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Wilson C, Adams GG, Patel P, Windham K, Ennis C, Caffrey E. A Review of Recent Low-dose Research and Recommendations for Moving Forward. HEALTH PHYSICS 2024; 126:386-396. [PMID: 38568156 DOI: 10.1097/hp.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
ABSTRACT The linear no-threshold (LNT) model has been the regulatory "law of the land" for decades. Despite the long-standing use of LNT, there is significant ongoing scientific disagreement on the applicability of LNT to low-dose radiation risk. A review of the low-dose risk literature of the last 10 y does not provide a clear answer, but rather the body of literature seems to be split between LNT, non-linear risk functions (e.g., supra- or sub-linear), and hormetic models. Furthermore, recent studies have started to explore whether radiation can play a role in the development of several non-cancer effects, such as heart disease, Parkinson's disease, and diabetes, the mechanisms of which are still being explored. Based on this review, there is insufficient evidence to replace LNT as the regulatory model despite the fact that it contributes to public radiophobia, unpreparedness in radiation emergency response, and extreme cleanup costs both following radiological or nuclear incidents and for routine decommissioning of nuclear power plants. Rather, additional research is needed to further understand the implications of low doses of radiation. The authors present an approach to meaningfully contribute to the science of low-dose research that incorporates machine learning and Edisonian approaches to data analysis.
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Affiliation(s)
- Charles Wilson
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Grace G Adams
- Gryphon Scientific, LLC, 6930 Carrol Ave., Suite 810, Takoma Park, MD 20912
| | - Pooja Patel
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Kiran Windham
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Colby Ennis
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
| | - Emily Caffrey
- University of Alabama at Birmingham, School of Health Professions, Clinical and Diagnostic Sciences, Health Physics Program
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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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Saito Y, Sato S, Nishikawa Y, Oguro F, Moriyama N, Sato K, Kobashi Y, Sawano T, Ozaki A, Nakayama T, Tsubokura M, Yasumura S, Sakai S. Outpatient rehabilitation for an older couple in a repopulated village 10 years after the Fukushima nuclear disaster:An embedded case study. Fukushima J Med Sci 2024; 70:49-54. [PMID: 37952979 PMCID: PMC10867431 DOI: 10.5387/fms.2023-01] [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] [Received: 01/06/2023] [Accepted: 09/21/2023] [Indexed: 11/14/2023] Open
Abstract
BackgroundLittle information is available on the role of community-based rehabilitation after a nuclear disaster. Here, we report the case of an older couple living in an area repopulated after the Fukushima nuclear disaster of 2011 who received outpatient rehabilitation.Case presentationAn 84-year-old woman underwent total hip arthroplasty (THA) after she fell and sustained a trochanteric fracture while caring for her husband with Alzheimer's disease. The 85-year-old husband experienced worsening behavioral and psychological symptoms of dementia (BPSD) following his wife's hospitalization. The couple received rehabilitation at an outpatient facility in a nearby village using a shuttle service. The woman's postoperative anxiety was relieved and her physical function improved. Moreover, the husband's BPSD symptoms decreased.ConclusionA wife and husband showed improvement in physical function after THA and alleviation of BPSD, respectively, following rehabilitation. In post-disaster, resource-scarce areas, older adults may benefit from utilizing the outpatient rehabilitation services available in the surrounding area.
