Hajo Zeeb Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany. Noboru Takamura Nagasaki University, Japan

Transcription

1 Hajo Zeeb Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany Noboru Takamura Nagasaki University, Japan WSDN Congress 2018, Bremen

2 Accident at Fukushima Dai-ichi Nuclear power Plant 2

3 The released radionuclides around the nuclear power plant at the initial phase of the accident, recorded by monitoring devices that were not damaged by the earthquake and tsunami. Average Germany: microsv/h Ambient dose equivalent (μsv/hour) a 1 b c d 2 e 3 1. Hydrogen explosion at Unit 1 at 15:36, March 12, Hydrogen explosion at Unit 3 at 11:01, March 14, Hydrogen explosion at Unit 2 at 06:14, March 15, a. Opened the vent at Unit 1 at 10:17, March 12, 2011 b. Opened the vent at Unit 3 at 08:41, March 13, 2011 c. Opened the vent at Unit 2 at 11:00, March 13, 2011 d. Opened the vent at Unit 3 at 05:20, March 14, 2011 e. Opened the vent at Unit 2 at 00:02, March 15, 2011 Shirakawa City Minamisoma City Tamagawa Village Fukushima Air Port Iidate Village Public Office Iwaki City Central Hill North Elementary School 10 Tamura City Gym Mar 13-Mar 15-Mar 17-Mar 19-Mar 21-Mar 23-Mar 25-Mar 27-Mar 29-Mar 31-Mar 12-Mar 14-Mar 16-Mar 18-Mar 20-Mar 22-Mar 24-Mar 26-Mar 28-Mar 30-Mar 1-Apr Tamura City administration Office Kawauchi Village Public Office

4 Released radionuclides in atmosphere 4 Approximately Bq of cesium-134 (Cs-134), Bq of cesium-137 (Cs-137) and Bq of iodine-131 (I-131) were released into the atmosphere. About 1/6 of Chernobyl release, but some uncertainties

5 Measurements of the individual external exposure dose using a personal dosimeter (0.2 msv/3 months) msv/3 months msv/3 months Fukishima City Date City 0.17 msv/64 days Nihonmatsu City 30km radius 20km radius Koriyama City Tamura City msv/103 days Total deposition of 134 Cs and 137 Cs (Bq/m 2 ) 3000k< k k k k 30-60k 10-30k <10k 0 25km

6 Countermeasures of the accident for external radiation exposure Instructions to evacuate or remain in homes were issued by the director general of the nuclear emergency response headquarters as follows: areas located within a radius of 2 km (20:50, March 11), 3 km (21:23, March 11), 10 km (morning of March 12) and 20 km (afternoon of March 12) from the FNPP were designated as evacuation zones.

7 Countermeasures of the accident for external radiation exposure On March 15, those living within 20 km to 30 km were instructed to seek shelter inside houses. FNPP-1 Kawauchi village

8 Countermeasures of the accident for internal radiation exposure On March 17, the Japanese government initiated food control to minimize internal radiation exposure; one action: disposal of all cow milk.

9 Participation in the medical team for the treatment of acute radiation injury (14 March 2011-) 9

10 Rescue workers 10 Nature News, based on UNSCEAR, WHO, METI

11 Screening of thyroid gland doses among 1,080 children under the age of 15 in Kawamata town, Iitate village, and Iwaki city (55.4%) (26.1%) 123 (11.4%) 51 (4.7%) (1.4%) (0.4%) (0.4%) (0.2%) (0.1%) 0 0,01 0,02 0,03 0,04 0,05 0,06 0,07 0,08 0,09 0,1 μsv/h Equivalent with 50mSv

12 Results of 1 st thyroid ultrasound screening in Fukushima Health Management Survey 12 Total case with malignancy or malignancy suspected 116 (cases) Sex (male/female) 39/77 Age at diagnosis 17.3±2.7 (8-22 yrs) Age at the accident 14.9±2.6 (6-18 yrs) (Cases) Total operated cases 102 (cases) Cytodiagnosis Benign nodule 1 Papillary carcinoma 100 Others Mean size of tumor 13.9 (mm) Age at the diagnosis (yrs) (Fukushima Health Management Survey 2016)

13 Number of operated cases with thyroid cancer Number of diagnosed cases with thyroid cancer October 2011-March Age at the accident at ChNPP (yrs) Age at the accident at FNPP (yrs) (Takamura et al. Lancet Diabetes Endocrinol 2016)

14 Two 2013 reports on Fukushima risks and consequences: WHO & IPPNW 14

15 Principal concerns - science 15 Cancer Thyroid Leukemia Other solid cancer Cancer after in utero exposure Other health effects Thyroid nodules Neurodevelopmental effects Genetic / hereditary (stress >> atomic divorce )

