Evaluation of the emergency medical system in an area following lifting of the mandatory evacuation order after the Fukushima Daiichi Nuclear Power Plant accident

Abstract

Following the lifting of the evacuation order due to the Fukushima Daiichi Nuclear Power Plant accident, the medical demand and emergency medical system (EMS) in the area where the evacuation orders were lifted have not been well-investigated. This study aimed to evaluate the emergency transportation in such areas and compare the differences with areas that had minimal impact. Using the local EMS transport records, the characteristics of patients who were transferred by an EMS vehicle in Minamisoma City were collected between July 12, 2016 and July 31, 2018, and were compared between former evacuation zones and outside the evacuation zones in the city. The number of emergency transports in the study period in Minamisoma City were 325 cases in the area where the evacuation orders were lifted and 4307 cases in the other areas. The total EMS time was significantly longer in the area where the evacuation order was lifted (48 ± 16 minutes) than in the other areas (40 ± 15 minutes) ( P < .001). In the analysis of each component of EMS times, the transport time, which is the time from departure from the patient's location to arrival at a hospital, was significantly longer in the former evacuation zone than in the other areas (16 ± 9 vs 9 ± 9 minutes, P < .001), suggesting that transport time contributed to the longer EMS response times. In areas where the evacuation orders were lifted, the EMS transport time was significantly longer than that in the area outside the former evacuation zone; correspondingly, the total EMS time significantly increased in the former evacuation zone. A plausible reason for this may be the closure of local medical facilities following the evacuation order after the nuclear accident.

Impact of lifting the mandatory evacuation order after the Fukushima Daiichi Nuclear Power Plant accident on the emergency medical system: a retrospective observational study at Minamisoma City with machine learning analysis

“…Furthermore, the evacuation order in Odaka Ward affected the Haramachi Ward in the non-evacuated areas (figure 1). Past studies have suggested that EMS response times in evacuated areas may be longer than that in non-evacuated areas after the evacuation order is lifted, [23][24][25][26] and the observed finding is not consistent with these previous studies. 26…”

“…Past studies have suggested that EMS response times in evacuated areas may be longer than that in non-evacuated areas after the evacuation order is lifted, 23–26 and the observed finding is not consistent with these previous studies. 26 There are three reasons for this. First, it is possible that the outcome measure is related to total EMS time, that is, when considering T2 time alone, distance is not involved, and it depends on the ease of deciding on the receiving site.…”

“…This is indicated by the fact that the average T2 time has increased for six consecutive years, resulting in T2 time extension (figure 3), which is consistent with previous studies showing an increasing trend in total EMS hours in the region. 26 For reasons that are unclear, it is conceivable that residents are returning to their homes and the supply of emergency medical care is not keeping up with demand. [23][24][25] This trend is expected to continue as residents return to their homes in the future; thus, it is imperative that the demand for EMS be properly forecasted for the returning population.…”

“…Previous studies have compared the status of EMS in the evacuated areas before and after the earthquake, 24 and investigated the status of EMS after the evacuation order was lifted. 26 These studies have shown that the time involved in EMS has increased in the evacuated zones after the earthquake. However, there are no longitudinal studies that investigated how times on EMS in the area changes with the lifting of the evacuation order.…”

Primary care clinic visits in formerly evacuated areas due to radiation disaster following the Great East Japan Earthquake: A retrospective descriptive study

“…[12,13] Unlike the Chernobyl accident, in the Great East Japan Earthquake (GEJE) and subsequent radiation disaster in 2011, air doses in Minamisoma were low and residents were able to return early. [14][15][16][17] Although there are some reports of emergency medical systems in evacuation areas after the disaster, [18][19][20] there are no reports of usual medical visits before and after the lifting of the evacuation order. The reopening of medical facilities is a top priority for residents when making decisions about returning to their homes.…”