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Hosoya M, Nakano H, Hashimoto K, Ohira T, Sakai A, Shimabukuro M, Yasumura S, Ohto H, Kamiya K. Influence of post-disaster evacuation on childhood obesity and liver dysfunction: The Fukushima Health Management Survey. Pediatr Int 2023; 65:e15663. [PMID: 38009919 DOI: 10.1111/ped.15663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND After the Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident in 2011, the Fukushima Prefectural Government launched a long-term health management survey for the population of Fukushima. Results of the Comprehensive Health Check (CHC) showed that some children aged 6-15 years, who resided in the evacuation area at the time of the disaster, had obesity, hyperlipidemia, liver dysfunction, and/or renal dysfunction from as early as 2011. The aim of the present study was to determine the long-term trend of obesity and hepatic enzyme abnormalities in Fukushima children. METHODS We evaluated the changes in body mass index standard deviation score (BMI-SDS), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase from 2011 to 2018. RESULTS Obesity (BMI-SDS ≥ 2) was significantly associated with hepatobiliary enzyme abnormalities. The mean BMI-SDS was significantly higher in 2011 after the disaster, but then soon showed a gradual decrease. The frequency of obesity did not increase significantly after the disaster. There were no significant differences in the prevalence of hepatobiliary enzyme abnormalities in the children aged 6-15 years of either sex from 2011 to 2018. CONCLUSIONS In the present study, we found that the increase in the mean BMI-SDS after the disaster was temporary, suggesting that the frequency of obesity and liver dysfunction might not have been significantly influenced by the disaster.
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Affiliation(s)
- Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koichi Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Radiation Life Science, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
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2
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Nakajima S, Eguchi E, Funakubo N, Hayashi F, Iwai-Takano M, Ohira T. Trends and Regional Differences in the Prevalence of Dyslipidemia before and after the Great East Japan Earthquake: A Population-Based 10-Year Study Using the National Database in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:560. [PMID: 36612881 PMCID: PMC9819528 DOI: 10.3390/ijerph20010560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Since the Great East Japan Earthquake in March 2011, an increase in lifestyle-related diseases due to changes in living environment following the nuclear power plant accident has been reported in Fukushima Prefecture, especially among evacuees. However, no long-term studies covering the entire Fukushima Prefecture have been conducted. The study aim was to investigate the effects of post-disaster evacuation life on the prevalence of dyslipidemia in Fukushima Prefecture using a national database. The data from 3,866,674 people who underwent specific health checkups between fiscal year (FY) 2008 and FY2017 were analyzed. Fukushima Prefecture was divided into four areas, and the prevalence of dyslipidemia and related parameters were compared. The prevalence of dyslipidemia increased overall, with a particularly sharp increase after FY2011 in the evacuation area. The sex- and age-adjusted odds ratio (95% confidence intervals) of having dyslipidemia in the evacuation area compared with that in the control area was 0.951 (0.929-0.973) in FY2008-2010, which increased to 1.130 (1.105-1.155) in FY2012-2014 and 1.117 (1.092-1.143) in FY2015-2017. Since the prevalence of dyslipidemia has increased and remained high after the earthquake in Fukushima Prefecture, especially in the evacuation area, continued measures to prevent cardiovascular diseases among the residents are needed.
