Postnuclear disaster evacuation and chronic health in adults in Fukushima, Japan: a long-term retrospective analysis

Abstract

ObjectiveJapan's 2011 Fukushima Daiichi Nuclear Power Plant incident required the evacuation of over a million people, creating a large displaced population with potentially increased vulnerability in terms of chronic health conditions. We assessed the long-term impact of evacuation on diabetes, hyperlipidaemia and hypertension.ParticipantsWe considered participants in annual public health check-ups from 2008 to 2014, administrated by Minamisoma City and Soma City, located about 10–50 km from the Fukushima nuclear plant.MethodsDisease risks, measured in terms of pre-incident and post-incident relative risks, were examined and compared between evacuees and non-evacuees/temporary-evacuees. We also constructed logistic regression models to assess the impact of evacuation on the disease risks adjusted for covariates.ResultsData from a total of 6406 individuals aged 40–74 years who participated in the check-ups both at baseline (2008–2010) and in one or more post-incident years were analysed. Regardless of evacuation, significant post-incident increases in risk were observed for diabetes and hyperlipidaemia (relative risk: 1.27–1.60 and 1.12–1.30, respectively, depending on evacuation status and post-incident year). After adjustment for covariates, the increase in hyperlipidaemia was significantly greater among evacuees than among non-evacuees/temporary-evacuees (OR 1.18, 95% CI 1.06 to 1.32, p<0.01).ConclusionsThe singularity of this study is that evacuation following the Fukushima disaster was found to be associated with a small increase in long-term hyperlipidaemia risk in adults. Our findings help identify discussion points on disaster planning, including preparedness, response and recovery measures, applicable to future disasters requiring mass evacuation.

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 .…”

“…Subsequent research highlighted the urgent need for long-term health supports for evacuees (Fukunaga and Kumakawa 2015). Lifestyle-related diseases, such as diabetes and hyperlipidemia, emerged as major health issues in EOAs in the chronic phase after the disaster (Ebner et al 2016;Nomura et al 2016;Ohira et al 2017;.…”

“…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 Two month Intervention to Improve Physical Activity of Evacuees in Temporary Housing after the Great East Japan Earthquake: Pilot Study

“…Another study suggested that survivors of GEJE who have experienced evacuation were more likely to develop noncommunicable diseases [8]. One consequence of the disaster was that it caused a break of social linkages, which may trigger health issues in survivors [9,10].…”

Public health after a nuclear disaster: beyond radiation risks

“…Rapid life changes can lead to social isolation and psychosocial stress, which are known to be associated with poor health outcomes, including an increased risk of noncommunicable diseases. Unsurprisingly, an increase in noncommunicable disease risks, such as high blood glucose levels and hyperlipidaemia, have been found in Fukushima, 7 , 8 alongside an increased burden of psychosocial distress, a phenomenon which has been described as a physical and mental health crisis 7 . In contrast with the findings of only marginal internal radiation contamination among children and adults, 2 , 9 it appears that the increasing burden of noncommunicable diseases and mental health problems may outweigh the burden of disease caused directly by radiation.…”