was associated with deterioration in SH. Those who utilized explanatory meetings showed increases in sadness, worry, and radiation anxiety, indicating that additional attention is required of the experts and authorities involved in explanatory meetings.
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Toda H, Nomura S, Gilmour S, Tsubokura M, Oikawa T, Lee K, Kiyabu GY, Shibuya K. Assessment of medium-term cardiovascular disease risk after Japan's 2011 Fukushima Daiichi nuclear accident: a retrospective analysis. BMJ Open 2017; 7:e018502. [PMID: 29275343 PMCID: PMC5770825 DOI: 10.1136/bmjopen-2017-018502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the medium-term indirect impact of the 2011 Fukushima Daiichi nuclear accident on cardiovascular disease (CVD) risks and to identify whether risk factors for CVD changed after the accident. PARTICIPANTS Residents aged 40 years and over participating in annual public health check-ups from 2009 to 2012, administered by Minamisoma city, located about 10 to 40 km from the Fukushima Daiichi nuclear plant. METHODS The sex-specific Framingham CVD risk score was considered as the outcome measure and was compared before (2009-2010) and after the accident (2011-2012). A multivariate regression analysis was employed to evaluate risk factors for CVD. RESULTS Data from 563 individuals (60.2% women) aged 40 to 74 years who participated in the check-ups throughout the study period was analysed. After adjusting for covariates, no statistically significant change was identified in the CVD risk score postaccident in both sexes, which may suggest no obvious medium-term health impact of the Fukushima nuclear accident on CVD risk. The risk factors for CVD and their magnitude and direction (positive/negative) did not change after the accident. CONCLUSIONS There was no obvious increase in CVD risks in Minamisoma city, which may indicate successful management of health risks associated with CVD in the study sample.
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Affiliation(s)
- Haruka Toda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Stuart Gilmour
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaharu Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Japan
| | - Tomoyoshi Oikawa
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Japan
| | - Kiwon Lee
- International Center for AIDS Care and Treatment Program (ICAP), Columbia University, New York City, New York, USA
| | - Grace Y Kiyabu
- Health Economics and Outcomes Research, Creativ-Ceutical K.K, Tokyo, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Ozaki A, Tsubokura M, Leppold C, Sawano T, Tsukada M, Nemoto T, Kosugi K, Nishikawa Y, Kato S, Ohira H. The importance of family caregiving to achieving palliative care at home: a case report of end-of-life breast cancer in an area struck by the 2011 Fukushima nuclear crisis: A case report. Medicine (Baltimore) 2017; 96:e8721. [PMID: 29145313 PMCID: PMC5704858 DOI: 10.1097/md.0000000000008721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The primary setting of palliative care has shifted from inpatient care to patients' residences. Family caregiving is essential for patients with life-limiting illnesses to receive palliative care at home, however little information is available regarding potential interventions to achieve palliative homecare for those without sufficient support from family members in various settings, including disasters. PATIENT CONCERNS In March 2011, Fukushima, Japan experienced an earthquake, tsunami and nuclear disaster. In August 2015, a 59-year-old Japanese female presented to our hospital, located 23 km north of Fukushima Daiichi Nuclear Power Plant, with a right breast ulcer. DIAGNOSES The patient was diagnosed with stage IV breast cancer. INTERVENTIONS The patient's general condition gradually worsened despite a one-year course of chemotherapy, and she became bedridden after a fall in October 2016. Although the patient wished to receive palliative homecare, this appeared challenging to achieve because she resided alone in a temporary housing shelter. Although she originally lived with her family in Odaka District, Fukushima, she relocated outside of the city following evacuation orders after the disaster. The evacuation orders for Odaka District were still in effect when she returned to the city alone in 2014. We contacted her sister who moved apart from her during the evacuation, and explained the necessity of family caregiving to enable her palliative homecare. OUTCOMES The sister decided to move back to their original residence in Odaka District and live with the patient again. The patient successfully spent her end-of-life period and died at home. LESSONS Health care providers and community health workers may need to take a pro-active approach to communicating with family members to draw informal support to enable patients' end-of-life management according to their values and preferences. This is a lesson which may be applicable to broader healthcare settings beyond cancer, or disaster contexts, considering that population ageing and social isolation may continue to advance worldwide.
