A review of the Fukushima nuclear reactor accident: radiation effects on the thyroid and strategies for prevention

Purpose of review: This is a summary of the nuclear accident at the Tokyo Electric Power Company Fukushima Daiichi Nuclear Power Stations (FDNPS) on 11 March 2011 to be used as a review of the radiation effects to the thyroid and strategies of prevention.\nRecent findings: The amount of radioiodine released to the environment following the Fukushima accident was 120?Peta Becquerel, which is approximately one-tenth of that in the Chernobyl accident. Residents near the FDNPS were evacuated within a few days and foodstuffs were controlled within 1 or 2 weeks. Therefore, thyroid radiation doses were less than 100?mSv (intervention levels for stable iodine administration) in the majority of children, including less than 1 year olds, living in the evacuation areas. Because the incidence of childhood thyroid cancer increased in those residing near the site following the Chernobyl accident, thyroid screening of all children (0?18 years old) in the Fukushima Prefecture was started. To date, screening of more than 280?000 children has resulted in the diagnosis of thyroid cancer in 90 children (approximate incidence, 313 per million). Thus, although the dose of radiation was much lower, the incidence of thyroid cancer appears to be much higher than that following the Chernobyl accident.\nSummary: A comparison of the thyroidal consequences following the Fukushima and Chernobyl nuclear reactor accidents is discussed. We also summarize the recent increased incidence in thyroid cancer in the Fukushima area following the accident in relation to increased thyroid ultrasound screening and the use of advanced ultrasound techniques

Post-crisis efforts towards recovery and resilience after the Fukushima Daiichi Nuclear Power Plant accident

One of thewell-known radiation-associated late-onset cancers is childhood thyroid cancer as demonstrated around Chernobyl apparently from 1991. Therefore, immediately after the Fukushima Daiichi Nuclear Power Plant accident on March 2011, iodine thyroid blocking was considered regardless of its successful implementation or not at the indicated timing and places as one of the radiation protection measurements, in addition to evacuation and indoor sheltering, because a short-lived radioactive iodine was massively released into the environment which might crucially affect thyroid glands through inhalation and unrestricted consumption of contaminated food and milk. However, very fortunately, it is now increasingly believed that the exposure doses on the thyroid as well as whole body are too low to detect any radiation-associated cancer risk in Fukushima. Although the risk of radiation-associated health consequences of residents in Fukushima is quite different from that of Chernobyl and is considerably low based on the estimated radiation doses received during the accident for individuals, a large number of people have received psychosocial and mental stresses aggravated by radiation fear and anxiety, and remained in indeterminate and uncertain situation having been evacuated but not relocated. It is, therefore, critically important that best activities and practices related to recovery and resilience should be encouraged, supported and implemented at local and regional levels. Since psychosocial well-being of individuals and communities is the core element of resilience, local individuals, health professionals and authorities are uniquely positioned to identify and provide insight into what would provide the best resolution for their specific needs

Evaluation of fat-free mass by whole-body counter in Japanese healthy young adults

Whole-body counters (WBCs) are special instruments for measuring internal irradiation doses and are usually housed within or around nuclear facilities in the event of unexpected radiation emergencies. As a substantial proportion of total body potassium (TBK) is found in fat-free mass (FFM), FFM volume can be predicted from WBC-measured 40K. We screened TBK in Japanese healthy young adults using a WBC and found strong linear correlations between TBK and lean body mass (LBM) and body mass index (r = 0.97, P < 0.01 and r = 0.47, P < 0.01, respectively). Multiple linear regression analysis, following adjustments for sex, indicates that only LBM has a significant correlation with TBK (P < 0.01). These results strongly support the feasibility of using WBCs for estimating FF

Awareness of the implementation of stable iodine prophylaxis by parental guardians living in the urgent protective action planning zone of an operating nuclear power plant in Japan

