論文 - 野村　周平

Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees.

Shuhei Nomura, Marta Blangiardo, Masaharu Tsubokura, Yoshitaka Nishikawa, Stuart Gilmour, Masahiro Kami, Susan Hodgson

Preventive medicine 82   77 - 82 2016年01月

査読有り,  ISSN  0091-7435

　概要を見る

BACKGROUND: Considering the health impacts of evacuation is fundamental to disaster planning especially for vulnerable elderly populations; however, evacuation-related mortality risks have not been well-investigated. We conducted an analysis to compare survival of evacuated and non-evacuated residents of elderly care facilities, following the Great East Japan Earthquake and subsequent Fukushima Dai-ichi nuclear power plant incident on 11th March 2011. OBJECTIVE: To assess associations between evacuation and mortality after the Fukushima nuclear incident; and to present discussion points on disaster planning, with reference to vulnerable elderly populations. METHODS: The study population comprised 1,215 residents admitted to seven elderly care facilities located 20-40km from the nuclear plant in the five years before the incident. Demographic and clinical characteristics were obtained from medical records. Evacuation histories were tracked until mid 2013. Main outcome measures are hazard ratios in evacuees versus non-evacuees using random-effects Cox proportional hazards models, and pre- and post-disaster survival probabilities and relative mortality incidence. RESULTS: Experiencing the disasters did not have a significant influence on mortality (hazard ratio 1.10, 95% confidence interval: 0.84-1.43). Evacuation was associated with 1.82 times higher mortality (95% confidence interval: 1.22-2.70) after adjusting for confounders, with the initial evacuation from the original facility associated with 3.37 times higher mortality risk (95% confidence interval: 1.66-6.81) than non evacuation. CONCLUSIONS: The government should consider updating its requirements for emergency planning for elderly facilities and ensure that, in a disaster setting, these facilities have the capacity and support to shelter in place for at least sufficient time to adequately prepare initial evacuation.

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Overview of health impacts caused by the Fukushima nuclear disaster and our opportunity to 'Build Back Better'

Sae Ochi, Shigeaki Kato, Claire Leppold, Toyoaki Sawano, Shuhei Nomura, Tomohiro Morita, Masaharu Tsubokura, Tomoyoshi Oikawa, Ryuzaburo Shineha

Proceedings of the 6th International Disaster and Risk Conference: Integrative Risk Management - Towards Resilient Cities, IDRC Davos 2016 （Global Risk Forum (GRF)）     481 - 484 2016年

Compliance with the proper use of an individual radiation dosimeter among children and the effects of improper use on the measured dose: a retrospective study 18-20 months following Japan's 2011 Fukushima nuclear incident.

Shuhei Nomura, Masaharu Tsubokura, Ryugo Hayano, Daisuke Yoneoka, Akihiko Ozaki, Yuki Shimada, Tomoyuki Furutani, Yukio Kanazawa, Tomoyoshi Oikawa

BMJ open 5 （ 12 ） e009555 2015年12月

査読有り,  ISSN  2044-6055

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OBJECTIVES: To identify profiles of children who did not properly use individual radiation dosimeters following Japan's 2011 Fukushima nuclear incident, and to assess how much error is generated by improper dosimeter use. PARTICIPANTS: The participants in this study comprised 1637 school children who participated in the external radiation exposure screening programme administrated by Minamisoma City (located 20-30 km from the Fukushima nuclear plant) between 18 and 20 months after the Fukushima incident. METHODS: We assessed the factors associated with improper use (non-use) of the dosimeters at specific time periods during the day (school commuting hours, at school, at home, outdoors and at bedtime) using logistic regression analyses. Ratios of the measured dose to regression estimates of the 'expected' dose (referred to as an error due to non-use) were also examined. RESULTS: Only 119 children (7.3%) used the dosimeters properly in all time periods. This low rate was attributed primarily to non-use when children were in the home and outdoors, rather than at school. School level, air dose rate at home, gender, membership in outdoor sports clubs and time spent outdoors on weekends, were significantly associated with improper use, after adjustment for covariates. Data from children who did not wear the dosimeters to school and outdoors had statistically significant (but clinically insignificant) errors (ratio: 1.13, p<0.01; and 0.97, p<0.05, respectively), whereas improper use of the dosimeters at school, at home and at bedtime did not generate significant errors. CONCLUSIONS: Well-targeted rigorous instructions on the use of the dosimeter are required, with particular focus on time periods other than school hours. However, given the small dose error due to the improper use of the dosimeters, even if the dosimeters are improperly used, solid evaluation of the radiation exposure may be possible with some accuracy.