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Affiliation(s)
- Akihiko Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Masaharu Tsubokura
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - Claire Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Manabu Tsukada
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Tsuyoshi Nemoto
- Department of Home Medical Care, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Care, Kawasaki Municipal Ida Hospital, Kawasaki, Kanagawa, Japan
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Shigeaki Kato
- Research Institute of Innovative Medicine (RIIM), Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Hiromichi Ohira
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Murakami M, Tsubokura M, Ono K, Nomura S, Oikawa T. Additional risk of diabetes exceeds the increased risk of cancer caused by radiation exposure after the Fukushima disaster. PLoS One 2017; 12:e0185259. [PMID: 28957385 PMCID: PMC5619752 DOI: 10.1371/journal.pone.0185259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 09/08/2017] [Indexed: 11/19/2022] Open
Abstract
The 2011 Fukushima disaster led to increases in multiple risks (e.g., lifestyle diseases and radiation exposure) and fear among the public. Here, we assessed the additional risks of cancer caused by radiation and diabetes related to the disaster and the cost-effectiveness of countermeasures against these conditions. Our study included residents of the cities of Minamisoma and Soma (10-40 km and 35-50 km north of the Fukushima Daiichi (N° 1) Nuclear Power Station, respectively). We used the loss of life expectancy (LLE) as an indicator to compare risks between radiation exposure and diabetes. We also estimated the cost-effectiveness of radiation-related countermeasures, including restricted food distribution, decontamination, and whole-body counter tests and interventions. Metformin therapy was selected as a representative management for diabetes. The diabetes-related LLEs among residents were 4.1 (95% confidence interval: 1.4-6.8) ×10-2 years for the whole population and 8.0 (2.7-13.2) ×10-2 years for 40s to 70s in a scenario that considered the additional incidence of diabetes during the first 10 years. The cancer-related LLEs caused by lifetime exposure to radiation were 0.69 (2.5-97.5 percentile: 0.61-0.79) ×10-2 years for the whole population and 0.24 (0.20-0.29) ×10-2 years for 40s to 70s. The diabetes-related LLEs among residents in the above-mentioned scenario were 5.9-fold and 33-fold higher than those attributed to average radiation among the whole population and among the 40s to 70s age groups, respectively. The costs per life-years saved of the radiation countermeasures (i.e., restricted food distribution, decontamination, and whole-body counter tests and interventions) were >1 to >4 orders of magnitude higher than those of general heath checkups and conventional management for diabetes. Our findings indicate that countermeasures to mitigate diabetes are warranted. Policy-makers' and individuals' understanding of multiple risks after any disaster will be essential to saving the lives of victims.
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Affiliation(s)
- Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, 2-54-6 Takami, Haramachi, Minamisoma, Fukushima, Japan
- Department of Radiation Protection, Soma Central Hospital, 3-5-18 Okinouchi, Soma, Fukushima, Japan
| | - Kyoko Ono
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology (AIST), 16–1, Onogawa, Tsukuba, Ibaraki, Japan
| | - Shuhei Nomura
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, United Kingdom
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, Japan
| | - Tomoyoshi Oikawa
- Department of Radiation Protection, Minamisoma Municipal General Hospital, 2-54-6 Takami, Haramachi, Minamisoma, Fukushima, Japan
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Morita T, Nomura S, Tsubokura M, Leppold C, Gilmour S, Ochi S, Ozaki A, Shimada Y, Yamamoto K, Inoue M, Kato S, Shibuya K, Kami M. Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study. J Epidemiol Community Health 2017; 71:974-980. [DOI: 10.1136/jech-2016-208652] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 11/04/2022]
Abstract
BackgroundEvidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan.MethodsThe mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year.ResultsThere were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006–2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44).ConclusionsIndirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster.
