Radiation risk perception: a discrepancy between the experts and the general population

Measuring societal attitudes and behaviours towards radon indoors: A case study of Slovenia

Public opinion surveys play a crucial role in assessing public awareness, knowledge, and radon risk perception in the context of national Radon Action Plans. However, many of these surveys are constructed without a solid foundation in behavioural theories, health protection theory, or social science methodology. This lack of foundation can lead to misguided priorities in radon mitigation interventions and ineffective communication strategies, ultimately resulting in low compliance with testing and mitigation in private homes. By developing and testing scales that measure a wide range of theory-based socio-psychological concepts influencing protective behaviour of individuals facing radon risk, this study provides researchers, authorities, and practitioners with a useful and versatile survey tool to explore the complexity of human behaviour in the context of radon. The results of this survey, conducted in Slovenia with a representative sample of respondents from low, middle, and high radon risk areas (N = 2012), offer a foundation for assessing gaps and strategies to increase testing and remediation of homes. The findings suggest that communication interventions need to be more precisely tailored to specific population groups and should go beyond enhancing awareness, knowledge and radon risk perception. Effective strategies should evoke emotions, share personal stories, highlight successful mitigation cases, and use personal testimonies from individuals affected by lung cancer. Moreover, incorporating positive social norms can inspire more individuals to engage in testing and mitigation measures. Assessing theory-driven socio-psychological concepts through a survey allows researchers and policymakers to craft more effective strategies aimed at promoting radon testing and mitigation, thereby enhancing overall public health.

Some observations on perceptions of radiation risks in the context of nuclear power plant accidents

As highlighted by public reactions to accidents at nuclear plants in the past, such as those that occurred in Chernobyl (1986) and Fukushima (2011), and from numerous opinion surveys, there are considerable differences or gaps between how the public and radiation experts perceive the risks from radiation. Even within the community of experts, radiation risk perception differences can be present. The reasons for differences in radiation risk perceptions between the public and experts are complex and involve sociological, ethical and behavioural aspects of society. This presents significant challenges to authorities in trying to improve radiation risk communications targeted at the public within the context of radiation emergency preparedness planning. Of particular importance is to make the communications more citizen-centred than heretofore by having meaningful two-way communications and dialogue with the public. It is emphasised that such strategies should take into account and address the significant mental health and socio-economic impacts of such accidents on affected populations. In particular, the mental health impacts are inadequately addressed by current international radiation protection recommendations reflecting their long established emphasis only on physical health effects. This approach is no longer acceptable or justified.

Evolutionary game analysis of indoor radon mitigation with local government involvement

Radon is the second leading risk factor for lung cancer after smoking. As a public policy, radon mitigation not only involves radon control technology or its cost-benefit analysis, but also includes the decision-making process of local governments. In this study, the evolutionary game theory was used to analyse the interaction between local governments and residents based on the subsidy of the central government. Considering the practical data in China, factors influencing the behaviour of local governments and residents were discussed using numerical simulations. The results indicated that radon mitigation is a fully government-promoted action; thus, its implementation largely depends on the subsidy of the central government and the share of radon control costs borne by the local government. The financial burden for both local governments and residents is a more important determinant than long-term health effects. The relatively poor local economic situation could limit the implementation of radon control. There would be a public policy paradox wherein cities or regions with higher radon risk would have lower willingness for radon control, mainly due to the significantly higher costs of radon control. This work provides reference data for decision-making to implement radon control and is expected to offer some suggestions for local governments.

USAR decision-making: the role of hazard-specific expertise and risk assessment

The accepted detrimental effects of climate change and the anticipated increased frequency of cascading disasters means there is a pressing requirement to equip search and rescue teams with the capability to perform effective and complex risk assessments. This paper investigates risk-based decision-making expertise in the aftermath of the 2011 earthquake and tsunami in Japan. It compares the actual decisions made by an Urban Search and Rescue (USAR) commander, with the decisions that a cohort of people working within search and rescue made, when provided with the same decision context using 3 vignettes. Variations in the results are explored in terms of the complexity of the risk decision and the type of expertise required. The findings indicate that as the risk becomes more complex, the percentage of answers that were the same as the USAR commander (that we deem as ‘correct’ as they did not result in any adverse outcomes for the USAR team) decreased. Training entities need to provide decision-makers with the necessary human capabilities so they can perform the complex risk assessments required to make decisions in low-probability yet high-consequence disasters.