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Affiliation(s)
- Shigetaka Nakajima
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Narumi Funakubo
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Masumi Iwai-Takano
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1-1 Hikariga-oka, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
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3
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Ohira T, Nakano H, Okazaki K, Hayashi F, Nagao M, Sakai A, Hosoya M, Shimabukuro M, Takahashi A, Kazama JJ, Hashimoto S, Kawasaki Y, Satoh H, Kobashi G, Yasumura S, Ohto H, Kamiya K. Trends in Lifestyle-related Diseases and Their Risk Factors After the Fukushima Daiichi Nuclear Power Plant Accident: Results of the Comprehensive Health Check in the Fukushima Health Management Survey. J Epidemiol 2022; 32:S36-S46. [PMID: 36464299 PMCID: PMC9703921 DOI: 10.2188/jea.je20210386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Residents were forced to evacuate owing to the radiation released after the Fukushima Nuclear Power Plant (NPP) accident following the Great East Japan Earthquake on 11/03/2021; thus, their lifestyles drastically changed. The Comprehensive Health Check (CHC) of the Fukushima Health Management Survey (FHMS) was performed to evaluate health statuses and prevent lifestyle-related diseases in evacuation area residents. The first part of the CHC survey is a retrospective analysis of pre- and post-disaster data on health check-ups of evacuation area residents. The second part is a cross-sectional, prospective analysis of post-disaster (fiscal year (FY) 2011-2017) data on health check-ups. Subjects were men and women living in 13 municipalities in areas surrounding the NPP in Fukushima Prefecture. Post-disaster (FY 2011-2012) overweight, hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome, liver dysfunction, hyperuricemia, polycythemia and atrial fibrillation cases increased from the pre-disaster (FY 2008-2010) levels. This tendency was strongest among residents who were forced to evacuate. Proportion of overweight people remained unchanged, the prevalence of liver dysfunction decreased and the proportion of people with treated hypertension and dyslipidemia increased during FY 2011-2017. Meanwhile, the prevalence of diabetes mellitus and mean levels of HbA1c increased. Furthermore, Evacuees showed higher risks of diabetes mellitus, dyslipidemia, chronic kidney diseases and liver dysfunction than non-evacuees. Therefore, residents in the evacuation area, especially evacuees, are at high risk of developing lifestyle-related diseases, especially cardiovascular diseases; therefore, it is necessary to observe health statuses and implement measures to prevent lifestyle-related diseases.
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Affiliation(s)
- Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junichiro J. Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Endocrinology, Metabolism, Diabetology and Nephrology, Fukushima Medical University Aizu Medical Center, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Diabetes and Metabolism, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan,Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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4
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Sakai A, Nagao M, Nakano H, Ohira T, Ishikawa T, Hosoya M, Shimabukuro M, Takahashi A, Kazama JJ, Okazaki K, Hayashi F, Yasumura S, Ohto H, Kamiya K. Effects of External Radiation Exposure Resulting From the Fukushima Daiichi Nuclear Power Plant Accident on the Health of Residents in the Evacuation Zones: the Fukushima Health Management Survey. J Epidemiol 2022; 32:S84-S94. [PMID: 36464304 PMCID: PMC9703929 DOI: 10.2188/jea.je20210286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Associations have been reported between lifestyle-related diseases and evacuation after the Great East Japan Earthquake (GEJE). However, the relationship between lifestyle-related diseases and the effective radiation dose due to external exposure (EDEE) after the GEJE remains unclear. METHODS From among 72,869 residents of Fukushima Prefecture (31,982 men; 40,887 women) who underwent a comprehensive health check in fiscal year (FY) 2011, the data of 54,087 residents (22,599 men; 31,488 women) aged 16 to 84 years were analyzed. The EDEE data of 25,685 residents with incomplete results from the basic survey, performed to estimate the external radiation exposure dose, were supplemented using multiple imputation. The data were classified into three groups based on EDEE (0 to <1, 1 to <2, and ≥2 mSv groups and associations between the incidence of diseases and EDEE from FY2011 to FY2017 were examined using a Cox proportional hazards model, with FY2011 as the baseline. RESULTS A higher EDEE was associated with a greater incidence of hypertension, diabetes mellitus, dyslipidemia, hyperuricemia, liver dysfunction, and polycythemia from FY2011 to FY2017 in the age- and sex-adjusted model. However, after further adjustment for evacuation status and lifestyle-related factors, the significant associations disappeared. No association was found between EDEE and other lifestyle-related diseases. CONCLUSION EDEE was not directly associated with the incidence of lifestyle-related diseases after the GEJE. However, residents with higher external radiation doses in Fukushima Prefecture might suffer from lifestyle-related diseases related to evacuation and the resultant lifestyle changes.
