Additional risk of diabetes exceeds the increased risk of cancer caused by radiation exposure after the Fukushima disaster

Abstract

The 2011 Fukushima disaster led to increases in multiple risks (e.g., lifestyle diseases and radiation exposure) and fear among the public. Here, we assessed the additional risks of cancer caused by radiation and diabetes related to the disaster and the cost-effectiveness of countermeasures against these conditions. Our study included residents of the cities of Minamisoma and Soma (10–40 km and 35–50 km north of the Fukushima Daiichi (N° 1) Nuclear Power Station, respectively). We used the loss of life expectancy (LLE) as an indicator to compare risks between radiation exposure and diabetes. We also estimated the cost-effectiveness of radiation-related countermeasures, including restricted food distribution, decontamination, and whole-body counter tests and interventions. Metformin therapy was selected as a representative management for diabetes. The diabetes-related LLEs among residents were 4.1 (95% confidence interval: 1.4–6.8) ×10−2 years for the whole population and 8.0 (2.7–13.2) ×10−2 years for 40s to 70s in a scenario that considered the additional incidence of diabetes during the first 10 years. The cancer-related LLEs caused by lifetime exposure to radiation were 0.69 (2.5–97.5 percentile: 0.61–0.79) ×10−2 years for the whole population and 0.24 (0.20–0.29) ×10−2 years for 40s to 70s. The diabetes-related LLEs among residents in the above-mentioned scenario were 5.9-fold and 33-fold higher than those attributed to average radiation among the whole population and among the 40s to 70s age groups, respectively. The costs per life-years saved of the radiation countermeasures (i.e., restricted food distribution, decontamination, and whole-body counter tests and interventions) were >1 to >4 orders of magnitude higher than those of general heath checkups and conventional management for diabetes. Our findings indicate that countermeasures to mitigate diabetes are warranted. Policy-makers’ and individuals’ understanding of multiple risks after any disaster will be essential to saving the lives of victims.

Demographic transition and factors associated with remaining in place after the 2011 Fukushima nuclear disaster and related evacuation orders

“…community disruption) especially among the elderly [ 23 , 24 ]. As a result, one report indicates that the health effects of radiation exposure were less serious than those related to the post-disaster increase in diabetes [ 25 ]. In addition, the timing of issues of evacuation instructions may be worth considering.…”

“…indoor sheltering instructions). Policy makers should issue evacuation instructions at appropriate timings while being aware of the potential risks of evacuation instructions and with preparation to mitigate such risk [ 25 ].…”

Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

“…This was most likely attributable to the copayment exemption for evacuees. As the health status of the evacuees worsened after the disaster (Ebner et al 2016;Nomura et al 2016;Ohira et al 2017;Murakami et al 2017), the increases in expenditure in both short-term and long-term EOAs may also be attributable to the poor health status of the evacuees. In addition, the increases in expenditure on long-term care might be attributable to reduced availability of informal care provided by younger family members and neighbors following evacuation .…”

“…No studies have systematically evaluated temporal changes in expenditure on healthcare and long-term care in pre-versus post-disaster periods. In particular, no detailed studies were performed to compare healthcare and longterm care between evacuees and non-evacuees, despite their health status difference (Ebner et al 2016;Nomura et al 2016;Ohira et al 2017;Murakami et al 2017). Detailed investigations, including comparative analyses of expenditure on healthcare and long-term care among evacuees and non-evacuees, would enhance understanding of temporal changes post-disaster.…”

Effect of Radiological Countermeasures on Subjective Well-Being and Radiation Anxiety after the 2011 Disaster: The Fukushima Health Management Survey

“…While radiation exposure has been estimated to be <30 mSv of additional lifetime effective dose [ 1 , 2 ], concerns about radiation risks have not been dispelled among the public [ 3 , 4 ]. Furthermore, an increase in other health risks such as psychological distress and lifestyle diseases has been reported among residents in Fukushima, especially evacuees [ 5 , 6 , 7 , 8 ]. Psychological distress was reported to be associated with a higher radiation risk perception [ 9 ], and its prevalence has decreased gradually but is still higher than before the 2011 disaster [ 10 ].…”