The Differences in Risk Perception between Practitioners in the Non-Coal-Mining Industry: Miners, Managers and Experts

Non-coal-mining accidents occur frequently in China, and individual unsafe behaviors are the direct cause. The cognitive diversity of practitioners in the non-coal-mining industry leads to various behaviors in work and hinders communication between groups. The aim of this study is to analyze the differences in risk perception (accidents and occupational diseases) between non-coal-mining practitioners (experts, miners, and managers) and to explore the contributing factors. The questionnaire survey method was used to collect the data on risk perception and influencing factors from 402 respondents working in non-coal mines and universities in China. Project analysis and exploratory factor analysis were used for preprocessing. A t-test and linear regression analysis were used to test the significance of the differences and assess the function of the factors, respectively. Regarding risk perception, two risks both have significant differences between the three groups. With the perceptions of accidents and occupational diseases ranked from high to low, the order of the practitioners is as follows: managers (3.88), experts (3.71), miners (3.55) and experts (4.14), miners (3.90), and managers (3.88). Regarding the influencing factors, risk attitude, risk communication, educational level, enterprise trust, and occupational satisfaction have great effects on the three groups. More precisely, three groups have different important predictors. Risk attitude has the greatest impact on miners (0.290) and experts (0.369), but sensibility preference has the greatest impact on managers (0.518). In summary, cognitive discrepancies are common among non-coal-mining practitioners, but the degree of deviation varies with the type and dimension of the risk. There are six factors that have a significant impact on all practitioners, but the effect is limited by specific risks and groups.

Research on older people's health information search behavior based on risk perception in social networks-A case study in China during COVID-19

Objective

COVID-19 has caused great loss of human life and livelihoods. The dissemination of health information in online social networks increased during the pandemic's quarantine. Older people are the most vulnerable group in sudden public health emergencies, and they have the disadvantage of infection rates and online search for health information. This study explores the relationship between the health risk perception and health information search behavior of older people in social networks, to help them make better use of the positive role of social networks in public health emergencies.

Method

Based on the Risk Information Search and Processing model, and in the specific context of COVID-19, this study redefines health risk perception as a second-order construct of four first-order factors (perceived probability, perceived severity, perceived controllability, and perceived familiarity), and constructs a research model of the health risk perception and health information search behavior of older people. An online survey of people over 55 years old was conducted through convenience sampling in China from February 2020 to March 2020.

Results

A total of 646 older adults completed the survey. The structural equation model showed that health risk perception is a second-order factor (H1), that health risk perception has significant positive effects on health information search behavior (H2: β = 0.470, T = 11.577, P < 0.001), and that health risk perception has significant positive effects on affective response (H3: β = 0.536, T = 17.356, P < 0.001). In addition, affective response has a significant positive mediating effect on information sufficiency (H4: β = 0.435, T = 12.231, P < 0.001), and information sufficiency has a significant positive mediating effect on health information search behavior (H5: β = 0.136, T = 3.081, P = 0.002).

Conclusion

The study results indicate that the health risk perception of older people during the COVID-19 outbreak not only directly affected their health information search behavior, but also had an indirect impact on their health information search behavior by affecting affective response and information sufficiency.

Textual Features and Risk Preference Effects on Mental Health Education Among Teenager Students in Chongqing, China

Background

Mental health is a public health problem of great concern. Previous studies show that textual features and individual psychological characteristics can influence the effect of receiving information.

Purpose

This study explores whether textual features influence the persuasiveness of teenager students’ mental health education while considering the influence of risk preference.

Methods

From November to December 2021, a cross-sectional study was conducted among 1,869 teenager students in grade 7–12 in Chongqing, China. Wilcoxon signed-rank test, multiple logistic regression, and subgroup analysis were used to analyze the data.

