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Kyozuka H, Ohhira T, Murata T, Yasuda S, Ishii K, Yasumura S, Fujimori K, Ohto H, Kamiya K. Eight-Year Trends in the Effect of the Great East Japan Earthquake on Obstetrics Outcomes: A Study from the Fukushima Health Management Survey. Life (Basel) 2023; 13:1702. [PMID: 37629559 PMCID: PMC10455406 DOI: 10.3390/life13081702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
Information regarding the longitudinal effects of natural/environmental disasters on obstetrics outcomes is limited. This study aimed to analyze the longitudinal changes in obstetrics outcomes over 8 years after the Great East Japan Earthquake and the Fukushima power plant accident. We used data from the first 8 years of the Pregnancy and Birth Survey by the Fukushima prefectural government, launched in 2011. We compared data on obstetrics outcomes by year and divided Fukushima Prefecture into six districts based on administrative districts. Longitudinal changes in the occurrence of preterm birth before 37 gestational weeks, low birth weight, and anomalies in newborns were accessed using the Mantel-Haenszel test for trends in all six districts. Overall, 57,537 participants were included. In 8 years, maternal age, conception rate after sterility treatment, and cesarean section delivery incidence increased. Although significant differences were observed in preterm birth and low birth weight occurrence among districts, there was no significant trend in the occurrence of preterm birth, low birth weight, and anomalies in newborns in all six districts of Fukushima Prefecture. The Great East Japan Earthquake and Fukushima power plant accident were associated with increased cesarean section delivery incidence but had no significant adverse effects on obstetrics outcomes.
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Affiliation(s)
- Hyo Kyozuka
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tetsuya Ohhira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Kayoko Ishii
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima 960-1295, Japan
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Winters TA, Cassatt DR, Harrison-Peters JR, Hollingsworth BA, Rios CI, Satyamitra MM, Taliaferro LP, DiCarlo AL. Considerations of Medical Preparedness to Assess and Treat Various Populations During a Radiation Public Health Emergency. Radiat Res 2023; 199:301-318. [PMID: 36656560 PMCID: PMC10120400 DOI: 10.1667/rade-22-00148.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/21/2022] [Indexed: 01/20/2023]
Abstract
During a radiological or nuclear public health emergency, given the heterogeneity of civilian populations, it is incumbent on medical response planners to understand and prepare for a potentially high degree of interindividual variability in the biological effects of radiation exposure. A part of advanced planning should include a comprehensive approach, in which the range of possible human responses in relation to the type of radiation expected from an incident has been thoughtfully considered. Although there are several reports addressing the radiation response for special populations (as compared to the standard 18-45-year-old male), the current review surveys published literature to assess the level of consideration given to differences in acute radiation responses in certain sub-groups. The authors attempt to bring clarity to the complex nature of human biology in the context of radiation to facilitate a path forward for radiation medical countermeasure (MCM) development that may be appropriate and effective in special populations. Consequently, the focus is on the medical (as opposed to logistical) aspects of preparedness and response. Populations identified for consideration include obstetric, pediatric, geriatric, males, females, individuals of different race/ethnicity, and people with comorbidities. Relevant animal models, biomarkers of radiation injury, and MCMs are highlighted, in addition to underscoring gaps in knowledge and the need for consistent and early inclusion of these populations in research. The inclusion of special populations in preclinical and clinical studies is essential to address shortcomings and is an important consideration for radiation public health emergency response planning. Pursuing this goal will benefit the population at large by considering those at greatest risk of health consequences after a radiological or nuclear mass casualty incident.
