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Nomura S.,Imperial College London | Blangiardo M.,Imperial College London | Tsubokura M.,Tokyo Medical University | Ozaki A.,Minamisoma Municipal General Hospital | And 2 more authors.
BMJ Open | Year: 2016

Objective: Japan's 2011 Fukushima Daiichi Nuclear Power Plant incident required the evacuation of over a million people, creating a large displaced population with potentially increased vulnerability in terms of chronic health conditions. We assessed the long-term impact of evacuation on diabetes, hyperlipidaemia and hypertension. Participants: We considered participants in annual public health check-ups from 2008 to 2014, administrated by Minamisoma City and Soma City, located about 10-50 km from the Fukushima nuclear plant. Methods: Disease risks, measured in terms of preincident and post-incident relative risks, were examined and compared between evacuees and non-evacuees/temporary-evacuees. We also constructed logistic regression models to assess the impact of evacuation on the disease risks adjusted for covariates. Results: Data from a total of 6406 individuals aged 40-74 years who participated in the check-ups both at baseline (2008-2010) and in one or more postincident years were analysed. Regardless of evacuation, significant post-incident increases in risk were observed for diabetes and hyperlipidaemia (relative risk: 1.27-1.60 and 1.12-1.30, respectively, depending on evacuation status and post-incident year). After adjustment for covariates, the increase in hyperlipidaemia was significantly greater among evacuees than among non-evacuees/temporaryevacuees (OR 1.18, 95% CI 1.06 to 1.32, p<0.01). Conclusions: The singularity of this study is that evacuation following the Fukushima disaster was found to be associated with a small increase in long-term hyperlipidaemia risk in adults. Our findings help identify discussion points on disaster planning, including preparedness, response and recovery measures, applicable to future disasters requiring mass evacuation.

Murakami M.,University of Tokyo | Murakami M.,Fukushima Medical University | Ono K.,Japan National Institute of Advanced Industrial Science and Technology | Tsubokura M.,Tokyo Medical University | And 5 more authors.
PLoS ONE | Year: 2015

After the 2011 accident at the Fukushima Daiichi nuclear power plant, nursing-home residents and staff were evacuated voluntarily from damaged areas to avoid radiation exposure. Unfortunately, the evacuation resulted in increased mortalities among nursing home residents. We assessed the risk trade-off between evacuation and radiation for 191 residents and 184 staff at three nursing homes by using the same detriment indicator, namely loss of life expectancy (LLE), under four scenarios, i.e. "rapid evacuation (in accordance with the actual situation; i.e. evacuation on 22 March)," "deliberate evacuation (i.e. evacuation on 20 June)," "20-mSv exposure," and "100-mSv exposure." The LLE from evacuation-related mortality among nursing home residents was assessed with survival probability data from nursing homes in the city of Minamisoma and the city of Soma. The LLE from radiation mortality was calculated from the estimated age-specific mortality rates from leukemia and all solid cancers based on the additional effective doses and the survival probabilities. The total LLE of residents due to evacuation-related risks in rapid evacuation was 11,000 per-sons-d - much higher than the total LLEs of residents and staff due to radiation in the other scenarios (27,1100, and 5800 persons-d for deliberate evacuation, 20 mSv-exposure, and 100 mSv-exposure, respectively). The latitude for reducing evacuation risks among nursing home residents is surprisingly large. Evacuation regulation and planning should therefore be well balanced with the trade-offs against radiation risks. This is the first quantitative assessment of the risk trade-off between radiation exposure and evacuation after a nuclear power plant accident. © 2015 Murakami et al.

Kato M.,Minamisoma Municipal General Hospital
Japanese Journal of Anesthesiology | Year: 2011

We report a late thrombosis of sirolimus-eluting stent 6 months after implantation of a drug-eluting stent. A 70-year-old man (52 kg, 148 cm) was diagnosed as acute cauda equina syndrome, and spinal surgery was scheduled. One week before the operation, the patient's aspirin and clopidogrel regimen was replaced with heparin injection, which was then discontinued 8 hours before the operation. The operation was completed uneventfully. The patient complained of severe chest pain 1 hour after the end of operation. Coronary angiography demonstrated stent thrombosis. PCI (removal of the thrombosis and plain old balloon angioplasty) was performed, and incomplete stent apposition was diagnosed with coronary angiography.

Hayano R.S.,University of Tokyo | Tsubokura M.,Tokyo Medical University | Miyazaki M.,Fukushima Medical University | Ozaki A.,Minamisoma Municipal General Hospital | And 10 more authors.
Proceedings of the Japan Academy Series B: Physical and Biological Sciences | Year: 2015

BABYSCAN, a whole-body counter (WBC) for small children was developed in 2013, and units have been installed at three hospitals in Fukushima Prefecture. Between December, 2013 and March, 2015, 2707 children between the ages of 0 and 11 have been scanned, and none had detectable levels of radioactive cesium. The minimum detectable activities (MDAs) for 137Cs were ≤3.5 Bq kg-1 for ages 0-1, decreasing to ≤2Bq kg-1 for ages 10-11. Including the 134Cs contribution, these translate to a maximum committed effective dose of ~16 μSv y-1 even for newborn babies, and therefore the internal exposure risks can be considered negligibly small. Analysis of the questionnaire filled out by the parents of the scanned children regarding their families' food and water consumption revealed that the majority of children residing in the town of Miharu regularly consume local or home-grown rice and vegetables, while in Minamisoma, a majority avoid tap water and produce from Fukushima. The data show, however, no correlation between consumption of locally produced food and water and the children's body burdens. © 2015 The Japan Academy.

Mori J.,Jyoban Hospital | Tsubokura M.,Minamisoma Municipal General Hospital | Sugimoto A.,University of Tokyo | Tanimoto T.,Jyoban Hospital | And 3 more authors.
Preventive Medicine | Year: 2013

Objective: The objective of this study is to assess the localized incidence of dog bites following the nuclear accident related to the Great East Japan Earthquake in March 2011. Methods: We identified the patients with dog bites in our hospital in Minamisoma City, Fukushima, during the period from 1. year prior to the earthquake to 3.5. months following it, and calculated the monthly and weekly incidence proportions by dividing the patient number by the total emergency room visits. We also analyzed the data by the characteristics of the patients. Results: We identified 27 dog-bite cases during the post-disaster period. The median monthly incidence proportion during the pre-disaster period and the highest monthly incidence proportion during the post-disaster period were 0.21 and 6.50 per 100 visits, respectively. The weekly incidence proportion peaked at 3. weeks after the earthquake and thereafter decreased to the baseline level. Conclusion: The Fukushima nuclear accident may be associated with an increased incidence of dog bites, and the prolonged evacuation in response to the radiation contamination may have prolonged the increased incidence after the disaster. Physicians and local residents should recognize this potential hazard. Countermeasures to contend with this risk should be a mandatory aspect of disaster preparedness, including for nuclear accidents. © 2013 Elsevier Inc.

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