Continuous improvement of fitness-for-duty management programs for workers engaging in stabilizing and decommissioning work at the Fukushima Daiichi Nuclear Power Plant

Abstract

Background: Numerous workers have participated in recovery efforts following the accident that occurred at the Tokyo Electric Power Company (TEPCO) Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake. These workers, belonging to various companies, have been engaged in various tasks since the accident. Given the hazards and stress involved in these tasks and the relatively long time required to transport sick or injured workers to medical institutions, it became necessary to quickly implement a more stringent management program for fitness for duty than in ordinary work environments. Case: It took considerable time to introduce and improve a fitness-for-duty program because of several concerns. Various efforts were conducted, sometimes triggered by guidance from the Ministry of Health, Labour and Welfare (MHLW), but the implementation of the program was insufficient. In April 2016, a new program was initiated in which all primary contractors confirmed that their subcontractors had achieved five conditions for workers' fitness for duty on the basis of guidance from the MHLW and occupational health experts. TEPCO confirmed that all primary contractors had implemented the program successfully as of the end of November 2016. Conclusion: Following a disaster, even though the parties concerned understand the necessity of fitness-for-duty programs and that companies in high positions have responsibilities beyond their legal requirements, it is highly possible that they may hesitate to introduce such programs without guidance from the government. It is necessary to prepare a governmental framework and professional resources that introduce these stringent management programs quickly.

Assessing the effect of mandatory progress reporting on treatment requirements identified during health examinations at the Fukushima Daiichi Nuclear Power Plant: A time series analysis

“…In response, TEPCO developed a system of thorough checks on the results of health examinations, including whether further investigations and treatment were required, and whether these had happened, with the technical support of occupational health specialists at UOEH. 4 The operation of the system required significant work from many stakeholders, so it was considered important to assess its effects on workers' health. It is not easy to use outcome indicators such as reduction in myocardial infarctions or cerebrovascular disease, so the evaluation used two alternative indicators.…”

“…3 However, there have been a number of incidents of workers dying at work from myocardial infarction and stroke, suggesting that improved measures were needed to check fitness for duty and provide preventive advice. 1,4 Enhancement of the fitness for duty procedures was resisted by the companies concerned because of the complexity and the possible impact on recruitment and retention. 4 From October 2012, however, new workers were required to have a doctor's certificate that they were "permitted to work at the nuclear power plant," based on the results of a health examination.…”

“…1,4 Enhancement of the fitness for duty procedures was resisted by the companies concerned because of the complexity and the possible impact on recruitment and retention. 4 From October 2012, however, new workers were required to have a doctor's certificate that they were "permitted to work at the nuclear power plant," based on the results of a health examination. Primary contractors were responsible for this procedure among subcontractors.…”

“…We proposed that the procedure was extended to all workers operating for a particular length of time, with periodic health examinations, but this was not implemented because it would place the primary contractors under a responsibility beyond the legal requirements. 4 Despite these procedures, however, there were three fatal cases of sudden cardiac arrest on the site of the power plant between August and September 2015. The Fukushima Labor Bureau considered the situation seriously, and gave TEPCO and the primary contractors an administrative instruction to ensure the health of workers.…”

“…Contractors reported to TEPCO on the new procedures at the end of November, in a summary report on health examinations for the third quarter (July to September) of 2016. 4 The report included the numbers judged to "need further examination," "need treatment," and "need ongoing treatment," and the numbers visiting a doctor for further examination and treatment on a quarterly basis.…”