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Affiliation(s)
- Thomas A Winters
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - David R Cassatt
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Jenna R Harrison-Peters
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Brynn A Hollingsworth
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Carmen I Rios
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Merriline M Satyamitra
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Lanyn P Taliaferro
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Andrea L DiCarlo
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
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Kyozuka H, Murata T, Yasuda S, Ishii K, Fujimori K, Goto A, Yasumura S, Ota M, Hata K, Suzuki K, Nakai A, Ohira T, Ohto H, Kamiya K. The Effects of the Great East Japan Earthquake on Perinatal Outcomes: Results of the Pregnancy and Birth Survey in the Fukushima Health Management Survey. J Epidemiol 2022; 32:S57-S63. [PMID: 36464301 PMCID: PMC9703925 DOI: 10.2188/jea.je20210444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
There are limited studies on the long-term effects of natural/environmental disasters, especially nuclear disasters, on obstetric outcomes. This study aimed to review the results of perinatal outcomes immediately after the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi Nuclear Power Plant accident, as well as their long-term trends over 8 years, in the Fukushima Health Management Survey. The annual population-based Pregnancy and Birth Survey is conducted as part of the Fukushima Health Management Survey. The Fukushima Prefecture government launched it to assess the health conditions of pregnant women and their neonates after the GEJE. The self-reported questionnaire was sent to 115,976 pregnant women by mail from January 2012, with 58,344 women responding to the questionnaire (50.3% response rate). Pregnancy complications, such as gestational hypertension, respiratory diseases, and mental disorders, increased in some women who were pregnant at the time of the earthquake and immediately after the earthquake. However, the direct effects on newborns, such as preterm birth, low birth weight, and congenital anomalies, were not immediately clear after the earthquake. Although there were significant differences in the occurrence of preterm birth and low birth weight among the districts, there was no change in the occurrences of preterm birth, low birth weight, or anomalies in newborns in Fukushima Prefecture from the fiscal year 2011 to the fiscal year 2018. Therefore, the long-term effects of the post-disaster radiation accident on perinatal outcomes are considered to be very small.
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Affiliation(s)
- Hyo Kyozuka
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kayoko Ishii
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Aya Goto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, 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
| | - Misao Ota
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Midwifery and Maternal Nursing, Fukushima Medical University School of Nursing, Fukushima, Japan
| | - Kenichi Hata
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Fukushima Society of Obstetrics and Gynecology, Fukushima, Japan
| | - Kohta Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Akihito Nakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Nippon Medical School Tamanagayama Hospital, Tokyo, Japan
| | - 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
| | - 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
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Allgood KL, Mack JA, Novak NL, Abdou CM, Fleischer NL, Needham BL. Vicarious structural racism and infant health disparities in Michigan: The Flint Water Crisis. Front Public Health 2022; 10:954896. [PMID: 36148337 PMCID: PMC9486078 DOI: 10.3389/fpubh.2022.954896] [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: 05/27/2022] [Accepted: 08/12/2022] [Indexed: 01/24/2023] Open
Abstract
Building on nascent literature examining the health-related effects of vicarious structural racism, we examined indirect exposure to the Flint Water Crisis (FWC) as a predictor of birth outcomes in Michigan communities outside of Flint, where residents were not directly exposed to lead-contaminated water. Using linear regression models, we analyzed records for all singleton live births in Michigan from 2013 to 2016, excluding Flint, to determine whether birth weight (BW), gestational age (GA), and size-for-gestational-age (SzGA) decreased among babies born to Black people, but not among babies born to White people, following the highly publicized January 2016 emergency declaration in Flint. In adjusted regression models, BW and SzGA were lower for babies born to both Black and White people in the 37 weeks following the emergency declaration compared to the same 37-week periods in the previous 3 years. There were no racial differences in the association of exposure to the emergency declaration with BW or SzGA. Among infants born to Black people, GA was 0.05 weeks lower in the 37-week period following the emergency declaration versus the same 37-week periods in the previous 3 years (95% CI: -0.09, -0.01; p = 0.0177), while there was no change in GA for infants born to White people following the emergency declaration (95% CI: -0.01, 0.03; p = 0.6962). The FWC, which was widely attributed to structural racism, appears to have had a greater impact, overall, on outcomes for babies born to Black people. However, given the frequency of highly publicized examples of anti-Black racism over the study period, it is difficult to disentangle the effects of the FWC from the effects of other racialized stressors.
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Affiliation(s)
- Kristi L. Allgood
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States,*Correspondence: Kristi L. Allgood
| | - Jasmine A. Mack
- 2Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Nicole L. Novak
- 3Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, United States
| | - Cleopatra M. Abdou
- 4Department of Children, Youth, and Families, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Nancy L. Fleischer
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Belinda L. Needham
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
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Rahman A, Giyarsih SR, Herumurti BSS. Modeling the Desire to have Children Post-Disaster Palu – Indonesian 2018. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The impact of a family death, especially on children, causes demographic changes, one of which is the mother's desire to have children. This research problem is how to model with a logistic regression approach and spatial modeling with overlay technique on the desire to have children. The purpose of this study is to model desire to have children with a logistic regression and overlay modeling approach. This research was conducted in Palu City. Participants in this study amounted to 382 mothers with proportional stratified random sampling method as the sampling technique, the data were analyzed using logistic regression modeling and spatial modeling with overlay techniques. In general, the results of logistic regression modeling show a significant effect between the type of disaster and geographical location on the desire to have children after the disaster in Palu City. Mothers who experience disasters (earthquake, tsunami, liquefaction) and live in disaster-prone zones have the opportunity to have children. The results of spatial modeling using the overlay technique show that the parameters of the disaster-affected area have a high priority, indicating that the zone/area of these parameters tends to have children.
