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

Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence

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.

Lifestyle behaviour patterns in the prevention of type 2 diabetes mellitus: the Fukushima Health Database 2015-2020

OBJECTIVES

Lifestyle behaviours associated with the incidence of type 2 diabetes mellitus (T2DM) need further clarification using health insurance data.

STUDY DESIGN

This is a cohort study.

METHODS

In 2015, 193,246 participants aged 40-74 years attended the specific health checkups and were observed up to 2020 in Fukushima, Japan. Using the principal component analysis, we identified two patterns from ten lifestyle behaviour questions, namely, the "diet-smoking" pattern (including smoking, alcohol drinking, skipping breakfast, eating fast, late dinner, and snacking) and the "physical activity-sleep" pattern (including physical exercise, walking equivalent activity, walking fast, and sufficient sleep). Then, individual pattern scores were calculated; the higher the scores, the healthier the behaviours.

RESULTS

The accumulative incidence rate of T2DM was 630.5 in men and 391.9 in women per 100,000 person-years in an average of 4 years of follow-up. Adjusted for the demographic and cardiometabolic factors at the baseline, the hazard ratio (95% confidence interval) of the highest versus lowest quartile scores of the "diet-smoking" pattern for T2DM risk was 0.82 (0.72, 0.92; P for trend = 0.002) in men and 0.87 (0.76, 1·00; P for trend = 0.034) in women; that of the "physical activity-sleep" pattern was 0.92 (0.82, 1·04; P for trend = 0.0996) in men and 0.92 (0.80, 1·06; P for trend = 0.372) in women. The "physical activity-sleep" pattern showed a significant inverse association in non-overweight men.

CONCLUSIONS

Lifestyle behaviour associated with a healthy diet and lack of smoking may significantly lower the risk of T2DM in middle-aged Japanese adults.

Chlorinated persistent organic pollutants in human breast milk in the Miyagi Prefecture disaster-affected area 1 year after the Great East Japan Earthquake of 2011

BACKGROUND

In the Great East Japan Earthquake of 11 March 2011, an earthquake and accompanying tsunami struck the Tohoku region of northeastern Japan. Buildings collapsed and the tsunami spread waste, including hazardous materials. This study aimed to determine the concentrations of persistent organic pollutants (POPs) in the breast milk of mothers living in the disaster-affected area of Sendai 1 year after the earthquake. Temporal trends in the POPs concentrations were evaluated by comparison with previous studies.

METHODS

One hundred breast milk samples were obtained from lactating mothers at a hospital in Sendai in 2012. The results were compared with those from other years to examine whether there were changes in the POPs concentrations after the earthquake. We measured polychlorinated biphenyls (PCBs) and organochlorine pesticides, such as chlordanes, using gas chromatography-mass spectrometer (GC-MS) with negative chemical ionization, and dichlorodiphenyl trichloroethane (DDT) and its metabolites using GC-MS with electron impact ionization.

RESULTS

The mean total PCBs (11 congeners), total chlordane, and total DDT concentrations were 76.2 ng/g lipid, 39.8 ng/g lipid, and 73.5 ng/g lipid, respectively. For the samples collected in 2012, the concentrations of POPs in breast milk showed minimal changes compared with results from previous years for samples collected at the same hospital in Sendai.

CONCLUSIONS

Our study demonstrates that 1 year after the earthquake and tsunami, the concentrations of chlorinated POPs in breast milk had not changed substantially.

Psychological and traumatic stress and the risk of developing diabetes and psychiatric disorders after a disaster-relief mission: An eight-year longitudinal study of Japan Maritime Self-Defense Force personnel dispatched for the 2011 Great East Japan Earthquake disaster-relief mission