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Affiliation(s)
- Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masanori Nagao
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuo Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Junichiro J. Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kanako Okazaki
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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5
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Okazaki K, Ohira T, Sakai A, Shimabukuro M, Kazama JJ, Takahashi A, Nakano H, Hayashi F, Nagao M, Yasumura S, Ohto H, Kamiya K. Lifestyle Factors Associated with Undernutrition in Older People after the Great East Japan Earthquake: A Prospective Study in the Fukushima Health Management Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063399. [PMID: 35329088 PMCID: PMC8951088 DOI: 10.3390/ijerph19063399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023]
Abstract
We conducted a longitudinal examination to assess the relationship between lifestyle habits, including exercise habits, and the incidence of undernutrition after the Great East Japan Earthquake in March 2011. Of the 31,411 participants aged ≥60 years who lived in the municipalities’ evacuation areas before the disaster and had undergone health examinations, 17,622 persons with a body mass index of 20–25 kg/m2 were followed up through the FY 2017 (a mean follow-up of 6.9 years). The analysis involved 13,378 individuals who could be followed. The associations between undernutrition after the disaster and lifestyle factors were estimated via multivariable-adjusted analysis using the Cox proportional hazard regression model. The dependent variable was the proportion of undernutrition after the disaster, whereas independent variables included evacuation, exercise habits/physical activity, alcohol consumption, smoking, meals before bedtime, gastrointestinal surgery history, history of lifestyle-related diseases, and two or more subjective symptoms. In total, 1712 of the 13,378 participants were newly undernourished after the disaster. The statistically significant variables influencing the occurrence of undernutrition were non-evacuation (hazard ratio (HR), 1.31; 95% confidence index (CI) 1.17–1.47), poor exercise habits (HR, 1.14; 95% CI 1.03–1.50), and poor physical activity (HR, 1.12; 95% CI 1.01–1.25). Other significant related variables were drinking habits, surgical history, lifestyle-related diseases, and two or more subjective symptoms. These results suggest that regular exercise and/or physical activity might be important in preventing undernutrition following a disaster, regardless of sex, other lifestyle habits, or past medical history.
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Affiliation(s)
- Kanako Okazaki
- Department of Physical Therapy, Fukushima Medical University School of Medical Sciences, Fukushima 960-8516, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Correspondence: ; Tel.: +81-(24)-5471762
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Junichiro J. Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (A.S.); (M.S.); (J.J.K.); (A.T.); (H.N.); (F.H.); (M.N.); (S.Y.); (H.O.); (K.K.)
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
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Ishikuro M, Noda A, Murakami K, Onuma T, Matsuzaki F, Ueno F, Kikuya M, Metoki H, Tomita H, Obara T, Yaegashi N, Kuriyama S. Families' Health after the Great East Japan Earthquake: Findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. TOHOKU J EXP MED 2022; 256:93-101. [PMID: 35197407 DOI: 10.1620/tjem.256.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Infectious diseases, chronic diseases, and mental disorders in both adults and children are reported after disasters occur. The correlation between chronic diseases and mental disorders has also been reported. Moreover, disasters may affect perinatal outcomes. Thus, both adult and child health should be carefully monitored in disaster aftermath. A prospective cohort study of pregnant women and their families, the Tohoku Medical Megabank Project (TMM) Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), has been conducted since 2013. A total of 73,529 family members participated in the TMM BirThree Cohort Study. Among siblings, the proportion of "small for gestational age" was the same in the pre- and post-disaster periods. Among parents and grandparents who answered the baseline questionnaire, 5.6% in the inland area and 19.8% in the coastal area had their houses totally/mostly destroyed by the Great East Japan Earthquake. Although a depression trend due to house damage was not observed in mothers, the proportion of psychological distress was high according to house damage (P for trend = 0.04). Among parents, there was an increase in overweight persons (P for trend = 0.004 in mothers and < 0.0001 in fathers) and in the number of smokers based on the severity of house damage (P for trend = 0.002 in mothers and < 0.0001 in fathers), whereas no such trend was observed in grandparents. Continuous monitoring and support for those who need are essential. Moreover, utilizing existing cohort studies to investigate health status when we face a new disaster is desirable.