16 Perception about health effects due to radiation exposure in Fukushima Prefecture Very low possibility Very high possibility 1 Do you think that acute radiation syndrome such as hair loss and nasal bleeding occur due to radiation exposure in Fukushima? 19,114 (58.5%) 7,240 (22.2%) 3,259 (10.0%) 3,045 (9.3%) 2 Do you think that late health effects such as malignancies will occur due to radiation exposure in Fukushima? 10,225 (31.4%) 9,531 (29.2%) 6,488 (19.9%) 6,352 (19.5%) 3 Do you think that genetic effects in offspring will occur due to radiation exposure in Fukushima? 7,857 (24.3%) 8,982 (27.7%) 7,331 (22.6%) 8,215 (25.4%) (Fukushima Health Management Survey 2012)

17 Non radiological health concerns 17 Evacuation effects Mortality among nursing home residents Lifestyle risk factors in evacuation situation Mental health consequences Among emergency personnel Among Fukushima residents exposed to the disaster Risk perception and stigmatisation Specific to non-natural disaster

18 Evacuees - mortality 18 Nursing home residents a particularly vulnerable population group in disasters Evacuation situation Chaos, lack of communication Environmental conditions: cold up to minus 5 C. Nomura et al. (2016) compared mortality and survival among evacuees and non-evacuees 1215 included nursing-home residents 5 nursing homes in Minamisoma evacuated day nursing homes in Soma no evacuation

19 Overall mortality risk 19 82%* increased mortality risk associated with evacuation (HR = 1.82) 232%* risk increase for initial evacuation (HR = 3.32) 93% non-significant increase for later evacuation Nomura et al., Prev Med. 2016

20 Changes of body mass index (BMI) in Fukushima Prefecture Men Number Av. age Av. BMI 25 < , % 2.0% , % 2.4% , % 2.5% , % 1.2% , % 1.5% 20 Women Number Av. age Av. BMI 25 < , % 3.3% , % 3.2% , % 2.5% , % 3.3% , % 3.3% (Fukushima Health Survey 2012)

21 Mental Health in the population 21 About 100,000 evacuees Particular features of this disaster (nuclear accident) Unclear relief process Timing of onset, end, permanency Invisible exposure and effects Uncertainty about situation and consequences Distrust towards experts and authorities PTSD-level in population relatively high, 10 m after accident: 21.6% of adults scored high on PCL-S scale Similar to World Trade Center relief workers (according to Maeda et al. 2018) Also higher values for depression and anxiety Some suggestion of increased alcohol abuse [suicide]

22 Stigma 22 Little research evidence Some reports indicating stigmatisation of current and former Fukushima prefecture residents Especially young people, partnerships Worries about being able to have a family (self-stigma) Term atomic divorce coined Reduced community resilience Contested intake of refugees in neighbouring communities Divided families, differing compensation regimes

23 One dedicated approach: return 23 Evacuated villages in km zone, southern area considered Kawauchi village as exemplary site Support through Nagasaki University personnel, structures

24 Decontamination of public schools, houses in Kawauchi village 24

25 Restart and innovation of agriculture (Kawauchi village office)

26 Mushroom map in the village based on the measurement of radiocesium concentrations in dried mushrooms 26 Hawk Wing Honey Mushroom Brick Cap Others 0 n.d >1,000 (Nakashima et al. Peer J. 2015)

27 Rate of return 100% Rate of residents returning to Kawauchi Village (April, 2016) Not returned Returned 27 90% 80% 70% 60% 50% 65% 40% 30% 20% 10% 0% <10 10's 20's 30's 40's 50's 60's 70's >80's Total Age group (Kawauchi village office)

28 Rate of return Rate of residents returning to Kawauchi Village (May, 2017) % Not returned Returned 90% 80% 70% 60% 50% 80% 40% 30% 20% 10% 0% <10 10's 20's 30's 40's 50's 60's 70's >80's Total Age group (Kawauchi village office)

29 Summary 29 Serious threat to livelihood caused by the accident Major differences to natural disasters Some (relatively limited) radiation-related effects so far Many other non-radiological consequences Increased mortality through evacuation Physical and mental health Long-term consequences evaluated through longitudinal study Return to evacuated villages in some circumstances Successful model, with high input of resources

30 Thank you

31 Summary: risk estimation results for the public (WHO, UNSCEAR similar) 31 Leukemia risks up 7% for male infants in the most exposed areas Thyroid cancer risks up 70% for female infants in most exposed areas Breast cancer risks up 6% for female infants in most exposed areas Only a proportion of these risks in less affected areas of Fukushima prefecture NOTE: These are all relative increases over baseline, Absolute risk increases small as baseline is low Probably represent upper boundaries of risk estimates

32 Summary results for emergency workers 32 Slightly different methodology for exposure grouping 75 w with external cum. doses > 100mSv (updated!) 12 w with internal dose > 100 msv (max. ca.700 msv) Worst case: Leukemia in Scenario 3 = 27% increase over baseline risk