Results

Among the four textual features mentioned in this study, a significant difference was reported in the persuasive effects of information with and without numerical features (p < 0.001), and such information tended to include digital features. The result for the symbolic features (p < 0.001) was consistent with the numerical features. The persuasive effects of positive and negative emotional information significantly differed (p < 0.001), with the former showing a better performance. No significant differences were observed between the persuasive effects of information with and without emotional conflicts (p > 0.05). Combined with those from the risk preference analysis, results showed that the regulatory effect of risk preference was only reflected in emotional conflicts. Students who prefer having no emotional conflict in the text showed the characteristics of risk avoidance, or lower grades, or rural or school accommodation. Most teenager students are also risk averse, especially females (or = 2.223, 95%CI:1.755–2.815) and juniors (or = 1.533, 95%CI: 1.198–1.963).

Conclusion

The numbers, symbols, and positive emotions in the text generate an active effect on teenager students receiving mental health education. Students avoiding risk are inclined to read texts without emotional conflicts. The probability of male choosing texts with positive emotional polarity is 33.5% lower than that of female. Female students and those from lower grades also demonstrate a higher inclination to risk avoidance compared with their male and higher grade counterparts. Therefore, educational materials with different text characteristics should be developed for teenager students with varying characteristics.

Societal aspects of NORM: An overlooked research field

While technical aspects of exposures to the naturally occurring radioactive material (NORM) are well explored, social science research on NORM is scarce, poorly indexed and dispersed across peer-reviewed literature, as well as various academic disciplines. Through an exploratory review of grey literature and a systematic review of scientific peer-reviewed articles published until December 2020, this paper addresses the following questions: (a) What are the societal challenges related to NORM? (b) What type of scientific research is being conducted on the societal aspects of NORM and (c) To what extent do the findings answer the identified challenges? Unfortunately, results of this study demonstrate a research gap related to the social, economic and cultural aspects of NORM management. Although the few existing studies offer some insights, for instance in relation to risk perception and risk communication, most of the societal challenges identified have not been addressed yet. This demonstrates the strong need for evidence based social science studies in order to improve the management of NORM.

PSYCHOPHYSIOLOGICAL FEATURES OF RADIATION RISK PERCEPTION

OBJECTIVE

to determine the subjective and psychophysiological characteristics of the perception of radiation risk,to identify destructive individual-typological personality traits, as well as factors that can be the basis of psycho-logical compensation for victims of various radiation disasters and accidents.

OBJECT AND METHOD

A comparative analysis of psychometric and neurophysiological parameters of hypertrophiedperception of radiation risk in the following groups was carried out: liquidators (clean-up workers) of the conse-quences of the Chornobyl accident and evacuees from the Chornobyl exclusion zone (CEZ) - 317 people total, par-ticipants in the anti-terrorist operation (ATO) - 101 people, and control group - 85 people. We used psychodiagnos-tic and neurophysiological (computerized electroencephalography) techniques.

RESULTS

In the groups of liquidators and evacuees from CEZ there are significantly more people with hypertrophiedperception of radiation risk compared to the control group and the comparison group (liquidators - 71.88 %, liqui-dators-evacuees - 80.0 %, evacuees 76.92 %, ATO participants - 33.78 %, control group - 35.0 %). Among therespondents with hypertrophied perception of radiation risk radiation factors, and, most of all, diseases associatedwith ionizing radiation, hold the first rank places among 31 evaluated factors in all groups. The respondents withadequate perception of the radiation risk are primarily concerned about social stress and environmental factors.Correlation analysis showed that there are no correlation between hypertrophied perception of radiation risk andactual documented radiation dose. Hypertrophied perception depends on gender, level of education, family incomeand level of knowledge about ionizing radiation. It affects perception of one's health, makes you feel helpless,increase the level of distress from the Chornobyl disaster and the Fukushima-1 disaster in Japan, and is also associ-ated with the Revolution of Dignity. Hypertrophied perception of radiation risk contributes to disorders of psycho-somatic health and deformation of personality traits. Comparative analysis of the parameters of bioelectrical activ-ity of the brain of persons with hypertrophied perception of the radiation threat showed an increase in brain's delta-,theta- and beta- activity with suppression of alpha-activity and dominant frequency.