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Affiliation(s)
- Yuta Saito
- Department of Rehabilitation, Hirata Central Hospital
| | | | - Yoshitaka Nishikawa
- Department of Internal Medicine, Hirata Central Hospital
- Department of Internal Medicine, Kawauchi Village National Health Insurance Clinic
- Department of Health Informatics, Kyoto University School of Public Health
| | - Fumiya Oguro
- Department of Internal Medicine, Hirata Central Hospital
| | - Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine
| | | | - Yurie Kobashi
- Department of Internal Medicine, Hirata Central Hospital
- Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Toyoaki Sawano
- Department of Radiation Health Management, Fukushima Medical University School of Medicine
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health
| | - Masaharu Tsubokura
- Department of Internal Medicine, Hirata Central Hospital
- Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine
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Orui M, Saeki S, Kozakai Y, Harada S, Hayashi M. The Impact of the COVID-19 Pandemic on Suicide Rate Trends in the Tsunami-Disaster-Affected Area Following the Great East Japan Earthquake. CRISIS 2023; 44:93-99. [PMID: 34859681 DOI: 10.1027/0227-5910/a000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: People who experienced the Great East Japan Earthquake (GEJE) were expected to have additional levels of psychological burden resulting from the stressful conditions imposed during the coronavirus disease 2019 (COVID-19) pandemic; consequently, suicide rates may increase. Aim: We aimed to carry out continuous monitoring of suicide rates in the affected area following the GEJE under COVID-19 pandemic conditions. Method: This descriptive study monitored the suicide rates of the coastal area of Miyagi Prefecture, where disaster-related mental health activities have been continuing following severe damage caused by the tsunami disaster. An exponential smoothing time-series analysis that converted suicide rates into a smooth trend was conducted. Results: Although the suicide rate in the affected area was higher than the national average in February 2020, it showed a declining trend during the COVID-19 pandemic, while showing an increase trend in the national and non-affected areas. Limitations: Uncertainty about the direct reasons for suicide and the short time-scale observation are the limitations of this study. Conclusion: Although the national suicide rate increased, this was not the case for the affected area. Our findings may provide important lessons for suicide prevention during the COVID-19 pandemic, which needs careful regional monitoring of the state of suicide and of high-risk approaches such as disaster-related mental health activities.
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Affiliation(s)
- Masatsugu Orui
- Sendai City Mental Health and Welfare Center, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Suzuka Saeki
- Sendai City Mental Health and Welfare Center, Sendai, Japan
| | - Yuki Kozakai
- Sendai City Mental Health and Welfare Center, Sendai, Japan
| | | | - Mizuho Hayashi
- Sendai City Mental Health and Welfare Center, Sendai, Japan
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Fukasawa M, Umeda M, Akiyama T, Horikoshi N, Yasumura S, Yabe H, Suzuki Y, Bromet EJ, Kawakami N. Worry about Radiation and Its Risk Factors Five to Ten Years after the Fukushima Nuclear Power Plant Disaster. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416943. [PMID: 36554824 PMCID: PMC9778659 DOI: 10.3390/ijerph192416943] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2023]
Abstract
Worry about radiation persists long after nuclear power plant accidents. Young age, low socioeconomic status, being married, and disaster-related experiences are known to be associated with greater worry about radiation. This study explored the duration of the effects of these risk factors on worry about radiation after the 2011 Fukushima nuclear power plant accident, using the longitudinal data of randomly sampled non-evacuee community residents who were followed five to ten years after the accident. Questionnaire surveys were conducted five times with 1825 respondents (37.2% of the 4900 initial targets). We examined the interaction of time and risk factors of worry about radiation using a mixed model. Fear or anxiety immediately after the accident had effects on worry about radiation that continued even after 10 years, though it slightly attenuated with time. Family problems stemming from the disaster retained their effects. While direct damage and evacuation experience were significantly associated with worry about radiation in the early phase, their effects diminished and became non-significant during the study period. Being under the age of 65, having low educational attainment, and being married were significantly associated with worry about radiation, although the association with age weakened over time. Individuals who experience intense fear or anxiety post-nuclear power plant accidents or disaster-related family problems may need continuous monitoring for their worry about radiation even 10 years after such accidents.
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Affiliation(s)
- Maiko Fukasawa
- Health Promotion Center, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Maki Umeda
- Research Institute of Nursing Care for People and Community, University of Hyogo, Akashi 673-8588, Japan
| | - Tsuyoshi Akiyama
- Department of Neuropsychiatry, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo 141-8625, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Yuriko Suzuki
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira 187-8551, Japan
| | - Evelyn J. Bromet
- Department of Psychiatry and Behavioural Health, Stony Brook University, Stony Brook, NY 11794, USA
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
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Miura I, Nagao M, Nakano H, Okazaki K, Hayashi F, Harigane M, Itagaki S, Yabe H, Maeda M, Ohira T, Ishikawa T, Yasumura S, Kamiya K. Associations Between External Radiation Doses and the Risk of Psychological Distress or Post-traumatic Stress After the Fukushima Daiichi Nuclear Power Plant Accident: the Fukushima Health Management Survey. J Epidemiol 2022; 32:S95-S103. [PMID: 36464305 PMCID: PMC9703924 DOI: 10.2188/jea.je20210226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The relationship between radiation levels and mental health status after a nuclear disaster is unknown. We examined the association between individual external radiation doses and psychological distress or post-traumatic stress after the Fukushima Daiichi nuclear power plant accident in March 2011 in Japan. METHODS The Mental Health and Lifestyle Survey was conducted from January 2012. Based on the estimated external radiation doses for the first 4 months, a total of 64,184 subjects were classified into <1 mSv, 1 to <2 mSv, and ≥2 mSv groups. Odds ratios (ORs) and 95% confidence intervals (CIs) of psychological distress and post-traumatic stress, with the <1 mSv group as the reference, were calculated using logistic regression analysis adjusted for age, sex, evacuation, perception of radiation risk, and subjective health status. RESULTS The prevalence of psychological distress/post-traumatic stress in the <1 mSv, 1 to <2 mSv, and ≥2 mSv groups was 15.1%/22.1%, 14.0%/20.1%, and 15.0%/21.7%, respectively. In women, although the ≥2 mSv group tended to have a higher risk of psychological distress with the age-adjusted OR of 1.13 (95% CI, 0.99-1.30), the adjusted OR decreased to 1.00 (95% CI, 0.86-1.16) after controlling for all variables. On the other hand, there were no dose-dependent associations between radiation dose and post-traumatic stress. CONCLUSION Although external radiation doses were not associated with psychological distress, evacuation and perception of radiation risk may increase the risk of psychological distress in women in the higher dose group.