Purpose: The aim of this study was to clarify the characteristics and awareness of the need for protection against ionizing radiation, such as sheltering, evacuation, and implementing stable iodine prophylaxis, of guardians parenting young children living in an urgent protective action planning zone (UPZ) of an operating nuclear power plant in Japan.Methods: Self-administered questionnaires were distributed to approximately 3000 guardians through 26 kindergartens located within a UPZ. Responses were obtained from 1172 who lived in the UPZ and were included in the analysis.Results: Of the 1172 guardians, 460 (39.2%) responded that sheltering is not useful to reduce the dose of radiation exposure. On the other hand, 395 (33.7%) guardians responded that implementing stable iodine (SI) prophylaxis could prevent exposure from all radionuclides, and 876 (74.7%) responded that pregnant women should also implement SI prophylaxis in a nuclear emergency. Furthermore, 83.0% (973) responded that they wanted to receive pre-distribution of stable iodine (PDSI) for their children. On the other hand, 38.9% (456) of guardians had not known about SI before the study, and 71.8% (841) of guardians felt anxious about implementing SI prophylaxis for their children.Conclusion: Most guardians had expectations regarding SI and received PDSI, but they felt anxious about implementing SI prophylaxis for their children. It is essential that guardians living in the UPZ of restarted nuclear power plants be educated, and that risk communication about protection against ionizing radiation, including the side effects of implementing SI prophylaxis and radiation health effects, be conducted

Eleven years of community efforts for the recovery from the nuclear disaster

Eleven years have passed since the accident at the Fukushima Daiichi Nuclear Power Station (FDNPP) in 2011. Since the accident, Nagasaki University (Nagasaki, Japan) has been assisting the reconstruction efforts of Kawauchi Village, Fukushima Prefecture, which was the first village to declare it safe for residents to return to their homes. In April 2013, Nagasaki University and the Kawauchi Government Office concluded an agreement concerning comprehensive cooperation toward the reconstruction of the village. Furthermore, the university began comprehensive support for the residents of Tomioka and Ohkuma towns. Elevn years after the accident, there are gaps in the recovery process in each municipality around the FDNPP. Radiation medical science experts should carefully understand the recovery situation in each municipality to contribute effectively

Estimation of Blood Loss in Total Knee Arthroplasty with and without Tourniquet

Total knee arthroplasty (TKA) without a tourniquet can reduce the risk of large venous emboli, but is associated with increased blood loss. To provide an accurate estimate of this blood loss, we divided 136 patients who underwent primary TKA into four groups based on the type of operation: 1) bilateral TKA with tourniquet; 2) bilateral TKA without tourniquet; 3) unilateral TKA with tourniquet; and 4) unilateral TKA without tourniquet. Blood loss was estimated by calculating the fall in hemoglobin and total blood volume corrected for Japanese. A small difference in intraoperative blood loss was seen between unilateral TKA without tourniquet (308 ml) and bilateral TKA without tourniquet (411 ml). Total blood loss was 879 ml in unilateral TKA with tourniquet, 1165 ml in unilateral TKA without tourniquet, 1458 ml in bilateral TKA with tourniquet and 1823 ml in bilateral TKA without tourniquet. Uni- and bilateral TKAs without a tourniquet were thus associated with an increased blood loss. Performing TKA without a tourniquet should thus be reconsidered to avoid venous thromboembolism

Measurements of Individual Radiation Doses in Residents Living Around the Fukushima Nuclear Power Plant

