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Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

ABSTRACT: After the accident of the Fukushima Daiichi nuclear power plant due to the Great East Japan Earthquake in March 2011, the Japanese government issued a mandatory evacuation order for people living within a 20 km radius of the nuclear power plant. The aim of the current study was to investigate long-term outcomes of these patients and identify factors related to mortality.Patients who were evacuated from hospitals near the Fukushima Daiichi nuclear power plant to the Aizu Chuo Hospital from 15 to 26 March, 2011 were included in this study. The following data were collected from medical records: age, sex, activities of daily life, hospital they were admitted in at the time of earthquake, distance between the facility and the nuclear power plant, reasons of evacuation and number of transfers. The patient outcomes were collected from medical records and/or investigated on the telephone in January 2012.A total of 97 patients (28 men and 69 women) were transferred from 10 hospitals via ambulances or buses. No patients died or experienced exacerbation during transfer. Median age of the patients was 86 years. Of the total, 36 patients were not able to obey commands, 44 were bed-ridden and 61 were unable to sustain themselves via oral intake of food. Among 86 patients who were followed-up, 41 (48%) died at the end of 2011. Multiple-regression analysis showed that non-oral intake [Hazard Ratio (HR): 6.07, 95% Confidence interval (CI): 1.94-19.0] and male sex [HR: 8.35, 95% CI: 2.14-32.5] had significant impact on mortality.This study found that 48% of the evacuated patients died 9 months after the earthquake and they had significantly higher mortality rate than the nursing home residents. Non-oral intake and male sex had significant impact on mortality. These patients should be considered as especially vulnerable in case of hospital evacuation.

SUBMITTER: Igarashi Y

PROVIDER: S-EPMC5903607 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

Igarashi Yutaka Y Tagami Takashi T Hagiwara Jun J Kanaya Takahiro T Kido Norihiro N Omura Mariko M Tosa Ryoichi R Yokota Hiroyuki H

PloS one 20180417 4

<h4>Introduction</h4>After the accident of the Fukushima Daiichi nuclear power plant due to the Great East Japan Earthquake in March 2011, the Japanese government issued a mandatory evacuation order for people living within a 20 km radius of the nuclear power plant. The aim of the current study was to investigate long-term outcomes of these patients and identify factors related to mortality.<h4>Materials and methods</h4>Patients who were evacuated from hospitals near the Fukushima Daiichi nuclea ...[more]

PMID: 29664960

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Project description:Importance:The association of the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Plant disaster of March 11 and 12, 2011, in Fukushima, Japan, with birth rates has not been examined appropriately in the existing literature. Objective:To assess the midterm and long-term associations of the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster with birth rates. Design, Setting, and Participants:Cohort study in which interrupted time series analyses were used to assess monthly changes in birth rates among residents of Fukushima City, Japan, from March 1, 2011, to December 31, 2017, relative to projected birth rates without the disaster based on predisaster trends. Birth rates from January 1, 2007, to December 31, 2017, in Fukushima City were determined using information from the Fukushima City government office. Exposure:The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster, expressed via 5 potential models of the association with birth rate: level change, level and slope changes, temporal level change, and temporal level change with 1 or 2 slope change(s). Main Outcomes and Measures:Birth rate, calculated from monthly data on the number of births and total population. Results:The mean birth rate before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster was 69.8 per 100 000 people per month; after the disaster, the mean birth rate was 61.9 per 100 000 people per month. Compared with birth rates before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster, there was an estimated 10% reduction in monthly birth rates in Fukushima City (rate ratio, 0.90; 95% CI, 0.86-0.93) in the first 2 years after the disaster. After that, the birth rate trend was similar to the predisaster trend. The predisaster trend suggested a continuous decrease in birth rate (rate ratio for 1 year, 0.98; 95% CI, 0.98-0.99). This gap model was optimal and parsimonious compared with others. A similar association was found when trimonthly averaged data were analyzed. Conclusions and Relevance:The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster were followed by significant reductions in birth rates for 2 years. There was insufficient evidence to indicate that the trend in the 3 to 7 years after the disaster differed from the predisaster trends. The recovery from the reductions in the birth rate may be indicative of the rebuilding efforts. The continuing long-term decrease in birth rates observed before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster suggests that continuing measures to support birth planning should be considered at the administrative level.

Project description:BackgroundFew studies have investigated the relationship between living arrangements and dietary intake among evacuees after disasters.ObjectivesTo examine the relationship between living arrangements and dietary intake using the data of a large-scale cohort survey of evacuees after the Great East Japan Earthquake in 2011.Methods73,433 residents in evacuation zones responded to the Fukushima Health Management Survey questionnaire. Subjects were excluded if they did not report their living conditions or were missing more than three pieces of information about dietary intake. The data of 52,314 subjects (23,149 men and 29,165 women ≥15 years old) were used for the analyses. Evacuees' living arrangements were characterized into three categories: evacuation shelters or temporary housing, rental houses or apartments, or a relative's home or their own home. Dietary intake was characterized in terms of grains, fruits and vegetables, meat, soybean products, dairy products, and fish. Daily consumption of the third quartile (Q3) or higher for each food group was defined as 'high consumption'. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression analyses.ResultsModified Poisson regression analyses showed that, compared with respondents living in a relative's home or their own home, the PRs and 95% CIs for the people living in rental apartments of high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products were 0.69 (95% CI, 0.61-0.77), 0.82 (95% CI, 0.73-0.91), 0.89 (95% CI, 0.83-0.94), and 0.83 (95% CI, 0.74-0.93) respectively. The corresponding PRs and 95% CIs for people living in evacuation shelters or temporary housing were 0.83 (95% CI, 0.78-0.88), 0.90 (95% CI, 0.86-0.95), 0.94 (95% CI, 0.91-0.97), and 0.91 (95% CI, 0.86-0.96) for high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products, respectively.ConclusionThe present study suggests that, after the earthquake, living in non-home conditions was associated with poor dietary intake of fruits and vegetables (non-juice), meat, soybean products, and dairy products, suggesting the need for early improvements in the provision of balanced meals among evacuees living in non-home conditions.

Dataset Information

Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

Publications

Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

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