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Whole body counter assessment of internal radiocontamination in patients with end-stage renal disease living in areas affected by the Fukushima Daiichi nuclear power plant disaster: a retrospective observational study.

Hiroaki Shimmura, Masaharu Tsubokura, Shigeaki Kato, Junichi Akiyama, Shuhei Nomura, Jinichi Mori, Tetsuya Tanimoto, Koichiro Abe, Shuji Sakai, Hiroshi Kawaguchi, Michio Tokiwa

BMJ open 5 （ 12 ） e009745 2015年12月

査読有り,  ISSN  2044-6055

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OBJECTIVE: To assess internal radiocontamination of patients with end-stage renal disease (ESRD) who were regularly taking haemodialysis (HD) and living in areas affected by the crippled Fukushima Daiichi nuclear plant after the Great East Japan earthquake on 11 March 2011. METHODS: Internal radiocontamination in 111 patients with ESRD regularly taking HD at Jyoban Hospital in Iwaki city, Fukushima from July 2012 to November 2012 was assessed with a whole body counter (WBC). The maximum annual effective dose was calculated from the detected Cs-137 levels. Interviews concerning patient dietary preferences and outdoor activities were also conducted. RESULTS: Among the 111 patients tested, internal radiocontamination with Cs-137 was detected in two participants, but the levels were marginal and just exceeded the detection limit (250 Bq/body). The tentatively calculated maximum annual effective dose ranged from 0.008 to 0.009 mSv/year, which is far below the 1 mSv/year limit set by the government of Japan. Relative to 238 non-ESRD participants, patients with ERSD had significantly more opportunities to consume locally grown produce that was not distributed to the market (p<0.01). However, the percentage of patients with ESRD with detectable Cs (1.8%) was lower than that for non-ESRD participants (3.8%), although this difference was not significant (p=0.51). CONCLUSIONS: These findings suggest that internal radiocontamination levels and the calculated annual additional effective doses were negligible for patients with ESRD taking HD in areas affected by the crippled Fukushima nuclear plant. Although HD is suggested to promote Cs-137 excretion, continuous inspection of locally grown produce together with WBC screening for radiocontamination should be continued for patients with ESRD regularly taking HD.

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Long-Term Changes in Stroke-Related Hospital Admissions After the Fukushima Triple Disaster.

Stuart Gilmour, Amina Sugimoto, Shuhei Nomura, Tomoyoshi Oikawa

Journal of the American Geriatrics Society 63 （ 11 ） 2425 - 6 2015年11月

査読有り,  ISSN  0002-8614

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Emergency medical service delay following Japan's 2011 Fukushima nuclear disaster

MORITA Tomohiro, TSUBOKURA Masaharu, FURUTANI Tomoyuki, OCHI Sae, KATO Shigeaki, TSUBOKURA Seiji, KAMI Masahiro, TSUBOKURA Seiji, SHIMADA Yuki, FUJIOKA Masaru, OIKAWA Tomoyoshi, NOMURA Shuhei, TAKAHARA Kazuhiro

日本救急医学会雑誌 （(一社)日本救急医学会）  26 （ 8 ） 353 - 353 2015年08月

査読有り,  ISSN  0915-924X

Comparison between direct measurements and modeled estimates of external radiation exposure among school children 18 to 30 months after the Fukushima nuclear accident in Japan.

