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Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study.

ABSTRACT: OBJECTIVES:Sustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster. DESIGN:This research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality. SETTING:The residents in Kawauchi Village, Fukushima, Japan were forced to evacuate after the 2011 Fukushima disaster. As the radiation dose was an acceptable level, the residents began the process of repopulation in April 2012. PARTICIPANTS:This study included patients transported by EMS from January 2009 to October 2015. Patients transported during the evacuation period (from March 2011 to March 2012) were excluded. RESULTS:A total of 781 patients were transferred by EMS (281 patients before the disaster, 416 after repopulation and 84 during the evacuation period). A Bayesian time series analysis revealed an increase in total EMS time, from the first request call to arrival at a hospital of 21.85?min (95% credible interval 14.2-29.0, Bayesian one-sided tail-area probability p=0.001). After the disaster, 42.3% of patients were transported to a partner hospital. CONCLUSIONS:Total EMS time increased after repopulation of the area affected because of a massive number of hospital closures. Proactive partnerships would be a possible countermeasure in the affected areas after a major disaster.

SUBMITTER: Nishikawa Y

PROVIDER: S-EPMC6377524 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study.

Nishikawa Yoshitaka Y Tsubokura Masaharu M Takahashi Yoshimitsu Y Nomura Shuhei S Ozaki Akihiko A Kimura Yuko Y Morita Tomohiro T Sawano Toyoaki T Oikawa Tomoyoshi T Nakayama Takeo T

BMJ open 20190209 2

<h4>Objectives</h4>Sustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster.<h4>Design</h4>This research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality.<h4>Setting</h4>The residents in Kawauchi Village, Fukush ...[more]

PMID: 30739080

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Project description:OBJECTIVES:After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village. METHODS:Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: "Diabetes (DM)" (FBG ? 126?mg/dL or HbA1c ? 6.5% or hospital visit for DM or usage of diabetic medication), "Borderline DM" (126?mg/dL > FBG ? 110?mg/dL or 6.5% > HbA1c ? 6.0%, and without hospital visit, and without diabetic medication), and "Normoglycemic" (FBG < 110?mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9?years in Kawauchi village and 3.6?years in Ono town. RESULTS:Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village. CONCLUSIONS:The current results confirmed that diabetes incidence was increased 6?years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority.

Project description:IntroductionDemographic changes as a result of evacuation in the acute phase of the 2011 Fukushima nuclear disaster are not well evaluated. We estimated post-disaster demographic transitions in Minamisoma City-located 14-38 km north of the nuclear plant-in the first month of the disaster; and identified demographic factors associated with the population remaining in the affected areas.Materials and methodsWe extracted data from the evacuation behavior survey administered to participants in the city between July 11, 2011 and April 30, 2013. Using mathematical models, we estimated the total population in the city after the disaster according to sex, age group, and administrative divisions of the city. To investigate factors associated with the population remaining in place after the disaster, a probit regression model was employed, taking into account sex, age, pre-disaster dwelling area, and household composition.ResultsThe overall population decline in Minamisoma City peaked 11 days after the disaster, when the population reached 7,107 people-11% of the pre-disaster level. The remaining population levels differed by area: 1.1% for mandatory evacuation zone, 12.5% for indoor sheltering zone, and 12.6% for other areas of the city. Based on multiple regression analyses, higher odds for remaining in place were observed among men (odds ratio 1.72 [95% confidence intervals 1.64-1.85]) than women; among people aged 40-64 years (1.40 [1.24-1.58]) than those aged 75 years or older; and among those living with the elderly, aged 70 years or older (1.18 [1.09-1.27]) or those living alone (1.71 [1.50-1.94]) than among those who were not.DiscussionDespite the evacuation order, some residents of mandatory evacuation zones remained in place, signaling the need for preparation to respond to their post-disaster needs. Indoor sheltering instructions may have accelerated voluntary evacuation, and this demonstrates the need for preventing potentially disorganized evacuation in future nuclear events.

Project description:BackgroundYouTube (Alphabet Incorporated) has become the most popular video-sharing platform in the world. The Fukushima Daiichi Nuclear Power Plant (FDNPP) disaster resulted in public anxiety toward nuclear power and radiation worldwide. YouTube is an important source of information about the FDNPP disaster for the world.ObjectiveThis study's objectives were to examine the characteristics of YouTube videos related to the FDNPP disaster, analyze the content and comments of videos with a quantitative method, and determine which features contribute to making a video popular with audiences. This study is the first to examine FDNPP disaster-related videos on YouTube.MethodsWe searched for the term "Fukushima nuclear disaster" on YouTube on November 2, 2019. The first 60 eligible videos in the relevance, upload date, view count, and rating categories were recorded. Videos that were irrelevant, were non-English, had inappropriate words, were machine synthesized, and were <3 minutes long were excluded. In total, 111 videos met the inclusion criteria. Parameters of the videos, including the number of subscribers, length, the number of days since the video was uploaded, region, video popularity (views, views/day, likes, likes/day, dislikes, dislikes/day, comments, comments/day), the tone of the videos, the top ten comments, affiliation, whether Japanese people participated in the video, whether the video recorder visited Fukushima, whether the video contained theoretical knowledge, and whether the video contained information about the recent situation in Fukushima, were recorded. By using criteria for content and technical design, two evaluators scored videos and grouped them into the useful (score: 11-14), slightly useful (score: 6-10), and useless (score: 0-5) video categories.ResultsOf the 111 videos, 43 (38.7%) videos were useful, 43 (38.7%) were slightly useful, and 25 (22.5%) were useless. Useful videos had good visual and aural effects, provided vivid information on the Fukushima disaster, and had a mean score of 12 (SD 0.9). Useful videos had more views per day (P<.001), likes per day (P<.001), and comments per day (P=.02) than useless and slightly useful videos. The popularity of videos had a significant correlation with clear sounds (likes/day: P=.001; comments/day: P=.02), vivid information (likes/day: P<.001; comments/day: P=.007), understanding content (likes/day: P=.001; comments/day: P=.04). There was no significant difference in likes per day (P=.72) and comments per day (P=.11) between negative and neutral- and mixed-tone videos. Videos about the recent situation in Fukushima had more likes and comments per day. Video recorders who personally visited Fukushima Prefecture had more subscribers and received more views and likes.ConclusionsThe possible features that made videos popular to the public included video quality, videos made in Fukushima, and information on the recent situation in Fukushima. During risk communication on new forms of media, health institutes should increase publicity and be more approachable to resonate with international audiences.

Dataset Information

Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study.

Publications

Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study.

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