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Ozaki A, Nomura S, Leppold C, Tsubokura M, Tanimoto T, Yokota T, Saji S, Sawano T, Tsukada M, Morita T, Ochi S, Kato S, Kami M, Nemoto T, Kanazawa Y, Ohira H. Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study. BMC Cancer 2017. [PMID: 28629330 PMCID: PMC5477136 DOI: 10.1186/s12885-017-3412-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Little information is available concerning how patient delay may be affected by mass disasters. The main objectives of the present study are to identify whether there was a post-disaster increase in the risk of experiencing patient delay among breast cancer patients in an area affected by the 2011 triple disaster in Fukushima, Japan, and to elucidate factors associated with post-disaster patient delay. Sociodemographic factors (age, employment status, cohabitant status and evacuation status), health characteristics, and health access- and disaster-related factors were specifically considered. Methods Records of symptomatic breast cancer patients diagnosed from 2005 to 2016 were retrospectively reviewed to calculate risk ratios (RRs) for patient delay in every year post-disaster compared with the pre-disaster baseline. Total and excessive patient delays were respectively defined as three months or more and twelve months or more from symptom recognition to first medical consultation. Logistic regression analysis was conducted for pre- and post-disaster patient delay in order to reveal any factors potentially associated with patient delay, and changes after the disaster. Results Two hundred nineteen breast cancer patients (122 pre-disaster and 97 post-disaster) were included. After adjustments for age, significant post-disaster increases in RRs of experiencing both total (RR: 1.66, 95% Confidence Interval (CI): 1.02–2.70, p < 0.05) and excessive patient delay (RR: 4.49, 95% CI: 1.73–11.65, p < 0.01) were observed. The RRs for total patient delay peaked in the fourth year post-disaster, and significant increases in the risk of excessive patient delay were observed in the second, fourth, and fifth years post-disaster, with more than five times the risk observed pre-disaster. A family history of any cancer was the only factor significantly associated with total patient delay post-disaster (odds ratio: 0.38, 95% CI: 0.15–0.95, p < 0.05), while there were no variables associated with delay pre-disaster. Conclusions The triple disaster in Fukushima appears to have led to an increased risk of patient delay among breast cancer patients, and this trend has continued for five years following the disaster. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3412-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Akihiko Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan. .,Department of Epidemiology and Biostatistics, Teikyo University Graduate School of Public Health, Minamisoma, Tokyo, 173-8605, Japan.
| | - Shuhei Nomura
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Minamisoma, Tokyo, 113-0033, Japan
| | - Claire Leppold
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - Masaharu Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, 972-8322, Japan
| | - Takeru Yokota
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan
| | - Manabu Tsukada
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan
| | - Tomohiro Morita
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, 976-0016, Japan
| | - Sae Ochi
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, 976-0016, Japan
| | - Shigeaki Kato
- Research Institute of Innovative Medicine, Jyoban Hospital of Tokiwakai Group, Iwaki, Fukushima, 972-8322, Japan
| | - Masahiro Kami
- Medical Governance Research Institute, Minato-ku, Tokyo, 108-0074, Japan
| | - Tsuyoshi Nemoto
- Department of Home Medical Care, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - Yukio Kanazawa
- Department of Gastroenterology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, 975-0033, Japan
| | - Hiromichi Ohira
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi, Minamisoma, Fukushima, 975-0033, Japan
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Effect of Residence in Temporary Housing After the Great East Japan Earthquake on the Physical Activity and Quality of Life of Older Survivors. Disaster Med Public Health Prep 2017. [PMID: 28625213 DOI: 10.1017/dmp.2017.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to compare the physical activity level and health-related quality of life (HRQOL) between older survivors residing in temporary housing after the Great East Japan Earthquake (GEJE; temporary housing group) and older individuals residing in their own homes (control group) and to clarify whether mobility function and muscle strength were correlated with physical activity among older temporary housing residents. METHODS Subjects were recruited to the temporary housing group (n=64, 19 men and 45 women) or control group (n=64, 33 men and 31 women) according to their residence. Physical activity was assessed by the number of walking steps determined by using a triaxial accelerometer, mobility function by the Timed Up and Go test, muscle strength by the grasping power test, and HRQOL by the Medical Outcome Study 36-Item Short Form Survey v2. RESULTS In the temporary housing group, reduced physical activity and correlation between physical activity and mobility function in men, and muscle strength in both men and women, were observed. There was no significant difference in HRQOL between groups except for bodily pain in women. CONCLUSION Support for older evacuees should focus on maintaining their physical activity level as well as on HRQOL to avoid deterioration of health in these survivors. (Disaster Med Public Health Preparedness. 2017;11:701-710).