CONCLUSIONS

In all examined groups a significant percentage of people with hypertrophied perception wererevealed. The key role in the process of perception of a radiation risk is played not by the real danger of the situa-tion and the documented dose of radiation, but by its perception and awareness. Hypertrophied perception of theradiation risk contributes to psychosomatic health disorders and deformation of personality traits, which is con-firmed by neurophysiological studies.

The Current Safety Regulation for Radiation Emergency Medicine in Korea

Radiation emergency medicine (REM) systems are operated around the world to provide specialized care for injured individuals who require immediate medical attention in accidents. This manuscript describes the current status of REM safety regulation in Korea and summarizes an assessment of the effects of this regulation. Responding to the requests of people for stronger safety regulations related to radiation exposure, a unique REM safety regulation for nuclear licensees, which is enforceable by laws, has been established and implemented. It is not found in other countries. It can provide a good example in practice for sustainable REM management including document reviews on medical response procedures and inspections of equipment and facilities. REM preparedness of nuclear or radiologic facilities has been improved with systematic implementation of processes contained in the regulation. In particular, the medical care system of licensees has become firmly coordinated in the REM network at the national level, which has enhanced their abilities by providing adequate medical personnel and facilities. This legal regulation service has contributed to preparing the actual medical emergency response for unexpected accidents and should ultimately secure the occupational safety for workers in radiation facilities.

Assessing radiation risk perception by means of a European stakeholder survey

It is increasingly recognised that stakeholder views can be essential for ascertaining the credibility of those entrusted with protection of the public and workers against radiation risks, the robustness of the approaches to protection and the relevance of research underpinning radiation protection (RP). The CONCERT European Joint Programme of RP research included consideration of stakeholder views. These were evaluated by means of a publicly available survey, translated into 15 languages, to encourage responses from a wide range of European countries. The survey ran in 2017 and received some 1961 responses from many countries, although response rates varied widely between countries. The survey respondents were largely highly educated, with many having a professional connection to RP or the use of radiation in medicine or industry. Survey results indicated a high level of scientific/technical knowledge relevant to RP and indicated a general trust of most actors involved in the RP field, perhaps unsurprisingly given the nature of the sampled population. Most expressed a reasonable level of satisfaction with the information available to them on radiation risk, but there is clearly room for improvement. Additionally, the survey identified potential training needs amongst the groups who responded. It is concluded that, while the survey results are limited by the non-representativeness of the respondents by comparison with the population of the European Union as a whole, it has been successful in gaining insights into areas where communication could be improved, where professional training gaps are present and where research could help to build wider trust in RP.

Spatial characteristics and influencing factors of risk perception of haze in China: The case study of publishing online comments about haze news on Sina

Haze has become an important factor to harm people's health. In the face of the harm of haze, people express risk perception behavior through publishing online comments on haze news. To a certain extent, online comments affect the government's decision to deal with haze. However, most of the previous efforts only focused on several cities from a micro perspective whereas the existing research lacks to explore the regional differences of risk perception behavior of the whole country from a macro perspective. The macro perspective of research can help policymakers to formulate strategies of haze control according to local conditions. Therefore, it is important to understand the risk perception behavior of publishing online comments and haze from the macro perspective. In this study, we use quantitative methods to study the spatial-temporal characteristics of online comments and PM_2.5 in 334 cities in China from 2014 to 2018. From the spatial perspective, the spatial characteristics of online comments are quite different from those of PM_2.5 at the city level. It can be seen that the spatial mismatch can affect the government's strategy of haze control according to local conditions. From the perspective of influencing factors, we find that the risk perception behavior of publishing online comments conforms to the theory of environmental risk perception. Firstly, the local social development level is the largest driving force accelerating risk perception behavior. Secondly, information channel also has significantly positive effect on public risk perception behavior. Finally, the harmful degree of haze has the least positive effect on people's risk perception behavior. This gives us enlightenment. The number of online comments does not reflect the harmful degree of haze in different regions. We suggest that online comments should not be the main reference factor for policymakers to make strategies.