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Lindberg JC, Archer D. Radiophobia: Useful concept, or ostracising term? PROGRESS IN NUCLEAR ENERGY 2022. [DOI: 10.1016/j.pnucene.2022.104280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data. Disaster Med Public Health Prep 2022; 17:e94. [PMID: 35236537 PMCID: PMC9440161 DOI: 10.1017/dmp.2021.367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to examine birth outcomes in areas affected by Hurricane Michael. METHODS Vital statistics data of 2017-2019 were obtained from the state of Florida. Births occurring in the year before and after the date of Hurricane Michael (October 7, 2018) were used. Florida counties were divided into 3 categories reflecting extent of impact from Hurricane Michael. Birth outcomes including incidence of preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) were also compared before and after Hurricane Michael. Spontaneous and indicated PTBs were distinguished based on previously published algorithms. Multiple regression was used to control for potential confounders. RESULTS Both LBW (aRR 1.19, 95% CI: 1.07, 1.32) and SGA (aRR 1.11, 95% CI: 1.01, 1.21) were higher in the year after Michael than the year before in the most-affected area; a similar effect was not seen in other areas. A stronger effect was seen for exposure in the first trimester or in the 2 months after Michael than in the second or third trimester. CONCLUSION Consistent with many previous studies, this study of Hurricane Michael found an effect on fetal growth.
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Wang J, Wang Y, He MY, Li YX, Cheng X, Yang X, Li RM, Wang G. Maternal and infant outcomes during the COVID-19 pandemic: a retrospective study in Guangzhou, China. Reprod Biol Endocrinol 2021; 19:126. [PMID: 34404413 PMCID: PMC8369138 DOI: 10.1186/s12958-021-00807-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022] Open
Abstract
In late December 2019, the COVID-19 pandemic caused a great threat to people's lives worldwide. As a special category of the population, pregnant women are vulnerable during emergencies. This study was designed to explore whether or not the COVID-19 pandemic has influenced maternal and infant outcomes. We collected maternal characteristics, laboratory results, condition in the third trimester, maternal outcome, fetal or neonatal outcomes, and characteristics of amniotic fluid, umbilical cord and placenta from pregnant women and fetals or newborns in the first affiliated hospital of Jinan university from 24 January to 31 March 2020 (peak period), chose the same types of data at the hospital during the same period in 2019 and 1 January-23 January 2020 (prior to the outbreak of COVID-19 in 2020) as a control. Our study focused on uncomplicated singleton pregnancies among women not infected by COVID-19. The results demonstrated that there was not an increase in adverse outcomes of pregnant women and newborns during the COVID-19 pandemic; This might be associated with the updated design of major epidemic prevention and control systems in Guangzhou, and the extension of pregnant women's rest time during the third trimester of pregnancy. Nevertheless, the survey showed an increased incidence rate of 25-hydroxyvitamin D and zinc deficiency in newborns during the epidemic, implying that pregnant women should participate in appropriate physical exercise, increase their exposure to outdoor sunlight and improve nutrition intake to ensure healthy newborns during the quarantine period. Our study has provided some guidance for maternal management during the COVID-19 pandemic.
