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

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.

[1]  R. Sievert,et al.  Book Reviews : Recommendations of the International Commission on Radiological Protection (as amended 1959 and revised 1962). I.C.R.P. Publication 6. 70 pp. PERGAMON PRESS. Oxford, London and New York, 1964. £1 5s. 0d. [TB/54] , 1964 .

[2]  W. J. Meredith Report of the United Nations Scientific Committee on the Effects of Atomic Radiation , 1967 .

[3]  L. Hagmar,et al.  [Cancer incidence]. , 2018, Duodecim; laaketieteellinen aikakauskirja.

[4]  Henry I. Kohn,et al.  Sources, Effects and Risks of Ionizing Radiation , 1989 .

[5]  A S Detsky,et al.  How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. , 1992, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[6]  岩崎 民子 SOURCES AND EFFECTS OF IONIZING RADIATION : United Nations Scientific Committee on the Effects of Atomic Radiation UNSCEAR 2000 Report to the General Assembly, with Scientific Annexes , 2002 .

[7]  Tosihiro Oka,et al.  Ranking the risks of 12 major environmental pollutants that occur in Japan. , 2003, Chemosphere.

[8]  D. Kinly,et al.  Chernobyl’s Legacy: Health, Environmental and Socio-Economic Impacts , 2006 .

[9]  Jack Valentin,et al.  The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. , 2007, Annals of the ICRP.

[10]  D. L. Preston,et al.  Solid Cancer Incidence in Atomic Bomb Survivors: 1958–1998 , 2007, Radiation research.

[11]  Dale L Preston,et al.  Solid cancer incidence in atomic bomb survivors exposed in utero or as young children. , 2008, Journal of the National Cancer Institute.

[12]  Yukiko Shimizu,et al.  Studies of the Mortality of Atomic Bomb Survivors, Report 14, 1950–2003: An Overview of Cancer and Noncancer Diseases , 2012, Radiation research.

[13]  M. Tsubokura,et al.  Changes in metabolic profiles after the Great East Japan Earthquake: a retrospective observational study , 2013, BMC Public Health.

[14]  Hiroshi Nishimoto,et al.  Cancer incidence and incidence rates in Japan in 2007: a study of 21 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project. , 2013, Japanese journal of clinical oncology.

[15]  Bernadette A. Thomas,et al.  Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[16]  M. Reich,et al.  Excess mortality among relocated institutionalized elderly after the Fukushima nuclear disaster. , 2013, Public health.

[17]  Daisuke Yoneoka,et al.  Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study , 2013, PloS one.

[18]  Akifumi Fukumura,et al.  NIRS external dose estimation system for Fukushima residents after the Fukushima Dai-ichi NPP accident , 2013, Scientific Reports.

[19]  Y. Kanda,et al.  Investigation of the freely available easy-to-use software ‘EZR' for medical statistics , 2012, Bone Marrow Transplantation.

[20]  Sophie Ancelet,et al.  Predicted cancer risks induced by computed tomography examinations during childhood, by a quantitative risk assessment approach , 2014, Radiation and environmental biophysics.

[21]  M. Tsubokura,et al.  Impact of Natural Disaster Combined with Nuclear Power Plant Accidents on Local Medical Services: a Case Study of Minamisoma Municipal General Hospital after the Great East Japan Earthquake , 2014, Disaster Medicine and Public Health Preparedness.

[22]  T. Oki,et al.  Estimated Dietary Intake of Radionuclides and Health Risks for the Citizens of Fukushima City, Tokyo, and Osaka after the 2011 Nuclear Accident , 2014, PloS one.

[23]  Tomoyuki Takahashi,et al.  Radiation dose rates now and in the future for residents neighboring restricted areas of the Fukushima Daiichi Nuclear Power Plant , 2014, Proceedings of the National Academy of Sciences.