Shuhei Nomura, Masaharu Tsubokura, Ryugo Hayano, Tomoyuki Furutani, Daisuke Yoneoka, Masahiro Kami, Yukio Kanazawa, Tomoyoshi Oikawa

Environmental science & technology 49 （ 2 ） 1009 - 16 2015年01月

査読有り,  ISSN  0013-936X

　概要を見る

After a major radioactive incident, accurate dose reconstruction is important for evaluating health risks and appropriate radiation protection policies. After the 2011 Japan Fukushima nuclear incident, we assessed the level of agreement between the modeled and directly measured dose and estimated the uncertainties. The study population comprised 520 school children from Minamisoma city, located 20 km north of the nuclear plant. The annual dose 18–30 months after the incident was assessed using two approaches: estimation using the model proposed by the Japanese government and direct measurement by radiation dosemeters. The ratio of the average of modeled and measured doses was 3.0 (standard deviation (SD): 2.0). The reduction coefficient, an index for radiation attenuation properties, was 0.3 (SD: 0.1) on average, whereas the value used in the government model was 0.6. After adjusting for covariates, the coefficient had a significant negative correlation with the air dose rate in the dwelling location (p < 0.001), indicating that stronger building shielding effects are valuable in areas with higher air contamination levels. The present study demonstrated that some overestimation may have been related to uncertainties in radiation reduction effects, and that the air contamination level might provide a more important indicator of these effects.

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Absence of internal radiation contamination by radioactive cesium among children affected by the Fukushima Daiichi nuclear power plant disaster.

Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Tomohiro Morita, Amina Sugimoto, Stuart Gilmour, Masahiro Kami, Tomoyoshi Oikawa, Yukio Kanazawa

Health physics 108 （ 1 ） 39 - 43 2015年01月

査読有り,  ISSN  0017-9078

　概要を見る

Chronic internal radiation contamination accounts for a substantial fraction of long-term cumulative radiation exposure among residents in radiation-contaminated areas. However, little information is available on ongoing chronic internal radiation contamination among residents near the crippled Fukushima Daiichi nuclear power plant. Using a whole body counter, internal radiation contamination levels among elementary and middle school students who commute to 22 schools located within Minamisoma city were assessed between May and July 2013 (26 to 28 mo after the disaster). Of 3,299 elementary and middle school students in the city, 3,255 individuals (98%) were screened through school health check-ups. Not a single student was detected with internal radiation contamination due to radioactive cesium. The study found no risk of chronic internal radiation exposure among residents near the crippled nuclear power plant. Current food inspection by local governments, volunteers, and farmers has been functioning well within Fukushima prefecture. However, food management by screening suspected contamination along with whole body counter screening are key public health interventions and should be continued to avoid further internal radiation exposure in radiation-contaminated areas.

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An assessment of the characteristics and quality of diagnostic accuracy studies for positron emission tomography conducted in Japan: a systematic review.

Shuhei Nomura, Akinori Hisashige, Daisuke Yoneoka, Mikiko Kanda, Karin Miyamoto, Miwako Segawa, Erika Ota, Kenji Shibuya

EJNMMI research 5   6 - 6 2015年

査読有り,  ISSN  2191-219X

　概要を見る

BACKGROUND: Systematic evaluations of the diagnostic accuracy of positron emission tomography (PET) imaging have been widely conducted in many countries. Although Japan's total number of PET units is the second highest in the world, very limited effort has been made to systematically assess the methodological quality of PET studies in Japan. We performed a systematic review to assess the characteristics and quality of PET diagnostic accuracy studies conducted in Japan and to analyze the factors related to their quality. METHODS: All PET studies conducted in Japan were identified using MEDLINE and the Japan Medical Abstract Society Database. The characteristics of the Japanese studies were examined and their methodological quality evaluated by the standardized quality assessment of diagnostic accuracy studies (QUADAS) tool. We compared the quality of studies indexed in MEDLINE with non-indexed studies, followed by a comparison of the studies' conclusions with those of international health technology assessment (HTA) reports. RESULTS: A total of 138 studies were identified. Half of them were not indexed in MEDLINE. The mean quality score of the Japanese studies was 6.7 and the proportion of high-quality studies (with a quality score higher than 8) was 32.6%. A significant difference was observed in several quality items between MEDLINE-indexed and non-indexed studies, although there was no difference in total quality score. Three variables (i.e., target diseases, publication year, and study type) were identified as factors related to the quality of the studies. Conclusions of Japanese studies relating to several target diseases were relatively consistent with international assessments. CONCLUSIONS: Although a considerable number of diagnostic accuracy studies of PET have been conducted in Japan, a substantial proportion of high-quality studies were not indexed in international databases. High-quality Japanese studies, therefore, should be searched using Japanese databases and assessed by systematic reviews and HTA conducted internationally.

