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Zölzer F, Schneider T, Ainsbury E, Goto A, Liutsko L, O'Reilly G, Lochard J. Ethical and societal aspects of radiological protection for offspring and next generations. Int J Radiat Biol 2023:1-11. [PMID: 37947483 DOI: 10.1080/09553002.2023.2281523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Over the last decade or so, ethical and societal aspects of radiological protection have received increasing attention. This is also reflected in the publications of the International Commission on Radiological Protection (ICRP). The current paper aims at identifying relevant ethical and societal topics which should receive attention in the context of radiological protection for offspring and next generations. MATERIALS AND METHODS We present a non-comprehensive review of the subject, based on presentation made at an ICRP workshop in Budapest in 2022. We first discuss the ethical values promoted by ICRP, and the application of these values in cases of (potential) pre-conceptual and prenatal radiation exposures. We then consider experience gained after the Fukushima accident indicating particular societal concerns about the health effects of such exposures. RESULTS AND CONCLUSIONS Beneficence/non-maleficence, prudence, justice and dignity, the "core values" of the system of radiological protection have special roles to play when heritable and/or in utero effects are to be considered. Prudence, in particular, must be taken account of in view of the fact that solid scientific data in humans are largely lacking in this area, and it is necessary to rely on insights from animal experiments as well as theoretical considerations. As regards societal considerations, the perception of risk among (potentially) affected populations needs to be taken seriously. Accountability, transparency, and inclusivity, the "procedural values" promoted by ICRP for the practical implementation of the system of radiological protection play a central role in overcoming skepticism and creating trust. Stakeholder involvement should emphasize cooperation and dialogue, which allows for the joint evaluation of an exposure situation by experts and affected people.
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Affiliation(s)
- F Zölzer
- Faculty of Health and Social Sciences, University of South Bohemia in České Budějovice, Czech Republic
| | - T Schneider
- Nuclear Protection Evaluation Centre (CEPN), Fontenay-aux-Roses, France
| | | | - A Goto
- Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan
| | - L Liutsko
- Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAP Jordi Gol) & ISGlobal, Barcelona, Spain
| | | | - J Lochard
- Institute of Atomic Bomb Diseases, Nagasaki University, Nagasaki, Japan
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Rahu K, Rahu M, Zeeb H, Auvinen A, Bromet E, Boice JD. Suicide and other causes of death among Chernobyl cleanup workers from Estonia, 1986 - 2020: an update. Eur J Epidemiol 2023; 38:225-232. [PMID: 36609895 PMCID: PMC9905157 DOI: 10.1007/s10654-022-00957-3] [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: 09/13/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
Mortality was studied in a cohort of 4831 men from Estonia who participated in the environmental cleanup of the radioactively contaminated areas around Chernobyl in 1986-1991. Their mortality in 1986-2020 was compared with the mortality in the Estonian male population. A total of 1503 deaths were registered among the 4812 traced men. The all-cause standardized mortality ratio (SMR) was 1.04 (95% CI 0.99-1.09). All-cancer mortality was elevated (SMR 1.16, 95% CI 1.03-1.28). Radiation-related cancers were in excess (SMR 1.20, 95% CI 1.03-1.36); however, the excesses could be attributed to tobacco and alcohol consumption. For smoking-related cancers, the SMR was 1.20 (95% CI 1.06-1.35) and for alcohol-related cancers the SMR was 1.56 (95% CI 1.26-1.86). Adjusted relative risks (ARR) of all-cause mortality were increased among workers who stayed in the Chernobyl area ≥ 92 days (ARR 1.20, 95% CI 1.08-1.34), were of non-Estonian ethnicity (ARR 1.33, 95% CI 1.19-1.47) or had lower (basic or less) education (ARR 1.63, 95% CI 1.45-1.83). Suicide mortality was increased (SMR 1.31, 95% CI 1.05-1.56), most notably among men with lower education (ARR 2.24, 95% CI 1.42-3.53). Our findings provide additional evidence that unhealthy behaviors such as alcohol and smoking play an important role in shaping cancer mortality patterns among Estonian Chernobyl cleanup workers. The excess number of suicides suggests long-term psychiatric and substance use problems tied to Chernobyl-related stressors, i.e., the psychosocial impact was greater than any direct carcinogenic effect of low-dose radiation.