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Affiliation(s)
- Mami Ishikuro
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine
| | - Aoii Noda
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Keiko Murakami
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine
| | - Tomomi Onuma
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Fumiko Matsuzaki
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine
| | - Fumihiko Ueno
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Hirohito Metoki
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hiroaki Tomita
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Department of Psychiatry, Tohoku University Graduate School of Medicine.,Department of Psychiatry, Tohoku University Hospital.,Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Nobuo Yaegashi
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University.,Department of Gynecology and Obstetrics, Tohoku University Graduate School of Medicine.,Department of Gynecology and Obstetrics, Tohoku University Hospital
| | - Shinichi Kuriyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine.,Division of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University
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7
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Kamiya K. Health management and care following the Fukushima nuclear power plant accident: overview of Fukushima Health Management Survey. Ann ICRP 2021; 50:82-89. [PMID: 34218678 DOI: 10.1177/01466453211015402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Following the accident at Fukushima Daiichi nuclear power plant, Fukushima Prefecture is conducting the Fukushima Health Management Survey, which has been contracted out to Fukushima Medical University. The purpose of this survey is to investigate the exposure doses and health conditions of the residents of Fukushima Prefecture in order to prevent, diagnose, and treat diseases at an early stage, and to maintain and improve the health of residents in the future.This survey consists of a basic survey to estimate external exposure doses and detailed surveys to investigate health conditions. The detailed surveys comprise: (i) thyroid ultrasound examination; (ii) comprehensive health check; (iii) mental health and lifestyle survey; and (iv) pregnancy and birth survey.In the basic survey, the external exposure dose was estimated for >466,000 people during the first 4 months after the accident; it was estimated to be <5 mSv for 99.8% of residents.The thyroid ultrasound examination included four rounds of echo examinations covering approximately 380,000 children aged <18 years at the time of the accident in each round. The first, second, third, and fourth examinations identified 116, 71, 31, and 21 children with thyroid cancer/suspected cancer, respectively. The Fukushima Prefectural Oversight Committee analysed the results from the first and second examinations, and evaluated that 'the detected increased rate is unlikely to be the impact of radiation'. However, the Oversight Committee is deliberating the future direction of thyroid examination, taking into consideration the advantages and disadvantages of the examination as well as ethical viewpoints.In the comprehensive health check, approximately 210,000 people in the evacuation area were examined, and increased rates of lifestyle-related diseases [e.g. obesity, hypertension, diabetes, and dyslipidaemia (low high-density-lipoprotein cholesterol)] were confirmed. In the mental health and lifestyle survey, approximately 210,000 people, including residents in the evacuation area, were examined. A deterioration in general mental health was found for the period immediately after the accident across a wide range of age groups, and although recovery was seen over the years, the rate of mental health issues remains above the national average. The pregnancy and birth survey revealed that the pre-term birth rate, low-birthweight rate, and rate of congenital anomalies did not differ from the national average.The purpose of Fukushima Health Management Survey is not only to collect data on the health of the residents of Fukushima Prefecture, but to provide direct support to residents regarding the health issues clarified by the survey. Moreover, various initiatives are being implemented in cooperation with various local government authorities with the aim of maintaining and promoting the health of the residents.
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Affiliation(s)
- Kenji Kamiya
- Fukushima Medical University Radiation Medical Science Centre for the Fukushima Health Management Survey, 1 Hikarigaoka, Fukushima City 960-1295, Japan.,Hiroshima University Radiation Emergency Medicine Promotion Centre, Japan
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8
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Nomura S, Murakami M, Ozaki A, Sawano T, Leppold C, Nishikawa Y, Saito H, Oikawa T, Tsubokura M. Comparative risk assessment of non-communicable diseases by evacuation scenario- a retrospective study in the 7 years following the Fukushima Daiichi nuclear power plant accident. Glob Health Action 2021; 14:1918886. [PMID: 34058969 PMCID: PMC8172221 DOI: 10.1080/16549716.2021.1918886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: As a result of the Fukushima Daiichi nuclear power plant accident, many residents evacuated and were exposed to changes in their living environment and socioeconomic status, and to persistent stressors. Past studies have suggested the potential for these circumstances to contribute to long-term changes to population health.Objective: The objective of this study was to gain a better understanding of long-term health effects of evacuation, by evaluating the risk of non-communicable diseases among evacuees from Minamisoma City (one of the closest municipalities to the power plant) until 2017.Methods: The study evaluated data from annual health check-ups for residents aged 40-74 years covered by National Health Insurance (who are largely self-employed) from 2010 to 2017 administered by Minamisoma City. Diabetes, hyperlipidemia, and hypertension were defined from the results of blood sampling. Annual changes in age-adjusted prevalence were estimated by evacuation scenario. We also performed an inverse-probability weighting (IPW) analysis to adjust for baseline covariates in 2010 and estimated the differences in the risk of diabetes, hyperlipidemia, and hypertension by evacuation scenario as of the 2017 health check-up in reference to the no-evacuation group.Results: A total of 1,837 individuals were considered in this study. Regardless of evacuation scenario, there was statistical evidence suggesting an upward and a downward trend in diabetes and hypertension from 2010 to 2017, respectively, while hyperlipidemia showed no remarkable change. IPW analyses demonstrated that disease risks in 2017 did not differ significantly among people with different evacuation scenarios.Conclusions: Region-specific factors played an important role in the health effects of the evacuation. Our findings have important implications for the need of an assessment of the health effects of evacuations in more localized manner. Further research in this area will strengthen the communities' preparedness for future disasters that require mass evacuation.