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Assessment of the Annual Additional Effective Doses amongst Minamisoma Children during the Second Year after the Fukushima Daiichi Nuclear Power Plant Disaster.

Masaharu Tsubokura, Shigeaki Kato, Tomohiro Morita, Shuhei Nomura, Masahiro Kami, Kikugoro Sakaihara, Tatsuo Hanai, Tomoyoshi Oikawa, Yukio Kanazawa

PloS one 10 （ 6 ） e0129114 2015年

査読有り,  ISSN  1932-6203

　概要を見る

An assessment of the external and internal radiation exposure levels, which includes calculation of effective doses from chronic radiation exposure and assessment of long-term radiation-related health risks, has become mandatory for residents living near the nuclear power plant in Fukushima, Japan. Data for all primary and secondary children in Minamisoma who participated in both external and internal screening programs were employed to assess the annual additional effective dose acquired due to the Fukushima Daiichi nuclear power plant disaster. In total, 881 children took part in both internal and external radiation exposure screening programs between 1st April 2012 to 31st March 2013. The level of additional effective doses ranged from 0.025 to 3.49 mSv/year with the median of 0.70 mSv/year. While 99.7% of the children (n = 878) were not detected with internal contamination, 90.3% of the additional effective doses was the result of external radiation exposure. This finding is relatively consistent with the doses estimated by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). The present study showed that the level of annual additional effective doses among children in Minamisoma has been low, even after the inter-individual differences were taken into account. The dose from internal radiation exposure was negligible presumably due to the success of contaminated food control.

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Managing Type 2 Diabetes Mellitus through Periodical Hospital Visits in the Aftermath of the Great East Japan Earthquake Disaster: A Retrospective Case Series.

Yoshitaka Nishikawa, Yuji Fukuda, Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Yasutoshi Saito

PloS one 10 （ 5 ） e0125632 2015年

査読有り,  ISSN  1932-6203

　概要を見る

AIMS: To assess the impact of the Great East Japan Earthquake Disaster on daily diabetes practice and to determine the feasibility of controlling type 2 diabetes mellitus in an outpatient department. METHODS: We retrospectively reviewed the data on disaster-affected patients with type 2 diabetes who periodically attended outpatient department of Soma Central Hospital. There were 767 patients with type 2 diabetes mellitus in total. The primary outcome measure was the change in HbA1c. RESULTS: HbA1c levels of 58 patients with periodical hospital visits did not deteriorate after the disasters. Moreover, there observed no significant difference in the mean of HbA1c levels among all age and sex throughout the year. While several changes in diabetes medication usage occurred, DPP4-inhibitor was the only oral diabetic agent that increased in frequency (+60%). CONCLUSIONS: Patients with type 2 diabetes who were managed with periodical hospital visits did not show significant deterioration in HbA1c levels.

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Was the Risk from Nursing-Home Evacuation after the Fukushima Accident Higher than the Radiation Risk?

Michio Murakami, Kyoko Ono, Masaharu Tsubokura, Shuhei Nomura, Tomoyoshi Oikawa, Tosihiro Oka, Masahiro Kami, Taikan Oki

PloS one 10 （ 9 ） e0137906 2015年

査読有り,  ISSN  1932-6203

　概要を見る

After the 2011 accident at the Fukushima Daiichi nuclear power plant, nursing-home residents and staff were evacuated voluntarily from damaged areas to avoid radiation exposure. Unfortunately, the evacuation resulted in increased mortalities among nursing home residents. We assessed the risk trade-off between evacuation and radiation for 191 residents and 184 staff at three nursing homes by using the same detriment indicator, namely loss of life expectancy (LLE), under four scenarios, i.e. "rapid evacuation (in accordance with the actual situation; i.e. evacuation on 22 March)," "deliberate evacuation (i.e. evacuation on 20 June)," "20-mSv exposure," and "100-mSv exposure." The LLE from evacuation-related mortality among nursing home residents was assessed with survival probability data from nursing homes in the city of Minamisoma and the city of Soma. The LLE from radiation mortality was calculated from the estimated age-specific mortality rates from leukemia and all solid cancers based on the additional effective doses and the survival probabilities. The total LLE of residents due to evacuation-related risks in rapid evacuation was 11,000 persons-d-much higher than the total LLEs of residents and staff due to radiation in the other scenarios (27, 1100, and 5800 persons-d for deliberate evacuation, 20 mSv-exposure, and 100 mSv-exposure, respectively). The latitude for reducing evacuation risks among nursing home residents is surprisingly large. Evacuation regulation and planning should therefore be well balanced with the trade-offs against radiation risks. This is the first quantitative assessment of the risk trade-off between radiation exposure and evacuation after a nuclear power plant accident.