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Affiliation(s)
- Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 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
| | - 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
| | - Mayumi Harigane
- 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
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, 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
| | - Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, 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
| | - 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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Loss of participation among evacuees aged 20-37 years in the disaster cohort study after the Great East Japan Earthquake. Sci Rep 2022; 12:19600. [PMID: 36380078 PMCID: PMC9665037 DOI: 10.1038/s41598-022-23896-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to clarify the characteristics of young evacuees who had missed the Comprehensive Health Check of the Fukushima Health Management Survey (FHMS) after the Great East Japan Earthquake in 2011. The FHMS has been conducted as a prospective cohort study to evaluate the health status of evacuees annually after the great earthquake in 2011. This study focused on the annual participation rate in the Comprehensive Health Check of evacuees aged between 20 and 37 years in 2011 who evacuated due to the Fukushima Daiichi Nuclear Power Plant accident. The characteristics of subjects who did not participate after the second survey year were identified with a multivariate logistic regression model. The participation rate was estimated at 26.6% (9720 among 36,502 residents) and 15.6% (5691 residents) in 2011 and 2012, respectively. The logistic regression model revealed the following characteristics at baseline as independent predictors of non-participation after the second year of the survey: age ≤ 24 years (adjusted odds ratio 2.11, 95% CI 1.84-2.42), 25-29 years of age (1.28, 1.13-1.45), men (1.52, 1.38-1.69), evacuation outside the municipality but within Fukushima prefecture (1.54, 1.40-1.70), evacuation outside the Fukushima prefecture (1.40, 1.21-1.63), anemia (1.23, 1.06-1.43), smoking habit (1.34, 1.21-1.48), and drinking habit (1.20, 1.09-1.32). A medical history of heart disease showed opposite odds ratios, which indicate the association with continuous participation (0.43, 0.26-0.72, respectively). We observed deteriorated participation in the prospective study of the Comprehensive Health Check of the FHMS among evacuees of a younger age group, men, those evacuated outside their municipalities, and those with history of anemia, smoking and drinking habits. Hence, the cohort study may have missed certain population groups with worse health behaviors. Thus, it is necessary to consider various measures to increase the participation rate in the disaster cohort study to understand the long-term health effects of disasters on younger residents in evacuation zones.
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Nagai M, Kato M, Dote K. Psychological distress-pathophysiology of newly developed hypertension after the Great East Japan Earthquake. Hypertens Res 2022; 45:1664-1666. [PMID: 35931875 DOI: 10.1038/s41440-022-00989-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
| | - Masaya Kato
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Keigo Dote
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
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9
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Miyagawa A, Tanigawa K. Health and Medical Issues in the Area Affected by Fukushima Daiichi Nuclear Power Plant Accident. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:144. [PMID: 35010401 PMCID: PMC8750495 DOI: 10.3390/ijerph19010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Futaba County was the area most affected by the 2011 Fukushima Daiichi nuclear power plant accident. To understand issues around the re-development of the medical system, we investigated the post-accident changes in medical needs and the system's transition. We analyzed reports from Fukushima Prefecture and local municipalities, ambulance transport data from the Futaba Fire Department, and patient data from Futaba Medical Center (FMC). After the accident, all medical institutions were closed, and the number of ambulance use dropped sharply. With the lifting of evacuation orders beginning in 2014, the amount of ambulance use increased at an annual rate of about 10%. Early on, the proportion of trauma caused by occupational and traffic accidents increased rapidly to more than 30%. As residents returned, the proportion related to endogenous diseases (most commonly respiratory) increased. Soon after the FMC opened in 2018, the majority of the patients were in their 60s, and by 2019 the proportion of patients in their 80s markedly increased. The return of the residents as well as ongoing decontamination and reconstruction projects were related to changes in the demographics of patients and the types of injuries and illnesses observed.