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Affiliation(s)
- Shuhei Nomura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akihiko Ozaki
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | - Toyoaki Sawano
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Claire Leppold
- Child and Community Wellbeing Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Yoshitaka Nishikawa
- Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan.,Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Tomoyoshi Oikawa
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Masaharu Tsubokura
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
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9
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Association between Psychological Factors and Evacuation Status and the Incidence of Cardiovascular Diseases after the Great East Japan Earthquake: A Prospective Study of the Fukushima Health Management Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217832. [PMID: 33114634 PMCID: PMC7663529 DOI: 10.3390/ijerph17217832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/28/2022]
Abstract
Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30–89 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants’ psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.
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10
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Takahashi A, Ohira T, Okazaki K, Yasumura S, Sakai A, Maeda M, Yabe H, Hosoya M, Ohtsuru A, Kawasaki Y, Shimabukuro M, Kazama J, Hashimoto S, Watanabe K, Nakano H, Hayashi F, Ohto H, Kamiya K, Ohira H. Effects of Psychological and Lifestyle Factors on Metabolic Syndrome Following the Fukushima Daiichi Nuclear Power Plant Accident: The Fukushima Health Management Survey. J Atheroscler Thromb 2020; 27:1010-1018. [PMID: 32009075 PMCID: PMC7508722 DOI: 10.5551/jat.52225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Aim: The Fukushima Daiichi Nuclear Power Plant accident dramatically changed the lifestyle of residents who lived near the plant. We evaluated the association of metabolic syndrome (MetS) with specific lifestyle- and disaster-related factors in residents following the accident. Methods: This cross-sectional study included 20,920 residents who underwent both the Comprehensive Health Check and the Mental Health and Lifestyle Survey from June 2011 to March 2012. Associations between MetS and lifestyle- and disaster-related factors, including psychological distress (post-traumatic stress disorder [PTSD]), were estimated using logistic regression analysis, adjusted for demographic and lifestyle factors, in 2019. Results: MetS was present in 30.4% of men and 11.5% of women. There were significant differences in smoking, drinking status, and PTSD prevalence between subjects with and without MetS. Multivariable logistic regression analysis showed that age, quitting smoking, and low physical activity were significantly associated with MetS. Moreover, PTSD and light to moderate drinking were also significantly associated with MetS in women. Conclusions: Lifestyle- and disaster-related factors, including PTSD, were associated with MetS among subjects who lived near the Fukushima Daiichi Nuclear Power Plant accident.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Public Health, Fukushima Medical University School of Medicine
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Radiation Life Sciences, Fukushima Medical University School of Medicine
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Diabetology and Endocrinology, Fukushima Medical University School of Medicine
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine
| | | | - Kazuyuki Watanabe
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine
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11
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Manukhina EB, Tseilikman VE, Karpenko MN, Pestereva NS, Tseilikman OB, Komelkova MV, Kondashevskaya MV, Goryacheva AV, Lapshin MS, Platkovskii PO, Sarapultsev AP, Alliluev AV, Downey HF. Intermittent Hypoxic Conditioning Alleviates Post-Traumatic Stress Disorder-Induced Damage and Dysfunction of Rat Visceral Organs and Brain. Int J Mol Sci 2020; 21:ijms21010345. [PMID: 31948051 PMCID: PMC6981426 DOI: 10.3390/ijms21010345] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/11/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) causes mental and somatic diseases. Intermittent hypoxic conditioning (IHC) has cardio-, vaso-, and neuroprotective effects and alleviates experimental PTSD. IHC’s ability to alleviate harmful PTSD effects on rat heart, liver, and brain was examined. PTSD was induced by 10-day exposure to cat urine scent (PTSD rats). Some rats were then adapted to 14-day IHC (PTSD+IHC rats), while PTSD and untreated control rats were cage rested. PTSD rats had a higher anxiety index (AI, X-maze test), than control or PTSD+IHC rats. This higher AI was associated with reduced glycogen content and histological signs of metabolic and hypoxic damage and of impaired contractility. The livers of PTSD rats had reduced glycogen content. Liver and blood alanine and aspartate aminotransferase activities of PTSD rats were significantly increased. PTSD rats had increased norepinephrine concentration and decreased monoamine oxidase A activity in cerebral cortex. The PTSD-induced elevation of carbonylated proteins and lipid peroxidation products in these organs reflects oxidative stress, a known cause of organ pathology. IHC alleviated PTSD-induced metabolic and structural injury and reduced oxidative stress. Therefore, IHC is a promising preventive treatment for PTSD-related morphological and functional damage to organs, due, in part, to IHC’s reduction of oxidative stress.