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Whole-body counter survey results 4 months after the Fukushima Dai-ichi NPP accident in Minamisoma City, Fukushima.

Ryugo S Hayano, Yuni N Watanabe, Shuhei Nomura, Tsuyoshi Nemoto, Masaharu Tsubokura, Tatsuo Hanai, Yuki Kumemoto, Satoshi Kowata, Tomoyoshi Oikawa, Yukio Kanazawa

Journal of radiological protection : official journal of the Society for Radiological Protection （IOP PUBLISHING LTD）  34 （ 4 ） 787 - 99 2014年12月

査読有り,  ISSN  0952-4746

　概要を見る

Using the first WBC unit installed in Fukushima Prefecture after the accident, the radiocesium body burdens of 566 high-risk residents of Minamisoma city were measured in July 2011 at the Minamisoma Municipal General Hospital. The analysis of the data was challenging because this chair-type, WBC unit, did not have sufficient shielding against background gamma rays and methods had to be developed to reliably compensate for the body-attenuated background radiation. Fortunately, data for repeated tests of hospital staff members using both the chair-type and well-shielded FASTSCAN WBC units, installed in September 2011, were available and could be used to check the validity of the analysis. The CEDs of all subjects, estimated under the assumption of acute inhalation in March 2011, were found to be less than 1 mSv.

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Assessment of the risk of medium-term internal contamination in Minamisoma City, Fukushima, Japan, after the Fukushima Dai-ichi nuclear accident.

Amina Sugimoto, Stuart Gilmour, Masaharu Tsubokura, Shuhei Nomura, Masahiro Kami, Tomoyoshi Oikawa, Yukio Kanazawa, Kenji Shibuya

Environmental health perspectives （US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE）  122 （ 6 ） 587 - 93 2014年06月

査読有り,  ISSN  0091-6765

　概要を見る

BACKGROUND: The Fukushima Dai-ichi nuclear disaster, the first level-7 major nuclear disaster since Chernobyl, raised concerns about the future health consequences of exposure to and intake of radionuclides. Factors determining the risk and level of internal radiation contamination after a nuclear accident, which are a key to understanding and improving current nuclear disaster management, are not well studied. OBJECTIVE: We investigated both the prevalence and level of internal contamination in residents of Minamisoma, and identified factors determining the risk and levels of contamination. METHODS: We implemented a program assessing internal radiation contamination using a whole body counter (WBC) measurement and a questionnaire survey in Minamisoma, between October 2011 and March 2012. RESULTS: Approximately 20% of the city's population (8,829 individuals) participated in the WBC measurement for internal contamination, of which 94% responded to the questionnaire. The proportion of participants with detectable internal contamination was 40% in adults and 9% in children. The level of internal contamination ranged from 2.3 to 196.5 Bq/kg (median, 11.3 Bq/kg). Tobit regression analysis identified two main risk factors: more time spent outdoors, and intake of potentially contaminated foods and water. CONCLUSIONS: Our findings suggest that, with sensible and reasonable precautions, people may be able to live continuously in radiation-affected areas with limited contamination risk. To enable this, nuclear disaster response should strictly enforce food and water controls and disseminate evidence-based and up-to-date information about avoidable contamination risks.

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Detection of 131I in a patient with thyroid cancer by internal radiation exposure screening using a whole-body counter in Fukushima.