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Affiliation(s)
- Kaja Rahu
- Department of Registries, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
| | - Mati Rahu
- Formerly: Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Health Sciences, University of Bremen, Bremen, Germany
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Environmental Radiation Surveillance, Radiation and Nuclear Safety Authority-STUK, Tampere University, Vantaa, Finland
| | - Evelyn Bromet
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - John D Boice
- National Council On Radiation Protection and Measurements, Bethesda, MD, USA
- Division of Epidemiology, School of Medicine, Vanderbilt University, Nashville, TN, USA
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Gajewski AJ, Zhang H, Abu-Hamad S, Pollio W, McDonald K, Pollio DE, North CS. Making Meaning of Surviving the Oklahoma City Bombing Seven Years Later. Psychiatry 2022; 86:42-52. [PMID: 36190776 PMCID: PMC9992151 DOI: 10.1080/00332747.2022.2120309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
Objective: No previous studies examined how survivors made meaning (i.e. interpreted the personal significance) of a disaster experience after seven years. This qualitative study follows up on a previously published analysis of 182 directly-exposed survivors of the Oklahoma City bombing, assessed after six months had elapsed for bombing-related psychopathology and meaning-making processes. The current study examines how 113 survivors (62% follow-up rate) made meaning of their bombing experience after seven years. Method: Survivors answered questions about the effects of the bombing on their beliefs and perspectives. Their responses were hand recorded by interviewers and transcribed. Content was coded into themes, allowing codes of multiple themes. Excellent interrater reliability was obtained (Cohen's kappa≥.8). Results: The survivors were 50% (57/113) male, 93% (105/113) Caucasian, 34% (38/113) college educated, and 71% (80/113) married with a mean (SD) age of 42.5 (10.6) (range = 19-69) years at the time of the bombing. Eight themes emerged and indicated that survivors matured in personal goals and character, interpersonal relationships, and philosophical thought (e.g., reconsideration of human nature and religion). More than one third of the comments included negative remarks about personal harm, especially psychological effects. Conclusions: Nearly two thirds of the material was positive in tone and consistent between six months and seven years. Negative content was entirely new relative to six-month baseline interview responses, suggesting many survivors incorporate greater reflection on negative outcomes in meaning-making processes over time. After several years, clinicians could encourage survivors to integrate positive and negative consequences as meaning. Longer-term studies are needed.
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Affiliation(s)
| | - Helena Zhang
- Medical School, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Samir Abu-Hamad
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Whitney Pollio
- Colledge of Nursing, The University of South Florida, USA
| | - Katy McDonald
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, USA; and Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, USA
| | | | - Carol S. North
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, USA
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, USA; and Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, USA
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Sharifi A, Dinparastisaleh R, Kumar N, Mirsaeidi M. Health effects of radioactive contaminated dust in the aftermath of potential nuclear accident in Ukraine. Front Public Health 2022; 10:959668. [PMID: 36072376 PMCID: PMC9441805 DOI: 10.3389/fpubh.2022.959668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/22/2022] [Indexed: 01/24/2023] Open
Affiliation(s)
- Arash Sharifi
- Department of Marine Geosciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL, United States,Isobar Science-Beta Analytic, Research and Development Department, Miami, FL, United States
| | - Roshan Dinparastisaleh
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Naresh Kumar
- Department of Public Health Sciences, University of Miami, Miami, FL, United States
| | - Mehdi Mirsaeidi
- Division of Pulmonary and Critical Care Medicine, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, United States,*Correspondence: Mehdi Mirsaeidi
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Lagergren Lindberg M, Hedman C, Lindberg K, Valentin J, Stenke L. Mental health and psychosocial consequences linked to radiation emergencies-increasingly recognised concerns. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:031001. [PMID: 35767945 DOI: 10.1088/1361-6498/ac7d19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
A major radiological or nuclear emergency may, apart from causing a substantial loss of life and physical damage, also put a substantial strain on affected societies with social, economic and political consequences. Although such emergencies are relatively uncommon, it is now being increasingly recognised that their subsequent psychosocial impact can be widespread and long lasting. Mental health effects, such as depression, anxiety and post-traumatic stress disorder, are highly represented in a population affected by a radiation disaster. In order to reach the majority of the people affected by radiation accidents, we need to be aware of how to distribute relevant and accurate information related to both short- and long-term medical effects. Effective risk communication is associated with improved compliance with any given recommendations. It is important to protect the public from physical radiation damage, but it is also essential to take into account the social and mental health effects that radiation disasters may induce. This article provides a brief review of recent reporting on the psychological consequences after a major radiation emergency.
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Affiliation(s)
- Marita Lagergren Lindberg
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Palliative Care Unit, Byle Gård, Förenade Care, Stockholm, Sweden
| | - Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Karin Lindberg
- Department of Pathology and Oncology, Karolinska Institutet, Stockholm, Sweden
- Pulmonary Oncology Centre, Section of Head, Neck, Lung and Skin Cancers, Karolinska University Hospital, Stockholm, Sweden
| | - Jack Valentin
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Leif Stenke
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
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Kashiwazaki Y, Matsunaga H, Orita M, Taira Y, Oishi K, Takamura N. Occupational Difficulties of Disaster-Affected Local Government Employees in the Long-Term Recovery Phase after the Fukushima Nuclear Accident: A Cross-Sectional Study Using Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073979. [PMID: 35409662 PMCID: PMC8997478 DOI: 10.3390/ijerph19073979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
Local government officials play a central role in post-disaster community reconstruction. However, few studies have reported on the actual difficulties during a complex disaster involving a nuclear accident. A self-rated questionnaire survey was administered to a total of 583 public employees in four municipalities around the Fukushima Daiichi Nuclear Power Station. The relationship between universal occupational factors and radiation disaster-specific factors on job satisfaction and intention to leave the job due to radiation anxiety was evaluated using structural equation modeling. The results showed that interpersonal problems (β = −0.246) and service years (β = −0.127) were related to job satisfaction, whereas radiation-specific factors were not related to job satisfaction, and only to the intention to leave work due to radiation anxiety. A sense of coherence was associated with job satisfaction (β = 0.373) and intention to leave work due to radiation anxiety (β = −0.182), and it served as a moderator of the universal occupational factors and the radiation disaster-specific factors. Therefore, it is suggested that outcomes could be improved through increased stress coping capacity by providing support for relationships and radiation risk communication to public employees during the disaster recovery period.
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