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Affiliation(s)
- Eugenia B. Manukhina
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
- Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology and Pathophysiology, Moscow 125315, Russia
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Correspondence:
| | - Vadim E. Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
| | - Marina N. Karpenko
- I.P. Pavlov Physiology Department, Institute of Experimental Medicine, St. Petersburg 197376, Russia
| | - Nina S. Pestereva
- I.P. Pavlov Physiology Department, Institute of Experimental Medicine, St. Petersburg 197376, Russia
| | - Olga B. Tseilikman
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
- School of Basic Medicine, Chelyabinsk State University, Chelyabinsk 454001, Russia
| | - Maria V. Komelkova
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
| | - Marina V. Kondashevskaya
- Laboratory for Immunomorphology of Inflammation, Research Institute of Human Morphology, Moscow 117418, Russia
| | - Anna V. Goryacheva
- Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology and Pathophysiology, Moscow 125315, Russia
| | - Maxim S. Lapshin
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
| | - Pavel O. Platkovskii
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
| | - Alexey P. Sarapultsev
- Laboratory of Immunopathophysiology, Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences, Ekaterinburg 620049, Russia
| | - Anatoly V. Alliluev
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
| | - H. Fred Downey
- School of Medical Biology, South Ural State University, Chelyabinsk 454080, Russia
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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12
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Sakai A, Nakano H, Ohira T, Maeda M, Okazaki K, Takahashi A, Kawasaki Y, Satoh H, Ohtsuru A, Shimabukuro M, Kazama J, Hashimoto S, Hosoya M, Yasumura S, Yabe H, Ohto H, Kamiya K. Relationship between the prevalence of polycythemia and factors observed in the mental health and lifestyle survey after the Great East Japan Earthquake. Medicine (Baltimore) 2020; 99:e18486. [PMID: 31895781 PMCID: PMC6946557 DOI: 10.1097/md.0000000000018486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.
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Affiliation(s)
- Akira Sakai
- Department of Radiation Life Sciences
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Disaster Psychiatry
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Gastroenterology
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Metabolism and Endocrinology, Juntendo University, Tokyo
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Health Management
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Diabetes, Endocrinology, and Metabolism
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Nephrology and Hypertension
| | | | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
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13
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Takahashi A, Ohira H. Autoimmune hepatitis, fatty liver, and Fukushima. Fukushima J Med Sci 2019; 65:25-29. [PMID: 31270280 DOI: 10.5387/fms.2019-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The use of direct antiviral agents (DAAs) for hepatitis C virus has led to a paradigm shift from viral hepatitis to non-viral disease. Autoimmune hepatitis (AIH) remains to be an issue in liver disease after the DAAs era. Moreover, fatty liver had been increasing in incidence and has attracted attention because of its risk for hepatocellular carcinoma. In 2011, the Great East Japan Earthquake, with the associated tsunami and accident at Fukushima Daiichi Nuclear Power Plant, has changed the lifestyle of residents in Fukushima prefecture. In this manuscript, we outlined the recent topics about AIH, fatty liver, and Fukushima.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine
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14
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Kusama T, Aida J, Sugiyama K, Matsuyama Y, Koyama S, Sato Y, Yamamoto T, Igarashi A, Tsuboya T, Osaka K. Does the Type of Temporary Housing Make a Difference in Social Participation and Health for Evacuees of the Great East Japan Earthquake and Tsunami? A Cross-Sectional Study. J Epidemiol 2018; 29:391-398. [PMID: 30344193 PMCID: PMC6737186 DOI: 10.2188/jea.je20180080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Although the majority of survivors of the huge Great East Japan Earthquake and Tsunami evacuated to two types of temporary housings, prefabricated housing and rented housing, health effects of these different environments were unclear. We examined whether prevalent social participation in prefabricated housing brought larger health benefits than in rented housing using the largest health survey data of the disaster survivors. Methods This cross-sectional study used a 2012 survey by the Miyagi Prefectural Government, in which almost all of evacuees were targeted (response rate: 61.6%). Self-rated health (SRH) and psychological