Masaharu Tsubokura, Shuhei Nomura, Takeaki Ishii, Masahiro Kami, Shigeaki Kato

Clinical nuclear medicine （LIPPINCOTT WILLIAMS & WILKINS）  39 （ 3 ） 281 - 2 2014年03月

査読有り,  ISSN  0363-9762

　概要を見る

We have been performing a systematic screening using a whole-body counter of internal radiation exposure in the affected areas by the Fukushima Daiichi nuclear incident. This case suggests 2 important points regarding the thyroid internal exposure screening immediately after a nuclear disaster. First, clinicians should recognize the possibility of overestimation of I exposure during the initial checkups of thyroid internal exposure if a detailed history of treatment by radioisotopes is not obtained. Second, in vivo measurements should be taken immediately after the disaster because all of the radioactive iodine generated after the disaster disappears within a few months.

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The immediate physical and mental health crisis in residents proximal to the evacuation zone after Japan's nuclear disaster: an observational pilot study.

Masaharu Tsubokura, Kazuo Hara, Tomoko Matsumura, Amina Sugimoto, Shuhei Nomura, Masamitsu Hinata, Kenji Shibuya, Masahiro Kami

Disaster medicine and public health preparedness （CAMBRIDGE UNIV PRESS）  8 （ 1 ） 30 - 6 2014年02月

査読有り,  ISSN  1935-7893

　概要を見る

OBJECTIVE: The 2011 earthquake and Fukushima nuclear disaster in Japan have had devastating effects on residents near the damaged nuclear power plant, but quantifying its effect on their health has been difficult. METHODS: Among the 564 residents of Iitate Village and Soma City who enrolled in this study, we evaluated the changes of clinical parameters in 155 participants who underwent annual health evaluations in the previous year and after the earthquake. Psychological distress was also measured by using patient health questionnaire 9 (PHQ-9). RESULTS: Participants (median age, 64 years) showed significant post-disaster increases in body weight, body mass index, systolic and diastolic blood pressure, blood glucose levels, and triglyceride levels. PHQ-9 scores of 10 or greater were found in 12% of the subjects, indicating that a substantial number had major depression. CONCLUSIONS: The findings in this study showed substantial deterioration in clinical parameters related to lifestyle diseases and the presence of general psychological distress among residents living near the damaged nuclear power plant after the Fukushima Daiichi disaster. In addition to controlling the levels of radiation exposure, aggressive management of immediate physical and mental health crisis for residents may be necessary in future nuclear accidents.

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Are Japanese randomized controlled trials up to the task? A systematic review.

Daisuke Yoneoka, Akinori Hisashige, Erika Ota, Karin Miyamoto, Shuhei Nomura, Miwako Segawa, Stuart Gilmour, Kenji Shibuya

PloS one （PUBLIC LIBRARY SCIENCE）  9 （ 3 ） e90127 2014年

査読有り,  ISSN  1932-6203

　概要を見る

OBJECTIVES: Despite increasing numbers of RCTs done in Japan, existing international databases fail to capture them, and detailed information on the quality of Japanese RCTs is still missing. This study assessed the characteristics and quality of Japanese RCTs and analyzed factors related to their quality. METHODS: All RCTs conducted in Japan, and published as original articles that assessed the effect of healthcare interventions on humans in 2010, were included. We excluded study protocols, conference abstracts, and comments. In addition, quasi-RCTs were excluded. Data were independently abstracted and assessed by two of the authors and disagreements were resolved by consensus. The quality of Japanese RCTs randomly sampled was assessed using the method guidelines for systematic reviews from the Cochrane Back Review Group. The factors affecting RCT quality were analyzed using a logistic regression model. RESULTS: A total of 1013 RCTs conducted in Japan were published in 2010. The majority was small-scale (55% of RCTs with sample size less than 50). Eighty percent of RCTs had no information on the funding source and only 8% had been registered before their implementation. RCTs not indexed in international databases were a moderate number (118 RCTs: 37.7% of non-indexed RCTs were of high quality). Surgical intervention studies for external causes of morbidity and mortality with a large sample size, trial registration and a large number of arms were most likely to be of higher quality. CONCLUSION: Despite a considerable number of RCTs conducted in Japan, their quality is not satisfactory in some domains. On the other hand, there are high-quality, non-indexed RCTs. The full disclosure of trial information and quality control of clinical trials are urgently needed in Japan.

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Reduction of high levels of internal radio-contamination by dietary intervention in residents of areas affected by the Fukushima Daiichi nuclear plant disaster: a case series.

Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Stuart Gilmour, Masahiko Nihei, Yu Sakuma, Tomoyoshi Oikawa, Yukio Kanazawa, Masahiro Kami, Ryugo Hayano

PloS one （PUBLIC LIBRARY SCIENCE）  9 （ 6 ） e100302 2014年

査読有り,  ISSN  1932-6203

　概要を見る

Maintaining low levels of chronic internal contamination among residents in radiation-contaminated areas after a nuclear disaster is a great public health concern. However, the efficacy of reduction measures for individual internal contamination remains unknown. To reduce high levels of internal radiation exposure in a group of individuals exposed through environmental sources, we performed careful dietary intervention with identification of suspected contaminated foods, as part of mass voluntary radiation contamination screenings and counseling program in Minamisoma Municipal General Hospital and Hirata Central Hospital. From a total of 30,622 study participants, only 9 residents displayed internal cesium-137 (Cs-137) levels of more than 50 Bq/kg. The median level of internal Cs-137 contamination in these residents at the initial screening was 4,830 Bq/body (range: 2,130-15,918 Bq/body) and 69.6 Bq/kg (range: 50.7-216.3 Bq/kg). All these residents with high levels of internal contamination consumed homegrown produce without radiation inspection, and often collected mushrooms in the wild or cultivated them on bed-logs in their homes. They were advised to consume distributed food mainly and to refrain from consuming potentially contaminated foods without radiation inspection and local produces under shipment restrictions such as mushrooms, mountain vegetables, and meat of wild life. A few months after the intervention, re-examination of Cs levels revealed remarkable reduction of internal contamination in all residents. Although the levels of internal radiation exposure appear to be minimal amongst most residents in Fukushima, a subset of the population, who unknowingly consumed highly contaminated foodstuffs, experienced high levels of internal contamination. There seem to be similarities in dietary preferences amongst residents with high internal contamination levels, and intervention based on pre- and post-test counseling and dietary advice from medical care providers about risky food intake appears to be a feasible option for changing residents' dietary practices, subsequently resulting in a reduction in Cs internal contamination levels.

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Measurement of internal radiation exposure among decontamination workers in villages near the crippled Fukushima Daiichi Nuclear Power Plant.

Masaharu Tsubokura, Masahiko Nihei, Katsumi Sato, Shin Masaki, Yu Sakuma, Shigeaki Kato, Amina Sugimoto, Shuhei Nomura, Tomoko Matsumura, Makoto Miyazaki, Ryugo Hayano, Kenji Shibuya, Masahiro Kami, Taro Sasaki

Health physics 105 （ 4 ） 379 - 81 2013年10月

査読有り,  ISSN  0017-9078

　概要を見る

Decontamination workers may face a high risk of exposure to internal irradiation through inhalation during decontamination activities; there is, however, little previous research on the levels of internal contamination during decontamination procedures. The authors reviewed the medical records, including whole body counter measurements, of decontamination workers in villages near the crippled Fukushima Daiichi Nuclear Power Plant to assess their levels of internal radiation exposure. In total, 83 decontamination workers were enrolled in this study. They were regularly engaged in decontamination activities in highly contaminated areas where surface 137Cs deposition density was over 100 kBq m-2. The present study showed low levels of internal exposure among the decontamination workers near the Fukushima Daiichi nuclear plant. The cesium burdens of all the decontamination workers were below detection limits. They had reported no acute health problems. The resuspension of radioactive materials may cause minimal internal contamination during decontamination activities.

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Interventions for reduction of stigma in people with HIV/AIDS

Windy M.V. Wariki, Shuhei Nomura, Erika Ota, Rintaro Mori, Kenji Shibuya

Cochrane Database of Systematic Reviews （John Wiley and Sons Ltd）  2013 （ 6 ）  2013年06月

査読有り,  ISSN  1469-493X

　概要を見る

This is the protocol for a review and there is no abstract. The objectives are as follows: 1. To assess the effectiveness of interventions to reduce stigma towards people living with HIV/AIDS, improve coping strategies and increase tolerance, compared with a control group. 2. To assess the most effective form of interventions to reduce stigma towards people living with HIV/AIDS, improve coping strategies and increase tolerance, compared with a control group.

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