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Ishikawa K. The predicament of elderly disaster victims: 6 years after the Great East Japan Earthquake and Fukushima nuclear power plant accident. Nihon Ronen Igakkai Zasshi 2017; 54:129-135. [PMID: 28592732 DOI: 10.3143/geriatrics.54.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Leppold C, Nomura S, Sawano T, Ozaki A, Tsubokura M, Hill S, Kanazawa Y, Anbe H. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050542. [PMID: 28534840 PMCID: PMC5451992 DOI: 10.3390/ijerph14050542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/08/2017] [Accepted: 05/16/2017] [Indexed: 12/19/2022]
Abstract
Changes in population birth outcomes, including increases in low birthweight or preterm births, have been documented after natural and manmade disasters. However, information is limited following the 2011 Fukushima Daiichi Nuclear Power Plant Disaster. In this study, we assessed whether there were long-term changes in birth outcomes post-disaster, compared to pre-disaster data, and whether residential area and food purchasing patterns, as proxy measurements of evacuation and radiation-related anxiety, were associated with post-disaster birth outcomes. Maternal and perinatal data were retrospectively collected for all live singleton births at a public hospital, located 23 km from the power plant, from 2008 to 2015. Proportions of low birthweight (<2500 g at birth) and preterm births (<37 weeks gestation at birth) were compared pre- and post-disaster, and regression models were conducted to assess for associations between these outcomes and evacuation and food avoidance. A total of 1101 live singleton births were included. There were no increased proportions of low birthweight or preterm births in any year after the disaster (merged post-disaster risk ratio of low birthweight birth: 0.98, 95% confidence interval (CI): 0.64–1.51; and preterm birth: 0.68, 95% CI: 0.38–1.21). No significant associations between birth outcomes and residential area or food purchasing patterns were identified, after adjustment for covariates. In conclusion, no changes in birth outcomes were found in this institution-based investigation after the Fukushima disaster. Further research is needed on the pathways that may exacerbate or reduce disaster effects on maternal and perinatal health.
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Affiliation(s)
- Claire Leppold
- Global Public Health Unit, School of Social and Political Science, University of Edinburgh, George Square, Edinburgh EH8 9LD, UK.
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Akihiko Ozaki
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Masaharu Tsubokura
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Sarah Hill
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Yukio Kanazawa
- Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
| | - Hiroshi Anbe
- Department of Obstetrics and Gynecology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima 975-0033, Japan.
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Murakami M, Sato A, Matsui S, Goto A, Kumagai A, Tsubokura M, Orita M, Takamura N, Kuroda Y, Ochi S. Communicating With Residents About Risks Following the Fukushima Nuclear Accident. Asia Pac J Public Health 2017; 29:74S-89S. [DOI: 10.1177/1010539516681841] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Fukushima nuclear accident in March 2011 posed major threats to public health. In response, medical professionals have tried to communicate the risks to residents. To investigate forms of risk communication and to share lessons learned, we reviewed medical professionals’ activities in Fukushima Prefecture from the prefectural level to the individual level: public communication through Fukushima Health Management Surveys, a Yorozu (“general”) health consultation project, communications of radiological conditions and health promotion in Iitate and Kawauchi villages, dialogues based on whole-body counter, and science communications through online media. The activities generally started with radiation risks, mainly through group-based discussions, but gradually shifted to face-to-face communications to address comprehensive health risks to individuals and well-being. The activities were intended to support residents’ decisions and to promote public health in a participatory manner. This article highlights the need for a systematic evaluation of ongoing risk communication practices, and a wider application of successful approaches for Fukushima recovery and for better preparedness for future disasters.
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Affiliation(s)
| | - Akiko Sato
- United Nations University Institute for the Advanced Study of Sustainability, Tokyo, Japan
| | | | - Aya Goto
- Fukushima Medical University, Fukushima, Japan
| | | | - Masaharu Tsubokura
- Soma Central Hospital, Fukushima, Japan
- Minamisoma Municipal General Hospital, Fukushima, Japan
| | | | | | | | - Sae Ochi
- Soma Central Hospital, Fukushima, Japan
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Ohto H, Yasumura S, Maeda M, Kainuma H, Fujimori K, Nollet KE. From Devastation to Recovery and Revival in the Aftermath of Fukushima’s Nuclear Power Plants Accident. Asia Pac J Public Health 2017; 29:10S-17S. [DOI: 10.1177/1010539516675700] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Japan’s earthquake, tsunami, and subsequent Fukushima nuclear power plant accident in March 2011 forced the evacuation of 185 000 residents. Psychological and social impacts exacerbated by long-term evacuation and widespread rumors have influenced residents’ physical and mental health, despite the fact that no direct fatalities occurred from radiation exposure. However, during the 5 years following the accident, steady recovery in industrial and economic activity has lessened previously widespread, deeply rooted stigma and self-stigma among a significant number of affected victims. More than 21 000 of 62 800 people who evacuated from Fukushima are gradually returning, and concurrently, Fukushima’s economic and social recovery are progressing, as can be seen from remarkable increases in residential construction, recovering agricultural production, job growth, and industrial output. Although post-disaster interventions such as seminars and dialogues with residents are credited with building resilience, a significant proportion of people in the area have depressive tendencies and loss of purpose.
