The International Workshop onRadiation and Thyroid Cancer: Tutorial Session

“Overview of the Fukushima Health Management Survey”

Time and Date: 14:10-14:55, February 21, 2014Venue: Shinagawa Prince Hotel, Tokyo

Department of Public Health, Fukushima Medical University School of Medicine,Radiation Medical Science Center for the Fukushima Health Management Survey,

Fukushima Medical University,Seiji YASUMURA (yasumura@fmu.ac.jp) 1

Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey4. Concluding Comments

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey4. Concluding Comments

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Fukushima City Minami-soma City Fukushima Dai-ichiNuclear Power Plant

“Great East Japan Earthquake”Triple Disasters in Fukushima

Earthquake Tsunami Nuclear Power Plant Accident

1,603 died and 207 are still lost due to Earthquake and/or Tsunami.

1,652 deaths were “disaster-related deaths”. No one died due to radiation due to NPP accident.

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey4. Concluding Comments

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Number of residents who were living in evacuation

area: 210,000 (March 11, 2011)

Number of evacuees(including Voluntary

evacuees)

・ Inside Fukushima Prefecture:88,416・ Outside Fukushima Prefecture:48,364

Total: 136,780(January, 16, 2014)

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Direct deaths/Disaster-related deaths

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Iwate Miyagi Fukushima

Direct deaths 4,673 9,537 1,607

Disaster-relateddeaths 434 879 1,656

(“Asahi Shinbun”, 20, Feb., 2014)

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Yasumura S, Goto A, Yamazaki S, Reich MR. Excess mortality among relocated institutionalized elderly after the Fukushima nuclear disaster. Public Health 127: 186-188, 2012.

Excess mortality

Excess mortality among relocated institutionalized elderlyafter the Fukushima Daiichi NPP accident

AccidentOccurred.

Evacuees outside Fukushima Prefecture 　 (Feb. 2, 2013)

北海道1,802

青森県550

岩手県538

秋田県925

宮城県2,328

Yamagata9,513

Niigata

5,724茨城県3,943

栃木県2,948群馬県

1,688

千葉県3,313

埼玉県3,820

Tokyo7,449

山梨県710

神奈川県2,449

静岡県823

長野県1,003

福井県243

石川県350

富山県243

岐阜県228

愛知県795

滋賀県229

京都府702

三重県213奈良県

106和歌山県54 大阪府

734

兵庫県604岡山県

339Hiroshima322

鳥取県133

島根県107

山口県　 83

香川県45

徳島県40

高知県63愛媛県

106

大分県176

佐賀県134

熊本県98宮崎県

134

鹿児島県148 Okinawa

738

福岡県353

※都道府県名に併記している数字は各都道府県への避難者数。　　　

福島県外への避難状況一覧 ( 　 )単位 人北海道 1,802滋賀県 229青森県 550京都府 702岩手県 538大阪府 734宮城県 2,328兵庫県 604秋田県 925奈良県 106Yamagata 9,513和歌山県 54茨城県 3,943鳥取県 133栃木県 2,948島根県 107群馬県 1,688岡山県 339埼玉県 3,820 Hiroshima 322千葉県 3,313山口県 83Tokyo 7,449徳島県 40神奈川県 2,449香川県 45Niigata 5,724愛媛県 106富山県 243高知県 63石川県 350福岡県 353福井県 243佐賀県 134山梨県 710 Nagasaki 89長野県 1,003熊本県 98岐阜県 228大分県 176静岡県 823宮崎県 134愛知県 795鹿児島県 148三重県 213 Okinawa 738

Total 57,135(Radiation　Medical　Center　for　the　Fukushima　Health　Management　Survey,　Fukushima　Medical　University)

Nagasaki

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福島県外への避難状況一覧 ( 　 )単位 人北海道 1,668滋賀県 197青森県 472京都府 625岩手県 538大阪府 613宮城県 2,514兵庫県 538秋田県 779奈良県 97Yamagata 5,708和歌山県 39茨城県 3,738鳥取県 119栃木県 2,922島根県 99群馬県 1,459岡山県 319埼玉県 2,797 Hiroshima 241千葉県 3,333山口県 86Tokyo 6,583徳島県 40神奈川県 2,117香川県 50Niigata 4,640愛媛県 89富山県 207高知県 49石川県 302福岡県 329福井県 196佐賀県 104山梨県 649 Nagasaki 85長野県 921熊本県 108岐阜県 219大分県 127静岡県 750宮崎県 136愛知県 747鹿児島県 125三重県 220 Okinawa 670