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10
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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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Orui M, Nakayama C, Moriyama N, Tsubokura M, Watanabe K, Nakayama T, Sugita M, Yasumura S. Those Who Have Continuing Radiation Anxiety Show High Psychological Distress in Cases of High Post-Traumatic Stress: The Fukushima Nuclear Disaster. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212048. [PMID: 34831804 PMCID: PMC8623122 DOI: 10.3390/ijerph182212048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/26/2023]
Abstract
Background: this cross-sectional study aimed to clarify the associations among media utilization, lifestyles, and the strong radiation anxiety that has persisted 9 years after the 2011 nuclear accident. Moreover, the relationships among psychological distress, post-traumatic stress, and strong radiation anxiety were examined. Methods: for the multivariate regression analysis, the independent variables were radiation anxiety at the time of the accident and the current status, categorized as “continuing/emerging strong radiation anxiety”. Media utilization (local, national, internet, and public broadcasts, and public relations information) and lifestyle variables (sleep quality, regular exercise, and drinking habits) were set as the dependent variables. Moreover, the psychological distress of residents with continuing/emerging strong radiation anxiety was examined by an analysis of covariance stratified by post-traumatic stress. Result: there was no significant association between lifestyle variables and media utilization, except for local media (OR: 0.435, 95% CI: 0.21–0.90). Conversely, significantly high psychological distress was confirmed among residents with continuing/emerging radiation anxiety. The K6 score, representing psychological distress, for those with higher post-traumatic stress was 12.63; for those with lower post-traumatic stress, it was 5.13 (p = 0.004). Conclusions: residents with continuing/emerging strong radiation anxiety showed high psychological distress, which has been strengthened by higher post-traumatic stress.
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Affiliation(s)
- Masatsugu Orui
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (C.N.); (N.M.); (S.Y.)
- Sendai City Mental Health and Welfare Center, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-24-547-1180
| | - Chihiro Nakayama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (C.N.); (N.M.); (S.Y.)
| | - Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (C.N.); (N.M.); (S.Y.)
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan;
| | - Kiyotaka Watanabe
- Department of Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan;
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto 606-8501, Japan;
| | | | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (C.N.); (N.M.); (S.Y.)
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Kuroda Y, Orui M, Hori A. Trends in Suicide Mortality in 10 Years around the Great East Japan Earthquake: Analysis of Evacuation and Non-Evacuation Areas in Fukushima Prefecture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116005. [PMID: 34205006 PMCID: PMC8199884 DOI: 10.3390/ijerph18116005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 12/11/2022]
Abstract
This study analyzed the suicide mortality rate in 12 municipalities in Fukushima Prefecture designated as evacuation areas following the 2011 nuclear disaster. Changes in suicide rates were examined using an exponential smoothing time series model. In the evacuation areas, the suicide rate of men increased immediately after the disaster and then decreased from 47.8 to 23.1 per 100,000 during about 1½ years after the disaster. However, with the lifting of the evacuation order, it again exceeded that of non-evacuation areas and continued to do so for the next 3 years. On the other hand, the suicide rate in women in the evacuation areas increased later than that in men. These results indicate the need for continuous support following the lifting of the evacuation order. In addition, it is necessary to enhance social networks, which continue to confer protection, because of the isolation of the elderly as highlighted in our previous study.
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Affiliation(s)
- Yujiro Kuroda
- Research Department, Fukushima Prefectural Centre for Environmental Creation, Fukushima 963-7700, Japan
- Correspondence: ; Tel.: +81-247-61-6140
| | - Masatsugu Orui
- Sendai City Mental Health and Welfare Center, Sendai 980-0845, Japan;
| | - Arinobu Hori
- Department of Psychiatry, Hori Mental Clinic, Fukushima 979-2335, Japan;
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