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Affiliation(s)
- Jingyun Wang
- The First Affiliate Hospital of Jinan University, Jinan University, Guangzhou, 510630, China
- International Joint Laboratory for Embryonic Development & Prenatal Medicine, Division of Histology and Embryology, Medical College, Jinan University, Guangzhou, 510632, China
| | - Yun Wang
- The First Affiliate Hospital of Jinan University, Jinan University, Guangzhou, 510630, China
| | - Mei-Yao He
- International Joint Laboratory for Embryonic Development & Prenatal Medicine, Division of Histology and Embryology, Medical College, Jinan University, Guangzhou, 510632, China
| | - Yi-Xiao Li
- The First Affiliate Hospital of Jinan University, Jinan University, Guangzhou, 510630, China
| | - Xin Cheng
- International Joint Laboratory for Embryonic Development & Prenatal Medicine, Division of Histology and Embryology, Medical College, Jinan University, Guangzhou, 510632, China
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, 510632, China
| | - Xuesong Yang
- International Joint Laboratory for Embryonic Development & Prenatal Medicine, Division of Histology and Embryology, Medical College, Jinan University, Guangzhou, 510632, China.
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, 510632, China.
- Guangdong-Hong Kong Metabolism & Reproduction Joint Laboratory, Medical College, Jinan University, Guangzhou, 510632, China.
| | - Rui-Man Li
- The First Affiliate Hospital of Jinan University, Jinan University, Guangzhou, 510630, China.
| | - Guang Wang
- International Joint Laboratory for Embryonic Development & Prenatal Medicine, Division of Histology and Embryology, Medical College, Jinan University, Guangzhou, 510632, China.
- Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, 510632, China.
- Guangdong-Hong Kong Metabolism & Reproduction Joint Laboratory, Medical College, Jinan University, Guangzhou, 510632, China.
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Lindberg JCH. 'J'accuse.!': the continuous failure to address radiophobia and placing radiation in perspective. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:459-469. [PMID: 34075897 DOI: 10.1088/1361-6498/abf9e2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
As far as carcinogens are concerned, radiation is one of the best studied, having been researched for more than 100 years. Yet, radiation remains feared in many contexts as a result of its invisibility, its relationship with cancers and congenital disorders, aided by a variety of heuristics and reinforced by negative imagery. The strong socio-psychological response relating to nuclear energy has made radiation a classical case in the risk literature. This is reflected clearly following the nuclear accidents that have taken place, where the socio-psychological impacts of the clear dissonance between real and perceived health effects due to radiation exposure have caused considerable health detriment, outweighing the actual radiological impacts. Despite considerable efforts to normalise humankind's relationship with radiation, there has been little shift away from the perceived uniqueness of the health risks of radiation. One consistent issue is the failure to place radiation within its proper perspective and context, which has ensured that radiophobia has persisted. The radiation protection community must get better at placing its research within the appropriate perspective and context, something that is far too rarely the case in discussions on radiation matters outside of the scientific community. Each member of the radiation protection community has an ethical, professional and moral obligation to set the record straight, to challenge the misconceptions and factual errors that surround radiation, as well as putting it into the proper perspective and context. Failing to do so, the well-established harms of radiophobia will remain, and the many benefits of nuclear technology risk being withheld.
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Affiliation(s)
- John C H Lindberg
- Department of Geography, King's College London, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Lian Q, Ni J, Zhang J, Little J, Luo S, Zhang L. Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study. BMC Pregnancy Childbirth 2020; 20:552. [PMID: 32962638 PMCID: PMC7510090 DOI: 10.1186/s12884-020-03206-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background The prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes. Methods We included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex. Results The bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings. Conclusions The 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.
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Affiliation(s)
- Qiguo Lian
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, 200237, China
| | - Jiaying Ni
- Obstetric and Gynecology Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jun Zhang
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - Shan Luo
- West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Lin Zhang
- Obstetric and Gynecology Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China. .,Obstetrics Department, International peace maternity and child health hospital of China, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Shanghai, 200030, China.
