Fukushima :health effects on the residents Susumu Shirabe, MD, PhD - - PowerPoint PPT Presentation

Fukushima :health effects on the residents

Susumu Shirabe, MD, PhD

Trustee & Vice president Nagasaki University Director of PCU(prefecture/city/university)-Nagasaki council

Moved in 1942 to Nagasaki

3-year prior to A-bomb disaster Family moved from Korea to Nagasaki

grandmother grandfather mother Uncles; A-bomb victims

Nagasaki University sent ship with food water and students

When I visited Fukushima, I felt I was at destroyed Nagasaki by Atomic Bomb.

RECNA

Research Center for Nuclear Weapons Abolition, Nagasaki University established April 1 2012

１）There was no research center for peace and abolition of nuclear weapons at Nagasaki. ２）We, Nagasaki University, decided to make RECNA by our own expense. ３）President Obama‘s speech in Prague boosted us.

Number of death due to the 2011 earthquake of the Pacific coast of Tohoku

3 4,632 1 9,391 1,601 24 20 2 4 1 7 4 Iwate Miyagi Fukushima

The Pacific

Aizu Naka-Dori Hama-Dori 166km 133km

Pacific Ocean Miyagi

Fukushima city

Fukushima Prefecture

• Distribution of meals

A long line to receive the relief supplies

Health management after the NPP accident

Object Situation Contents Plant workers High risk in radiation exposure & contamination, accident Radiation emergency medicine Emergency responder High risk in radiation exposure & contamination Consultation clinic for mental & physical health, radiation Residents Chronic low dose exposure, stress & fear Monitoring, communication, information, education

Thyroid monitoring of children

Internal Exposure Thyroid monitored of children in Iwaki-City, Kawamata-Town, and Iitate-Village was conducted from March 24 to March 30 in 2011. The screening survey indicated that thyroid doses were less than 0.2 μSv per hour for all the children, which is below the cutoff level defined by the Nuclear Safety Commission of Japan.

Based on the results of SPEEDI on 23rd Mar 2011, the Local Nuclear Emergency Response Headquarters conducted thyroid monitoring of 1,149 children to examine exposure levels. Valid data was obtained for 1,080 subjects, and all values were less than 0.2 μSv/h(equal to 100mSv). Number of subjects

Net value

μSv/h

598 (55.4%) 282 (26.1%) 123 (11.4%) 51 (4.7%) 15 (1.4%) 4 (0.4%) 4 (0.4%) 2 (0.2%) 1 (0.1%)

Fukushima Health Management (FHM) Survey

External Exposure Estimate

Basic survey Subjects: Residents(2 million) as of March11, 2011 Method: Self-administered questionnaire survey(three month) Content: Details of whereabouts and daily routine from March 11 onwards to estimate exposure.

Follow-up

‘Health Management File’ ・To keep health check up records ・To provide information on radiation Data base ・To provide long-term monitoring of residents’ health ・To guide treatment ・To inform and guide future generations

Health Status Assessment

Detailed Surveys Thyroid Ultrasound Examinations Subjects : Residents aged 18 years or younger Content : Ultrasound examination Survey period : Every three years Comprehensive Health Checks Subjects : Residents in evacuation zones Content : General health checkup items will differential leukocyte count Subject : Residents outside evacuation zones Content : General health checkup items Promotion of municipal and workplace health checks Additional health checkups to reach residents not includes in current services Mental Health and Lifestyle Survey Pregnancy and Birth Survey

• Whole body Counter
• Dosimeter

Consultation and support Follow up Treatment

Thyroid screening

Thyroid Screening Results

Total Number of Participants April 2011 - March 2012 April 2012 – January 2013 38,114 94,975 Results Status April 2011 - March 2012 April 2012 – January 2013 Number % Number % A A1 No ndules/cysts 24,469 64.2 99.5 53,028 55.8 99.4 A2 Nodules ≤ 5.0 mm or cysts ≤ 20.0mm 13,459 35.3 41,398 43.6 B Nodules ≥ 5.1 Mm or cysts ≥ 20.1mm 186 0.5 548 0.6 C Immediate need for secondary examination 0.0 1 0.001 Test results April 2011 – March 2012 April 2012 – January 2013 Number % Total(%) Number % Total(%) Nodules ≥5.1mm 185 0.48 385 (1.01) 538 0.57 951(1.00) ≤5.0mm 201 0.53 413 0.43 Cysts ≤20.1mm 1 0.003 13,383 (35.11) 10 0.006 41,439 (46.63) ≤20.0mm 13,382 35.11 41,433 43.63

(Cases)

Numbers of thyroid cancer identified by Fukushima Health Management Survey

Age at diagnosis

Female Male (years)

Total: 44 cases (Male: 17 cases, Female 27 cases)

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Frequency of thyroid cancer (%)

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) * Female Male Age in years at time of surgery %- %%.)+ Ito thyroid Hospital Fukushima screening Age in years at time of diagnosis

Incidence of pediatric thyroid cancer: Fukushima vs. Japan historical data

Cases Cases

External radiation exposure levels for all residents (386,572 persons) of Fukushima Prefecture

Age in years

Accident at Chernobyl (evacuees in Belarus and Ukraine) Accident at Fukushima (children in Iitate Village, Kawamata Town, and Iwaki City)

Comparison of external radiation exposure in Fukushima and Chernobyl evacuees

Fukushima shima Fukushima

Difference between Chernobyl and Fukushima in terms of thyroid radiation exposure