distress measured via K6 score were the dependent variables, and social participation was the independent variable. Odds ratios of the social participation on health variables were estimated using logistic regression models. To assess the contribution of social participation, the population attributable fraction (PAF) was estimated. Results The participants lived in prefabricated and rented housing numbered 19,726 and 28,270, respectively. Participants in prefabricated housing had poorer SRH and K6 than those in rented housing. The proportions of participants engaging in social participation of prefabricated and rented housing were 38.2% and 15.4%, respectively. The absence of social participation was significantly associated with poor SRH and K6 among participants in both housing types. The PAFs of social participation with good SRH were 39.5% in prefabricated housing and 14.4% in rented housing. For K6, the PAFs were 47.1% and 19.5% in prefabricated and rented housing, respectively. Conclusion Compared to the residents in rented housing, residents in prefabricated housing had more frequent opportunities for social participation, which was associated with larger health benefits.
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Affiliation(s)
- Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Miyagi Prefectural Government Office
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU).,Japan Society for the Promotion of Science
| | - Shihoko Koyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Community Oral Health Science, Department of Community Medical Supports, Tohoku Medical Megabank Organization
| | - Yukihiro Sato
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ayaka Igarashi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Toru Tsuboya
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Disaster Medical Science Division, Disaster Related Oral Health, International Research Institute of Disaster Science
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15
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Takahashi A, Ohira T, Okazaki K, Yasumura S, Sakai A, Maeda M, Yabe H, Hosoya M, Ohtsuru A, Kawasaki Y, Suzuki H, Shimabukuro M, Sugiura Y, Shishido H, Hayashi Y, Nakano H, Kobashi G, Kamiya K, Ohira H. Effects of lifestyle on hepatobiliary enzyme abnormalities following the Fukushima Daiichi nuclear power plant accident: The Fukushima health management survey. Medicine (Baltimore) 2018; 97:e12890. [PMID: 30335013 PMCID: PMC6211895 DOI: 10.1097/md.0000000000012890] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023] Open
Abstract
Dramatic lifestyle changes due to the Fukushima Daiichi Nuclear Power Plant accident increased the prevalence of hepatobiliary enzyme abnormalities (HEA). We aimed to evaluate associations of HEA with specific lifestyle- and disaster-related factors in residents who lived near the Fukushima Daiichi Nuclear Power Plant.This cross-sectional study included 22,246 residents who underwent a Comprehensive Health Check and the Mental Health and Lifestyle Survey from June 2011 to March 2012. Residents were divided into 2 groups based on residential area and housing status after the accident. Associations between HEA and lifestyle- and disaster-related factors, including psychological distress, were estimated using logistic regression analysis adjusted for demographic and lifestyle factors.HEA was present in 27.3% of subjects. The prevalence of HEA was significantly higher in evacuees than controls (29.5% vs 25.7%, P < .001). There were significant differences in various lifestyle characteristics and the prevalence of post-traumatic stress disorder between evacuees and controls. Multivariable logistic regression analysis showed that age, sex, moderate to heavy drinking, and low/no physical activity were significantly associated with HEA regardless of evacuation status. Changes in jobs and unemployment were significantly associated with HEA in controls and evacuees, respectively.Lifestyle and disaster-related factors, but not psychological distress, were associated with HEA among subjects who lived near the Fukushima Daiichi Nuclear Power Plant accident.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Life Sciences
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Disaster Psychiatry
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neuropsychiatry
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Health Management
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Cardiology
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Diabetes, Endocrinology and Metabolism
| | - Yoshihiro Sugiura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neurology
| | - Hiroaki Shishido
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Orthopaedic Surgery
| | - Yoshimitsu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine
- Radiation Medical Science Center for the Fukushima Health Management Survey
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16