The Great East Japan Earthquake caused triple disasters-the earthquake itself, tsunamis, and nuclear leakage. Japan Maritime Self-Defense Force (JMSDF) personnel engaged in disaster-relief suffered various degrees of psychological stress, which is associated with psychiatric as well as physical disorders, such as diabetes. This study aimed to assess the effect of mission-related stress on the development of diabetes and psychiatric disorders in these personnel using JMSDF annual physical check-up data from 2010 to 2018 and Impact of Events Scale-Revised (IES-R) and Kessler Psychological Distress Scale (K-10) questionnaire data. Cox proportional hazard models were used to assess the hazard ratios (HRs) of developing diabetes and psychiatric disorders in the dispatched (N = 3686) vs. non-dispatched (N = 13,953) groups and high IES-R (score ≥25) vs. low IES-R score and high K-10 (score ≥25) vs. low K-10 score subgroups. We found a significantly higher HR of developing diabetes in the high IES-R score subgroup (2.02; 95% confidence interval [CI], 1.08-3.80). However, the HRs were not significant when comparing dispatched vs. non-dispatched groups and high vs. low K-10 score subgroups. Although the HR of developing psychiatric disorders was significantly lower in the dispatched group (0.64; 95% CI, 0.48-0.84), it was significantly higher in the high IES-R (7.95; 95% CI, 3.38-18.74) and high K-10 (8.76; 95% CI, 4.34-17.68) score subgroups. Thus, this study indicates the importance of paying closer attention to the risk of diabetes and psychiatric disorders in individuals with high IES-R or K-10 scores after disaster-relief activities.

Cesium in Biology, Pancreatic Cancer, and Controversy in High and Low Radiation Exposure Damage-Scientific, Environmental, Geopolitical, and Economic Aspects

Radionuclide contamination in terrestrial ecosystems has reached a dangerous level. The major artificial radionuclide present in the environment is cesium-137 (137-Cs). In humans, animals, and plants cesium ion (Cs+) behaves like potassium ion (K+) and it is localized mainly inside the cells. Pancreas and salivary glands secrete Cs in the intestine thus eliminating about 14% of ingested Cs with the feces, the remaining 86% is eliminated by the kidney with the urine. Ingested radiocesium can also cause in humans several cases of pancreatitis with secondary diabetes (type 3c), which are both on the rise in the world. The Author studied the correlation between the geographical map of mortality from pancreatic cancer (PC) and the map of nuclear plant accidents, atomic bomb testing, and radioactive fallout. The worldwide death rate of PC is increasing, but the exact cause is still not known. Published data in medical literature at World, European and Italian levels are reviewed and compared. 137-Cs, with a half-life of about 30 years, is still present in the environment for about 300-600 years. Autoradiographic studies in mice have shown that 137-Cs is concentrated in greater quantity in the pancreas, particularly in exocrine cells, where most malignant PCs originate. Some methods of radiocesium removal and PC prevention are also suggested. But there is still a persistent, and not entirely disinterested, the controversy between damage from high and low exposure to ionizing radiations.

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

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.

Absence of Detectable Radionuclides in Breast Milk in Sendai, Japan in 2012 Even by High-Sensitivity Determination: Estimated Dose among Infants after the Fukushima Nuclear Disaster

The aim of this study was to estimate radionuclide levels in breast milk and the transferred dose to their infants in Sendai (100 km from Fukushima), Japan after the 2011 Fukushima nuclear disaster. Radionuclide concentrations were analyzed in 101 specimens of breast milk collected in 2012. Median values for minimum detectable activities were 0.39, 0.34, 1.1, 1.89, and 17.1 Bq/kg for ¹³⁷Cs, ¹³⁴Cs, ¹³¹I, ^110mAg, and ⁴⁰K, respectively. Only radionuclides from ⁴⁰K were detected. To estimate potential exposure and radiocesium dose, we assumed that the samples contained each minimum detectable activity level. The mean minimum detectable activity concentrations (standard deviation) of ¹³⁷Cs and ¹³⁴Cs were 0.42 (0.15) and 0.37 (0.14) Bq/kg, respectively. Means of estimated dietary intakes of ¹³⁷Cs and ¹³⁴Cs among infants were 0.35 (0.12) and 0.31 (0.11) Bq/day, respectively. The committed effective doses of radiocesium in infants aged 3 and 12 months via breastmilk were estimated at 5.6 (2.1) and 3.3 (1.2) μSv/year, respectively. Dietary intakes of ¹³⁷Cs and ¹³⁴Cs in breastfeeding mothers were back-calculated at 1.9 (0.71) and 1.7 (0.65) Bq/day, respectively. The study verified no discernible exposure to radionuclides among infants. The most conservative estimates were below the Japanese internal exposure limit of 1 mSv/year.