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Scherb H, Hayashi K. Spatiotemporal association of low birth weight with Cs-137 deposition at the prefecture level in Japan after the Fukushima nuclear power plant accidents: an analytical-ecologic epidemiological study. Environ Health 2020; 19:82. [PMID: 32646457 PMCID: PMC7346451 DOI: 10.1186/s12940-020-00630-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/24/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Perinatal mortality increased in contaminated prefectures after the Fukushima Daichi Nuclear Power Plant (FDNPP) accidents in Japan in 2011. Elevated counts of surgeries for cryptorchidism and congenital heart malformations were observed throughout Japan from 2012 onward. The thyroid cancer detection rate (2011 to 2016) was associated with the dose-rate at the municipality level in the Fukushima prefecture. Since the birth weight is a simple and objective indicator for gestational development and pregnancy outcome, the question arises whether the annual birth weight distribution was distorted in a dose-rate-dependent manner across Japan after Fukushima. METHODS The Japanese Ministry of Health, Labour, and Welfare provides prefecture-specific annual counts for 26.158 million live births from 1995 to 2018, of which 2.366 million births (9.04%) with weights < 2500 g. Prefecture-specific spatiotemporal trends of the low birth weight proportions were analyzed. Logistic regression allowing for level-shifts from 2012 onward was employed to test whether those level-shifts were proportional to the prefecture-specific dose-rates derived from Cs-137 deposition in the 47 Japanese prefectures. RESULTS The overall trend of the low birth weight prevalence (LBWp) in Japan discloses a jump in 2012 with a jump odds ratio (OR) 1.020, 95%-confidence interval (1.003,1.037), p-value 0.0246. A logistic regression of LBWp on the additional dose-rate after the FDNPP accidents adjusted for prefecture-specific spatiotemporal base-line trends yields an OR per μSv/h of 1.098 (1.058, 1.139), p-value < 0.0001. Further adjusting the logistic regression for the annual population size and physician density of the prefectures, as well as for the counts of the dead, the missing, and the evacuees due to earthquake and tsunami (as surrogate measures for medical infrastructure and stress) yields an OR per μSv/h of 1.109 (1.032, 1.191), p-value 0.0046. CONCLUSIONS This study shows increased low birth weight prevalence related to the Cs-137 deposition and the corresponding additional dose-rate in Japan from 2012 onward. Previous evidence suggesting compromised gestational development and pregnancy outcome under elevated environmental ionizing radiation exposure is corroborated.
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Affiliation(s)
- Hagen Scherb
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Computational Biology, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Keiji Hayashi
- Hayashi Children’s Clinic, 4-6-11-1F Nagata, Joto-ku Osaka-Shi, Osaka, 536-0022 Japan
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Hirata Y, Shimizu H, Kumamaru H, Takamoto S, Motomura N, Miyata H, Okita Y. Congenital Heart Disease After the Fukushima Nuclear Accident: The Japan Cardiovascular Surgery Database Study. J Am Heart Assoc 2020; 9:e014787. [PMID: 32613886 PMCID: PMC7670522 DOI: 10.1161/jaha.119.014787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background In March 2011, the Fukushima Daiichi nuclear power plant disaster inflicted radiation damage across the Tohoku region of Northern Japan. The consequent harm to pregnant mothers and newborns was a matter of concern. We performed a registry‐based analysis of the incidence of congenital heart disease during 2010 to 2013 using the Japan Cardiovascular Surgery Database. Methods and Results We selected patients who had complex congenital heart disease and who were born between January 1, 2010 and December 31, 2013 undergoing surgery, and assessed the trend in the number of first‐time surgeries performed for patients aged 2 years and younger by birth year over time. The numbers of first‐time surgeries for birth years 2010 to 2013 were 2978, 2924, 3077, and 2940, and no increasing trend was detected. Additionally, no increasing yearly trend was detected when the number of cases was divided by the total number of births in Japan in each birth month. The mortality of first‐time surgeries performed for complex diseases, which often involves multiple subsequent surgeries, decreased from 4.7% in 2010 to 2.2% in 2013. Conclusions Our analyses showed no increase in the number of patients with congenital heart disease during 2010 to 2013. The yearly increase in the total number of surgeries following the Fukushima Daiichi nuclear disaster in a previous report can be explained by the decline in the mortality of first‐time surgeries for complex cases. Such use of only the increase in the total yearly number of surgeries to claim the effects of a nuclear disaster on the incidence of congenital heart disease is a far too simplistic and dangerous proposition.