Belarus Ukraine

Death caused by disaster

Direct death Indirect Death

• Acute phase
• On the scene
• Trauma, drowning and

crush syndrome

• Subacute and chronic phase
• Shelter, hospital and

temporary housing

• Worsened chronic diseases
• “disuse syndrome”
• So-called “Inactive life-style disease”
• Depressive state-related

≒ Disaster related death

The number of direct and indirect death due to the 2011 earthquake of Pacific coast of Tohoku

Fukushima Prefecture Direct death: 1,599 (51.3%) Indirect death: 1,524 (48.7%) Miyagi Prefecture Direct death: 9,582 (91.6%) Indirect death: 873 (8.4%) Iwate Prefecture Direct death: 4,672 (91.8%) Indirect death: 417 (8.2%)

Fukushima Prefecture 50,633 (85.0%) Miyagi Prefecture 7,373 (12.4%) Iwate Prefecture 1,531 (2.6%)

Number of evacuees to other prefectures

Evacuated because there houses and life-line is broken at Miyagi and Iwate

5.6 6.3 7.0 12.8 14.1 19.4

5 10 15 20 25

岩手 宮城 福島

震災前 震災後

Source: Japan Medical Association

（％）

Physicians responding that their health was not good: pre-disaster vs. post-disaster

Iwate Miyagi Fukushima

Pre Post

Post-disaster : decrease in number of full-time physicians in Fukushima Year Number of physician Shift Mar, 2011 2024 Dec, 2011 1953

• 71

Aug, 2012 1945

• 8

March 11

Indirect 2303

Direct 15879

The disaster still processing. Without countermeasure for indirect death, Preventable indirect death would continue to increase.

26

Declaration of return from Koriyama city to Kawauchi village

Declaration of return from Koriyama city to Kawauchi village

Decontamination of Kawauchi village

Establishment of Nagasaki University Satellite Office in Kawauchi Village (April 2013)

Mission of Satellite Office 1.Evaluation of effectiveness of decontamination through the measurement of radionuclides in soils. 2.Evaluation of risks of internal exposure through the measurement of foods and waters. 3.Health consultation with inhabitants including evacuees according to the results of above mentioned measurements. 4.Health promotion of inhabitants including evacuees.

15% 15% 15% 15% 17% 17% 17% 17% 30% 30% 30% 30% 33% 33% 33% 33% 30% 30% 30% 30% 53% 53% 53% 53% 60% 60% 60% 60% 66% 66% 66% 66% 58% 58% 58% 58% 36% 36% 36% 36% 46% 46% 46% 46% 85% 85% 85% 85% 83% 83% 83% 83% 70% 70% 70% 70% 67% 67% 67% 67% 70% 70% 70% 70% 47% 47% 47% 47% 40% 40% 40% 40% 34% 34% 34% 34% 42% 42% 42% 42% 64% 64% 64% 64% 54% 54% 54% 54% 0% 0% 0% 0% 10% 10% 10% 10% 20% 20% 20% 20% 30% 30% 30% 30% 40% 40% 40% 40% 50% 50% 50% 50% 60% 60% 60% 60% 70% 70% 70% 70% 80% 80% 80% 80% 90% 90% 90% 90% 100% 100% 100% 100% １０才未満 １０才未満 １０才未満 １０才未満 １０代 １０代 １０代 １０代 ２０代 ２０代 ２０代 ２０代 ３０代 ３０代 ３０代 ３０代 ４０代 ４０代 ４０代 ４０代 ５０代 ５０代 ５０代 ５０代 ６０代 ６０代 ６０代 ６０代 ７０代 ７０代 ７０代 ７０代 ８０代 ８０代 ８０代 ８０代 ９０代以上 ９０代以上 ９０代以上 ９０代以上 合計 合計 合計 合計 ( ( ( (102 102 102 102) ) ) ) (1 (1 (1 (18 8 8 8) ) ) ) 12 12 12 120 ( ( ( (152 152 152 152) ) ) ) (3 (3 (3 (32 2 2 2) ) ) ) 1 1 1 184 84 84 84 (81 81 81 81) ( ( ( (185 185 185 185) ) ) ) 2 2 2 266 66 66 66 2 2 2 233 33 33 33 2 2 2 267 67 67 67 4 4 4 447 47 47 47 4 4 4 466 66 66 66 3 3 3 371 71 71 71 3 3 3 381 81 81 81 81 81 81 81

2 2 2 2816 816 816 816

(155 155 155 155) ) ) ) ( ( ( (78 78 78 78) ) ) ) ( ( ( (187 187 187 187) ) ) ) ( ( ( (80 80 80 80) ) ) ) (2 (2 (2 (237 37 37 37) ) ) ) (2 (2 (2 (210 10 10 10) ) ) ) (2 (2 (2 (278 78 78 78) ) ) ) ( ( ( (188 188 188 188) ) ) ) (244 44 44 44) ( ( ( (127 127 127 127) ) ) ) ( ( ( (159 159 159 159) ) ) ) ( ( ( (222 222 222 222) ) ) ) ( ( ( (52 52 52 52) ) ) ) (2 (2 (2 (29 9 9 9) ) ) ) ( ( ( (1517 1517 1517 1517) ) ) ) (1299 299 299 299)

Ratio of residents who returned to Kawauchi Village

Age(years)

:Returned :Not returned