Impacts of the 2011 Fukushima nuclear accident on emergency medical service times in Soma District, Japan: a retrospective observational study

Morita, Tomohiro; Tsubokura, Masaharu; Furutani, Tomoyuki; Nomura, Shuhei; Ochi, Sae; Leppold, Claire; Takahara, Kazuhiro; Shimada, Yuki; Fujioka, Sho; Kami, Masahiro; Kato, Shigeaki; Oikawa, Tomoyoshi

doi:10.1136/bmjopen-2016-013205

Cited by 15 publications

(21 citation statements)

References 32 publications

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“…As for the other two EMS time segments, on-scene time increased after the disaster while response time did not. Response time did not significantly change between the two periods, which was consistent with previous research immediately after the disaster 20. These results indicated that the initial performance of EMS did not change even after the disaster.…”

Section: Discussionsupporting

confidence: 90%

“…A local EMS governed by the Regional Fire Department in each medical zone is thus the sole public system to provide emergency transport for patients 19. When there are a limited number of nearby emergency hospitals available, particularly in remote areas, municipalities largely depend on EMS to transport emergency patients, as reported in the previous study 20. Thus, examining the EMS time of Kawauchi Village across the disaster is useful to assess the impact of the abrupt closure of emergency hospitals nearby on emergency care access in rural areas and consider countermeasures for such extrinsic factors.…”

Section: Introductionmentioning

confidence: 82%

“…Moreover, the distance to the hospital was associated with emergency patient distribution after the disaster 9. Although there was no sharp rise in the total number of ambulance calls after the disaster in the whole Fukushima,29 there was a delay in EMS transportation in the surrounding areas owing to the hospital closure 20. In rural areas, transport time would account for an important segment of total EMS time owing to the scarcity of hospitals.…”

Section: Discussionmentioning

confidence: 99%

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Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study

Nishikawa¹,

Tsubokura²,

Takahashi

et al. 2019

BMJ Open

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ObjectivesSustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster.DesignThis research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality.SettingThe residents in Kawauchi Village, Fukushima, Japan were forced to evacuate after the 2011 Fukushima disaster. As the radiation dose was an acceptable level, the residents began the process of repopulation in April 2012.ParticipantsThis study included patients transported by EMS from January 2009 to October 2015. Patients transported during the evacuation period (from March 2011 to March 2012) were excluded.ResultsA total of 781 patients were transferred by EMS (281 patients before the disaster, 416 after repopulation and 84 during the evacuation period). A Bayesian time series analysis revealed an increase in total EMS time, from the first request call to arrival at a hospital of 21.85 min (95% credible interval 14.2–29.0, Bayesian one-sided tail-area probability p=0.001). After the disaster, 42.3% of patients were transported to a partner hospital.ConclusionsTotal EMS time increased after repopulation of the area affected because of a massive number of hospital closures. Proactive partnerships would be a possible countermeasure in the affected areas after a major disaster.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study

Nishikawa¹,

Tsubokura²,

Takahashi

et al. 2019

BMJ Open

Self Cite

View full text Add to dashboard Cite

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“…Therefore, we suggested that the primary cause of delays in EMS activities was the fact that the overall EMS was not operating normally. The triple disaster that occurred in Fukushima, Japan, in 2011 (an earthquake, tsunami, and nuclear power plant incident) caused delays in EMS transport times that lasted several months [ 12 ] ; this research showed that infectious disease outbreaks could also affect EMS transport times over several months.…”

Section: Discussionmentioning

confidence: 99%

Impact of the coronavirus disease 2019 outbreak on the transportation of patients requiring emergency care

Kim¹,

Jang²,

Kim³

et al. 2020

Medicine

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The first confirmed community transmission of coronavirus disease 2019 in Daegu Metropolitan City, South Korea, occurred on February 18, 2020. In the following 70-day period, approximately 6000 new cases occurred, severely impacting the medical service system. This study investigated the crisis-impact on the local emergency transport system. Emergency medical service activity reports were retrospectively reviewed to determine patient demographics and initial vital signs. Delay in reaching the patient, transporting the patient to the hospital, and returning to the fire station were assessed and categorized based on patients’ initial vital signs. The study period was divided into 4 groups (1/1–2/18, 2/19–3/3, 3/4–3/31, and 4/1–04/30) and intergroup differences were analyzed. When compared to Period 1, the time-difference between the request to attend a scene and arrival at the scene was delayed in Periods 2, 3, and 4 by 4 minute 58 s, 3 minute 24 seconds, and 2 minute 20 seconds, respectively; that between arriving at the scene and at the hospital was delayed by 7 minute 43 seconds, 6 minutes 59 seconds, and 4 minutes 30 seconds, respectively; and that between arriving at the hospital and returning to the fire station was delayed by 29 minute 3 second, 25 minute 55 second, and 18 minute 44 second, respectively. In Period 2, for patients with symptoms of severe illness when compared to patients lacking such symptoms, the time-difference between the request to attend the scene and arrival at a hospital and between arrival at the hospital and returning to the fire station were 6 to 23 minute and 12 to 48 minute longer, respectively. Most of the delays impacted patients with a fever. In terms of condition, the statistical effect size for delay in transport time was from large to small: fever, hypoxia, abnormal respiratory rate, respiratory symptom, and hypotension. Outbreaks of infectious disease cause a paradoxical state in emergency medical transport systems, inducing delays in the transport of severely ill patients. Therefore, maintenance and improvement of the medical service system for both patients with infectious disease and those with other severe illnesses is required.

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“…[ 24 , 25 ] Health care systems in the affected areas remain heavily affected since many hospitals in the area were forced to close and remain closed even after the evacuation orders were lifted. [ 23 ] Notably, the situations of emergency transport in the area where the evacuation order was lifted have been shown to be different from those before the disaster, leading to the delay in EMS time. [ 23 , 24 , 26 , 27 ] Thus, in developing effective countermeasures for nuclear disaster recovery, it is important to accumulate evidence on the medical demand and the state of emergency transport in the area where the evacuation orders were lifted.…”

Section: Introductionmentioning

confidence: 99%

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

Yamamoto¹,

Sawano

Nishikawa

et al. 2021

Medicine

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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.

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Impacts of the 2011 Fukushima nuclear accident on emergency medical service times in Soma District, Japan: a retrospective observational study

Cited by 15 publications

References 32 publications

Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study

Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study

Impact of the coronavirus disease 2019 outbreak on the transportation of patients requiring emergency care

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

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