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Affiliation(s)
- Yasutaka Hirata
- The Japanese Association for Thoracic Surgery Tokyo Japan.,Department of Cardiac Surgery The University of Tokyo Hospital Tokyo Japan
| | - Hideyuki Shimizu
- The Japanese Association for Thoracic Surgery Tokyo Japan.,Department of Cardiovascular Surgery Keio University Hospital Tokyo Japan
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment University of Tokyo Japan
| | | | - Noboru Motomura
- The Japan Cardiovascular Surgery Database Organization Tokyo Japan.,Department of Cardiovascular Surgery Toho University Sakura Medical Center Sakura Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment University of Tokyo Japan
| | - Yutaka Okita
- The Japanese Association for Thoracic Surgery Tokyo Japan.,Takatsuki General Hospital Cardio-Aortic Center Osaka Japan
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Yamamoto K, Nomura S, Tsubokura M, Murakami M, Ozaki A, Leppold C, Sawano T, Takita M, Kato S, Kanazawa Y, Anbe H. Internal exposure risk due to radiocesium and the consuming behaviour of local foodstuffs among pregnant women in Minamisoma City near the Fukushima nuclear power plant: a retrospective observational study. BMJ Open 2019; 9:e023654. [PMID: 31289047 PMCID: PMC6615778 DOI: 10.1136/bmjopen-2018-023654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the internal cesium (Cs) level among pregnant women in Minamisoma City (the area straddling the evacuation zones) over a 5-year period after Japan's 2011 Fukushima nuclear accident and assess the status and transition of their food-acquiring preferences during this period. DESIGN A retrospective observational study of a screening along with a questionnaire survey. SETTING This study was conducted in an obstetrics and gynaecology service in Minamisoma City in Fukushima, Japan. PARTICIPANTS Participants included pregnant women who applied for the voluntary internal radiation exposure screening programme. PRIMARY AND SECONDARY OUTCOME MEASURES Internal radiation exposure was evaluated using the whole-body counter (WBC) in the screening programme. Data from a food acquisition preference questionnaire administered to the participants were analysed and compared across the 5-year period after adjusting for covariates. RESULTS Overall, 804 screening programmes were conducted with 579 participants during the study period. All participants had internal contamination levels below the detection limit of the WBC unit (220 and 250 Bq/body for Cs-134 and Cs-137, respectively). Based on the most conservative assumption, their maximum annual effective doses by Cs-134 and Cs-137 together were estimated at 16 µSv/year. Contrary to limited internal contamination risks and counter-dose initiatives by the government, a considerable number of pregnant women were still concerned about consuming potentially contaminated local food products when purchasing them at supermarkets between 2012 (78.4%) and 2015 (75.0%). CONCLUSIONS Health effects from post-accident internal radiation exposure were likely to be insignificant in pregnant women. National/local action is urgently needed to promote scientific understanding in pregnant women regarding limited internal exposure risks from local food products in the market. However, few mothers chose to participate in the internal radiation exposure screening programme, and thus, caution is required in interpreting the results of analyses.
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Affiliation(s)
- Kana Yamamoto
- Department of Internal Medicine, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Shuhei Nomura
- Department of Global Health Policy, The University of Tokyo, Tokyo, Bunkyo-ku, Japan
| | - Masaharu Tsubokura
- Department of Research, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima City, Japan
| | - Akihiko Ozaki
- Department of Research, Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Claire Leppold
- Department of Research, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Toyoaki Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Morihito Takita
- Department of Internal Medicine, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Shigeaki Kato
- Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yukio Kanazawa
- Department of Gastroenterology, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Hiroshi Anbe
- Department of Obstetrics and Gynecology, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Varzaghan Earthquake Affected Mothers' and Their Newborns' Health More Severely, in Socioeconomically Vulnerable Area. Disaster Med Public Health Prep 2018; 13:511-518. [PMID: 30295234 DOI: 10.1017/dmp.2018.96] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We aimed to compare the pregnancy status of the pregnant women and birth status of their newborns, socioeconomic status, and access to health services, between high- and low-damage areas in Heris, affected by the Varzaghan Earthquake, 2012. METHODS The study was conducted on pregnant women at any trimester of pregnancy (with complete medical profiles in local health centers) in August 2012 (time of the earthquake) who lived in Heris and delivered up to March 2013. Data were obtained on pregnancy- and infant-related variables, housing, socioeconomic status, and access to health services, including food supplies, before and after the earthquake. RESULTS Family income and mothers' education were lower in highly damaged areas. Among these women, underweight at first trimester of pregnancy was higher, and weight gain during the last trimester was lower, compared with low-damage regions. Preterm delivery was higher in low-damage areas. Birth indices of the infants were not significantly different between the 2 areas; however, in highly damaged areas, moderate malnutrition was more prevalent among children under 1 year (weight-for-age) and under 2 years (height-for-age). CONCLUSIONS Socioeconomic status of mothers was lower in highly damaged areas and might have played a role in their own and newborns' health status. (Disaster Med Public Health Preparedness. 2019;13: 511-518).
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