How Occupational Health can Contribute in a Disaster and What We should Prepare for the Future—Lessons Learned through Support Activities of a Medical School at the Fukushima Daiichi Nuclear Power Plant in Summer 2011: Koji MORI, et al. Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan— Background A nuclear accident occurred at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company (TEPCO) as a result of a mega‐earthquake and tsunami in March, 2011. A large number of workers were engaged in response and recovery operations under a complex structure of involved companies. They were exposed not only to radiation but also to other health hazards. TEPCO implemented programs to prevent radiation exposure, but had no effective systems for managing the other health risks and few occupational health (OH) professionals contributed to the health risk management. Activities: The University of Occupational and Environmental Health (UOEH), Japan, dispatched physicians to a quake‐proof building at the plant to provide first‐aid services from mid‐May, 2011, and took a strategic approach to protecting workers from existing health risks. UOEH presented recommendations on OH systems and preventive measures against heat stress to the Government and TEPCO. The Ministry of Health, Labour, and Welfare issued guidelines to TEPCO and contractors. TEPCO implemented a comprehensive program against heat stress according to the guidelines and in cooperation with UOEH. As a result, we successfully prevented severe heat illness during summer 2011. Discussion From our experiences, we believe that the following recommendations should be considered: 1) the role of OH and the participation of experts should be defined in emergency response plans; 2) regulations should allow the national government and main companies involved to lead safety and health initiatives for all workers at disaster sites; and 3) OH professionals, response manuals and drills should be organized at a national level.

Review of health issues of workers engaged in operations related to the accident at the Fukushima Daiichi Nuclear Power Plant: Koh Hiraoka, et al. Occupational Health Training Center, University of Occupational and Environmental Health, Japan Objective The aim of this review was to summarize the lessons learned from the experience in protecting the health of workers engaged in operations following the accident at the Fukushima Daiichi Nuclear Power Plant (NPP). Methods We reviewed all types of scientific papers examining workers’ health found in Medline and Web of Sciences as well as some official reports published by the Ministry of Health, Labour and Welfare of Japan and other governmental institutes. Results The papers and reports were classified into those investigating workers at the Fukushima Daiichi and Daini NPPs, workers engaged in decontamination operations in designated areas, and other workers. Regarding workers at the NPPs, many efforts were made to establish an emergency‐care and occupational health system. Risk management efforts were undertaken for radiation exposure, heat stress, psychological stress, outbreak of infectious diseases, and fitness for work. Only a few reports dealt with decontamination workers and others; however, the health management of these workers was clearly weaker than that for workers at the NPPs. Conclusions Many lessons can be learned from what occurred. That knowledge can be applied to ongoing decommissioning work and to future disasters. In addition, it is necessary to study the long‐term health effects of radiation exposure and to accumulate data about the health of workers engaged in decontamination work and other areas.

Occupational health management systems involving OH experts should be implemented to manage multiple health risks with several conflicts and trade-offs after a disaster.