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Ohira T, Nakano H, Nagai M, Yumiya Y, Zhang W, Uemura M, Sakai A, Hashimoto S. Changes in Cardiovascular Risk Factors After the Great East Japan Earthquake. Asia Pac J Public Health 2017; 29:47S-55S. [PMID: 28330394 DOI: 10.1177/1010539517695436] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Great East Japan Earthquake occurred on March 11, 2011, and was followed by a nuclear accident at the Fukushima Daiichi Nuclear Power Plant. The government ordered a mandatory evacuation from the high radioactive concentration area in Fukushima. This evacuation may have forced many evacuees to change specific aspects of their lifestyles such as diet and physical activity, which in turn may lead to future incidence of lifestyle diseases such as cardiovascular diseases (CVDs). To address this concern, the association between the evacuation and changes in CVD risk factors before and after the disaster was examined in the Fukushima Health Management Survey. In the present study, we reviewed the results of longitudinal studies in the Fukushima Health Management Survey. The proportion of overweight/obese people and those with hypertension, diabetes mellitus, dyslipidemia, liver dysfunction, atrial fibrillation, and polycythemia increased after the disaster. Furthermore, the evacuation was associated with an increase of these cardiovascular risk factors. Therefore, evacuees may be more disposed to CVDs such as myocardial infarction and stroke after the disaster. The prevention of future CVDs among evacuees from Fukushima requires ongoing preventive programs for obesity, hypertension, diabetes mellitus, and dyslipidemia, in collaboration with local governments and communities.
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Affiliation(s)
| | | | - Masato Nagai
- 1 Fukushima Medical University, Fukushima, Japan.,2 Tohoku University, Sendai, Japan
| | - Yui Yumiya
- 1 Fukushima Medical University, Fukushima, Japan
| | - Wen Zhang
- 1 Fukushima Medical University, Fukushima, Japan
| | - Mayu Uemura
- 1 Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- 1 Fukushima Medical University, Fukushima, Japan
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17
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Takahashi A, Ohira T, Uemura M, Hosoya M, Yasumura S, Hashimoto S, Ohira H, Sakai A, Ohtsuru A, Satoh H, Kawasaki Y, Suzuki H, Sugiura Y, Shishido H, Hayashi Y, Takahashi H, Nakano H, Kobashi G, Ozasa K, Ohto H, Abe M. Changes in Hepatobiliary Enzyme Abnormality After the Great East Japan Earthquake: The Fukushima Health Management Survey. Sci Rep 2017; 7:710. [PMID: 28386098 PMCID: PMC5429598 DOI: 10.1038/s41598-017-00776-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 03/14/2017] [Indexed: 12/20/2022] Open
Abstract
Although the incidence of hepatobiliary enzyme abnormality increased immediately after the Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident, longer-term trends remain unclear. The aims of this study were to determine longer-term trends in hepatobiliary enzyme abnormality and to elucidate lifestyle factors associated with such changes among residents of a nuclear-disaster-affected area. This longitudinal survey enrolled 20,395 adults living in the vicinity of Fukushima Daiichi Nuclear Power Plant. Data were obtained from the records of annual health checkups of adults aged ≥40 years between 2011 and 2012. Follow-up examinations were conducted from June 2013 to March 2014. Associations were assessed between changes in hepatobiliary enzyme abnormality immediately and 3–4 years after the disaster and lifestyle factors. The overall prevalence of hepatobiliary enzyme abnormality significantly decreased over the study period, from 29.9% to 27.1%. Multivariate logistic regression analysis revealed significant associations between improved hepatobiliary enzyme abnormality and improvements in daily physical activity and frequency of breakfast consumption. The results suggest that improvements in daily physical activity and frequency of breakfast consumption significantly reduced the incidence of hepatobiliary enzyme abnormality 3–4 years after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident.
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Affiliation(s)
- Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan. .,Fukushima Medical University School of Medicine, Fukushima, Japan. .,Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Mayu Uemura
- Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Hiromasa Ohira
- Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Cardiology, Fukushima Medical University, Fukushima, Japan
| | - Yoshihiro Sugiura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Shishido
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima, Japan
| | - Yoshimitsu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Information Management and Statistics Office, Fukushima Medical University, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kotaro Ozasa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Office of the Comprehensive Health Check and Health Promotion, Fukushima, Japan.,Fukushima Medical University School of Medicine, Fukushima, Japan
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