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Decontamination Work and the Long-term Increase in Hospital Visits for Hymenoptera Stings Following the Fukushima Nuclear Disaster. Disaster Med Public Health Prep 2017; 11:545-551. [DOI: 10.1017/dmp.2016.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveAnimals, including arthropods, are one health threat that can be affected by disasters. This institution-based study aimed to assess trends in Hymenoptera stings following the 2011 Fukushima nuclear disaster.MethodsWe reviewed the medical records of patients with hymenopteran stings who visited Minamisoma Municipal General Hospital, located 23 km from Fukushima Daiichi Nuclear Power Plant, from March 2005 to March 2016. Patient and sting characteristics of post-disaster patients were examined, and the annual incidence of hospital visits for hymenopteran stings was compared with the pre-disaster baseline, calculating an incidence rate ratio (IRR) for each year.ResultsWe identified 152 pre-disaster patients (2005-2011) and 222 post-disaster patients (2011-2016). In the post-disaster period, 160 males (72.1%) were identified, with a median age of 59 years (range: 2-89 years). A total of 45 patients (20.3%) were decontamination workers. Post-disaster increases were found in the IRR for hymenopteran stings, peaking first in 2011 (IRR: 2.8; 95% confidence interval [CI]: 1.9-4.2) and later in 2014 (IRR: 3.2; 95% CI: 2.4-4.3) and 2015 (IRR 3.3; 95% CI: 2.5-4.4).ConclusionsLong-term increases were found in the IRR of hospital visits for hymenopteran stings in an institution affected by the Fukushima nuclear disaster. Decontamination workers appear to have been particularly affected by this phenomenon. Better disaster field worker monitoring and education about potential environmental health hazards may help to identify and prevent worker exposure to insect stings and other vectors in these settings. (Disaster Med Public Health Preparedness. 2017;11:545–551)
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Liland A. ICRP Fukushima dialogue seminars: joint learning at many levels. Ann ICRP 2016; 45:92-98. [PMID: 28952351 DOI: 10.1177/0146645316680582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Norwegian Radiation Protection Authority and representatives from the CERAD Centre of Excellence participated at the majority of the International Commission on Radiological Protection dialogue seminars in Fukushima between 2011 and 2015. The open and sharing structure of the seminars contributed to an unprecedented understanding of the challenges faced by the general public affected by radioactive contamination due to an accident at a nuclear power plant. Most importantly by presentations from people in Fukushima, but also by presentations from lay people in Norway and Belarus who shared their experiences from the Chernobyl accident at several seminars. The seminars created new friendships and connections, which inter alia led to several exchange visits between affected people in Norway and Japan where worries and experiences could be shared in an open and reflective manner. The mix of actors (various experts, authorities, local populations) created joint learning across sectors and levels, representing an invaluable source of knowledge for organisations involved in nuclear and radiological emergency preparedness and planning.
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Affiliation(s)
- A Liland
- Norwegian Radiation Protection Authority and CERAD Centre of Excellence, P.O. Box 55, No-1332 Østerås, Norway
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Abstract
Various reports have shown that internal and external exposure levels of local residents after the accident at Fukushima Daiichi nuclear power plant were very low. However, there are serious postdisaster health effects in the form of increased prevalence of diabetes and other chronic conditions. Stress, changes in the social environment and in living arrangements, and disruption in healthcare support provided by a network of people have resulted in increasing the cost of care and changing patients' behaviour, such as delay in visiting a hospital. In addition to radiation protection, it is necessary, when looking after the health of Fukushima residents, to focus on human networking, social infrastructure, and protection of culture and history that are intangible, and not to overlook their roles in health.
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Affiliation(s)
- M Tsubokura
- Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi-ku, Minamisoma, Fukushima Prefecture, Japan
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