At the outset of the accident at Fukushima Daiichi Nuclear Power Plant in March 2011, the radiation doses experienced by residents were calculated from the readings at monitoring posts, with several assumptions being made from the point of view of protection and safety. However, health effects should also be estimated by obtaining measurements of the individual radiation doses. The individual external radiation doses, determined by a behavior survey in the "evacuation and deliberate evacuation area" in the first 4 months, were <5 mSv in 97.4% of residents (maximum: 15 mSv). Doses in Fukushima Prefecture were <3 mSv in 99.3% of 386,572 residents analyzed. External doses in Fukushima City determined by personal dosimeters were <1 mSv/3 months (September-November, 2011) in 99.7% of residents (maximum: 2.7 mSv). Thyroid radiation doses, determined in March using a NaI (TI) scintillation survey meter in children in the evacuation and deliberate evacuation area, were <10 mSv in 95.7% of children (maximum: 35 mSv). Therefore, all doses were less than the intervention level of 50 mSv proposed by international organizations. Internal radiation doses determined by cesium-134 (134C) and cesium-137 ( 137C) whole-body counters (WBCs) were <1 mSv in 99% of the residents, and the maximum thyroid equivalent dose by iodine-131 WBCs was 20 mSv. The exploratory committee of the Fukushima Health Management Survey mentions on its website that radiation from the accident is unlikely to be a cause of adverse health effects in the future. In any event, sincere scientific efforts must continue to obtain individual radiation doses that are as accurate as possible. However, observation of the health effects of the radiation doses described above will require reevaluation of the protocol used for determining adverse health effects. The dose-response relationship is crucial, and the aim of the survey should be to collect sufficient data to confirm the presence or absence of radiation health effects. In particular, the schedule of decontamination needs reconsideration. The decontamination map is determined based on the results of airborne monitoring and the radiation dose calculated from readings taken at the monitoring posts at the initial period of the accident. The decontamination protocol should be reevaluated based on the individual doses of the people who desire to live in those areas

Leptin is an independent determinant of bone mineral density in men with type 2 diabetes mellitus.

To investigate the possible relationship of leptin to bone mineral density (BMD) in men with type 2 diabetes mellitus (T2DM), we screened 168 Belarusian men aged 45-65 years. Plasma total cholesterol (TC), high-density lipoprotein cholesterol, and triglyceride concentrations were assessed, and low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol (LDL-C) were calculated. Hemoglobin A(1c), immune-reactive insulin (IRI), serum total testosterone, and sex hormone-binding globulin were also evaluated. BMD was evaluated using dual-energy X-ray absorptiometry. By univariate linear regression analysis, BMD was significantly correlated with body mass index (r = 0.23, P = 0.002) and leptin (r = 0.21, P = 0.006). By multivariate regression analysis adjusting for confounding factors, log leptin was independently correlated with BMD (β = 0.058, P = 0.001). Our study revealed that leptin is an independent determinant of BMD in patients with T2DM. Further research is necessary to confirm this association and to develop ways to correct abnormalities of bone metabolism in patients with T2DM

Comparison of quality of life between elderly and non-elderly adult residents in Okuma town, Japan, in a post-disaster setting

With the growing elderly population who are susceptible to poor health, improvement of their quality of life is essential. In the post-disaster setting of the 2011 Fukushima Dai-ichi nuclear power plant (FDNPP) accident, affected municipalities such as Okuma town commenced their recovery processes and lifted evacuation orders in 2019. This study examines the differences in self-reported mental and physical health status, social functioning, risk perception, and intention to return between elderly (age ≥65 years) and non-elderly (age 20–64 years) residents. Questionnaires were distributed to current residents and evacuees of Okuma. Results revealed that the elderly had a 1.4 times higher odds ratio (95%CI 1.0–1.8, p = 0.034) for having anxiety regarding radiation-related health effects on future generations and a 1.3 times higher odds ratio (95%CI 1.1–1.5, p = 0.001) for wanting to know about the release of FDNPP-treated water into the environment than the younger group. Elderly residents also demonstrated a 2.2 times higher odds ratio for reporting poor physical health than younger residents. Clearing misconceptions and disseminating coherent information will reduce risk perception among this group. Further in-depth research regarding the disposal of FDNPP-treated water and its perceived risks is required. Health promotion through the encouragement of social participation, improvement of surroundings to facilitate healthy behaviors, and enhanced access to health services will improve the quality of life of elderly Okuma residents