Total 48,364

北海道1,668

青森県472

岩手県538

秋田県779

宮城県2,514

茨城県3,738

栃木県2,922群馬県

1,459

千葉県3,333

埼玉県2,797

山梨県649

神奈川県2,117

静岡県750

長野県921

福井県196

石川県302

富山県207

岐阜県219

愛知県747

滋賀県197

京都府625

三重県220奈良県

97和歌山県39 大阪府

613

兵庫県538岡山県

319

鳥取県119

島根県99

山口県　 86

香川県50

徳島県40

高知県49愛媛県

89

大分県127

佐賀県104

熊本県108宮崎県

136

鹿児島県125

福岡県329

※都道府県名に併記している数字は各都道府県への避難者数。　　　(Radiation　Medical　Center　for　the　Fukushima　Health　Management　Survey,　Fukushima　Medical　University)

Evacuees outside Fukushima Prefecture 　 (Jan. 16, 2014)

Yamagata5,708

Niigata4,640

Tokyo

6,583

Okinawa670

Hiroshima241

Nagasaki85

57,135 (Feb. 2, 2013)10

Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey4. Concluding Comments

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1. To monitor residents’ long-term health and to promote their future well-being.

2. To confirm whether a long-term low-dose radiation exposure has an effect on health.

Objectives of the Fukushima Health Management Survey

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey: Basic survey4. Concluding Comments

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Table 1 Estimated external radiation doses (preceding and full-scale survey)

Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Outline and result of the Fukushima Health

Management Survey: Thyroid ultrasound examination

4. Concluding CommentsPlease wait a little!Professor Suzuki

will present tommorow!!

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey: Comprehensive health check

4. Concluding Comments

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The comprehensive health check in Date City

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Results

The proportion of abnormal test results (obesity, glucose metabolism, lipid metabolism and liver function) was higher in the study population compared with the reference populations; the trend was more pronounced in males. This may be due to possible lifestyle changes (such as less exercise and excessive alcohol consumption) caused by psychological distress and sleeping disorder after forced evacuation.

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey: The mental health and lifestyle survey

4. Concluding Comments

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The mental health and lifestyle survey Subjects Age criteria Mental health items MethodAdults Born before April 1, 1995

(include High school student on March 11, 2011)

・ K6 (Kessler, 2003)・ PCL (PTSD Checklist Stressor Specific Version, Weathers, 1994）

Self-administered

Children (3)

Born after April 2, 1995, and before April 1, 1998 (Junior high school student on March 11, 2011)

・ SDQ (Strengths and Difficulties Questionnaire)

Partially self-administered

Children (2)

Born after April 2, 1998, and before April 1, 2004 (Primary school student on March 11, 2011)

・ SDQ (Strengths and Difficulties Questionnaire)

Parents answer

Children (1)

Born after April 2, 2004, and before March 11, 2011 (Before primary school student on March 11, 2011)

・ SDQ (Strengths and Difficulties Questionnaire) for children aged 4 years and older

Parents answer

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Figure Distribution of K6 (Press release, 11, Sep, 2012)

K6 in total population

K6 by sex

Total score

Number

Number

Total score

MaleFemale

Total

Male

Female

↑

↑

↑

↑

↑

↑

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Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey: Pregnancy and birth survey

4. Concluding Comments

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The pregnancy and birth survey15,972

Subjects

Send a questionnaire

Research Office

Mid-wife, Doctors

Data company

Report of the result

Telephone consultation if needed

Confirm the answers, especially items of depression, and decide whether telephone consultation is needed or not

E-mail /Telephone consultation

Transmit the information

Order of data entry

Feedback of the consultation

Checkquestionnaire

Letter of thanks

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Result of the 2011 survey

1. Response RatesA total of 15,972 questionnaires were distributed in January 2012 and 9,298 (58.2%) were returned by 31 August 2012

2. Support after the SurveyInvalid answers and spontaneous abortions were excluded, and telephone counseling was provided by midwives and public health nurses for respondents who were identified as respondents requiring support on the basis of the survey. The proportion of miscarriage in Fukushima Prefecture was 0.79% and that of induced abortion was 0.09% in 2012, no different from the previous fiscal year. The proportion of premature delivery in 2012 was 5.86% which was higher than the previous fiscal year (4.75%). 31

Today’s topic

1. Overview of the Great East Japan Earthquake in Fukushima

2. Situation of evacuation and evacuees3. Overview of the Fukushima Health

Management Survey4. Concluding Comments

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Our greatest achievement:There are so many problems caused by the nuclear power plant accident now. Fukushima residents more concerned about their health than ever and feel anxiety of their own health. Under such circumstances, we implemented the presented multifaceted Fukushima Health Management Survey within one year after the Great East Japan Earthquake.

In collaboration with:Hiroshima University, Nagasaki University, Radiation Effects Research Foundation, National Institute of Radiological Science, and Fukushima Medical Association.33

Concluding Comments

Our best efforts continues;1. To outreach as many residents as possible.2. To implement further detailed investigations.3. To disseminate obtained results.

We hope continued concerns and collaboration by Hiroshima University and Nagasaki University.

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