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Vol. LXVII, No. 2
January 16, 2015
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Disaster Medicine
Assessing Health Effects of Japanís Quake, Tsunami, Nuclear Accident

On the front page...

NCI’s Dr. Kiyohiko Mabuchi
NCI’s Dr. Kiyohiko Mabuchi
Nearly 4 years ago, a three-part disaster ravaged Japan. On Mar. 11, 2011, a 9.0-magnitude earthquake caused widespread damage and triggered a series of tsunamis and a nuclear accident. The earthquake, the largest to hit Japan in modern times, occurred 230 miles northeast of Tokyo, off the coast of Honshu. The subsequent tsunamis devastated coastal areas, particularly in the Tohoku region, and sparked a meltdown at the Fukushima Daiichi Nuclear Power Plant, the largest nuclear accident since Chernobyl. The earthquake and tsunami killed more than 15,000 people and injured thousands more.

Within days of this catastrophe, NIH investigators arrived on the scene to help assess radiation levels; NIH continues to assist with recovery efforts. Recently, researchers from Japan and NIH gave a health assessment update, part of a 2-day NIH-Japan symposium co-sponsored by the Japan Society for the Promotion of Science.

Continued...

Researchers in Japan are conducting health surveys among adults and children to gauge the health consequences, though it will take more time to unravel the longer-term health effects. Similar past public health disasters have resulted in a host of health problems from anxiety and depression to cardiovascular problems, cancer and other diseases.

Preliminary survey results in Miyagi and Iwate districts show elevated stress and anxiety levels in the coastal areas, said Dr. Shinichi Kuriyama, a researcher and professor of disaster public health and molecular epidemiology at Tohoku University, in the hard-hit city of Sendai. Interestingly, suicide rates decreased for about 18 months but then began to climb.

“We think the decreased suicide rates after the disaster could be attributed to intensive mental health activities and these phenomena,” he said, adding that it’s important to continue to monitor and treat mental health issues in tsunami-stricken areas.

Child health studies have revealed significantly higher stress levels, said Kuriyama. A study of children who were in nursery school during the disaster revealed a significant increase in children who are now overweight as well as increased asthma cases among girls. Tohoku University is collecting data to further study increased risk for ADHD, asthma, autism, eczema, low birth weight and pregnancy hypertension.

“Diseases might increase in the affected areas,” said Kuriyama. “Continuous monitoring and medical support are needed.”

Attending the NIH-Japan symposium poster session were (from l) Dr. Marian Young, research biologist, NIDCR; Masaki Ishikawa, research fellow, NIDCR; Connie Lerma, postbac, NHLBI; and Dr. Kenneth Yamada, NIH distinguished investigator and head, cell biology section, NIDCR. Dr. Shinichi Kuriyama of Tohoku University discusses the mental health effects of disasters.

Attending the NIH-Japan symposium poster session were (from l) Dr. Marian Young, research biologist, NIDCR; Masaki Ishikawa, research fellow, NIDCR; Connie Lerma, postbac, NHLBI; and Dr. Kenneth Yamada, NIH distinguished investigator and head, cell biology section, NIDCR.

Dr. Shinichi Kuriyama of Tohoku University discusses the mental health effects of disasters.

Photos: Ernie Branson

Natural disasters and industrial accidents have some unique health consequences that vary depending on the type of disaster, socio-economic conditions and cultural factors. But public health disasters also have shared characteristics, said Dr. Michael Gottesman, NIH deputy director for intramural research. “There’s social disruption from public health catastrophes, the effect of stress on the survivors and the need to learn from the experience to mitigate the effects of similar disasters in the future.”

Studies are also under way to assess the health effects from the Fukushima nuclear accident. When 46-foot-high tsunami waves crashed over the nuclear plant’s seawall, flooding caused a power failure. Control instruments failed, cooling systems stopped and emergency generators flooded and failed, causing a meltdown of 3 of its 6 nuclear reactors. Radioactive materials spewed into the air and ground, contaminating food and water across the country. Tokyo’s tap water was tainted with cesium-137 and iodine-131 for weeks, said Dr. Yoshio Hosoi, a professor of radiation biology at Tohoku University.

Some experts are drawing comparisons between this accident and the 1986 Chernobyl accident in Ukraine as they anticipate health outcomes. The amount of I-131 released into the environment following the Fukushima meltdown was 1/10th that of Chernobyl, said Hosoi. The lower radiation release and faster countermeasures helped mitigate the scope of the Fukushima disaster, said Dr. Kiyohiko Mabuchi, deputy chief of NCI’s Radiation Epidemiology Branch. Although the radioactive release at Fukushima was significant, I-131 has a short half-life of 8 days and evacuation efforts in the Fukushima plant’s surrounding areas were much faster than in and around Chernobyl.

Still, an elevated risk of cancer persists in Japan. Hosoi said studies show thyroid cysts and nodules increased in children from 2011-2013 at a higher rate than expected. He said, “In Chernobyl, there was a close relationship between thyroid nodules and thyroid cancer, so the same is likely to occur in Japan.”

Dr. Yoshio Hosoi of Tohoku University
Dr. Yoshio Hosoi of Tohoku University

In Ukraine, NCI studied the protracted radiation exposure among plant cleanup workers over a 20-year period, said Mabuchi. Results, which were verified by an international panel of hematologists, showed a significant increase in leukemia cases among workers exposed to nuclear radiation, he said. A study of Fukushima plant workers is under way, although the projected risk is lower, limited to a smaller number of emergency crews. Mabuchi said additional epidemiological data and assessments are needed.

In response to the 2011 catastrophe in Japan, Tohoku University has established a program in disaster medicine, the International Research Institute of Disaster Science.

“NIH is no stranger to the management of disaster research as well,” said Gottesman, “with NIEHS dealing with Katrina and the Gulf oil spill, NCI dealing with radioactivity and NIAID and the Clinical Center with infectious diseases such as SARS and Ebola. There’s a natural affinity for our two academic communities to work together. I look forward to continuing to share experiences so we can all learn how best to respond to public health emergencies and mitigate their health effects.”


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