Assessment of an Emergency Medicine System for Radiation Accidents in Korea: A State Survey of the Workers Involved the Medical Response to Radiation Accidents

Radiation emergency medicine systems are operated around the world to provide special care for the injured that require immediate medical attention in accidents. The objective of this survey was to evaluate people’s perception of those who design the emergency medical plan for radiation accidents and those who supervise it in Korea. A questionnaire survey was conducted on the people involved in a regulatory system for medical response in a radiation emergency. Of 150 survey recipients, 133 (88.7%) completed the survey, including 92 workers and 41 inspectors. The respondents expressed the view that the national emergency medical plan is prepared above the average level using a Likert-style scale of 1 to 5 (mean = 3.55, SD = 0.74). Interestingly, using the Mann–Whitney U test, it could be shown that inspectors evaluated the emergency medical system for radiation accidents more strictly in all of the questions than the licensee workers, especially on radiation medical emergency preparedness (p = 0.004) and the governmental regulatory policy for radiation safety (p = 0.007). For a more efficient system of radiation emergency medicine, licensee workers prioritized the workforce, whereas inspectors favored laws and regulations for safety. The survey results show different perspectives between inspectors and licensee workers, which stem from the actual properties of each occupational role in the regulatory system for radiation medical emergency. These data could be utilized for communication and interaction with relevant people to improve the medical response preparedness against radiation accidents.

Understanding radiological protection systems among diagnostic radiology facilities in Mumbai, India

This study aims to understand radiological protection systems in diagnostic radiology practices among 30 diagnostic radiology facilities in Mumbai, India. It assesses the status of radiological protection systems in the facilities, continuous professional development (CPD) of workers and their risky working behaviour and perceptions using a semi-structured questionnaire. Then, we examine the perceptions of workers when they were working in facilities without proper protection systems. We also, attempt to understand the reasons why workers engage in risky behaviour despite the availability of protective systems. In doing so, we examine the influence of CPD on their work behaviour. The study observed that about 20% of the diagnostic radiology facilities in Mumbai had lack of implementation of the regulatory requirements and establishment of radiological protection systems. Obviously, it is expected that the workers of regulated facilities would comply with regulatory requirements, and their working behaviour would be better than those of their counterparts of unregulated facilities would. However, our study observes that some workers in the regulated practices also indulge in risky working behaviour. About 30% of workers were not using personal monitoring device during work procedures. Although lead aprons were available in the facilities, about 51% of workers were not wearing it wherever required. It was observed that about 10% of workers engaged in the activities like opening the door during radiation exposure, chatting with others on mobile phone during procedure and not checking collimator light before radiation exposure etc. The factors that contributed to workers' engagement in risky work behaviour are the non-availability of protection systems, lack of exposure to CPD, low-risk perception of workers and dearth of communication between institutes and regulator.

Risk perception of radiation emergency medical staff on low-dose radiation exposure: Knowledge is a critical factor

Radiation emergency medical (REM) staff respond to many types of disasters such as radiological and nuclear accidents as well as environmental radioactivity exposure. The objective of this study was to evaluate the risk perception of REM staff on radiation exposure in various situations and to analyze the factors that affect their risk perception. A questionnaire was given to 284 REM staff affiliated with various organizations, including nuclear power generation, nuclear fuel manufacturing, large-scale irradiation, and radiation-waste disposal facilities, as well as research and development institutions. To determine the substantially influential factors for risk perception, we analyzed the questionnaire responses using ordinal logistic regression, Kruskal-Wallis, and Spearman correlation analyses. It was generally perceived by REM staff that low-dose radiation exposure in daily life and work environments does not pose any health risks. A higher level of radiation knowledge was tightly associated with a lower risk perception of REM staff on extremely low-dose (several mSv) radiation exposure, thus exhibiting an inverse correlation. In contrast to radiation researchers, the work experience of REM staff was not a contributing factor to their risk perception. In our study, REM staff with a high level of radiation knowledge did not have any health concerns in their work environments. Efforts to enhance the radiation knowledge of REM staff through proper education and training would result in analytical risk evaluation, which may also improve their willingness to help meet surge capacity needs in large-scale radiological events.

Differences in Risk Perception of Water Quality and Its Influencing Factors between Lay People and Factory Workers for Water Management in River Sosiani, Eldoret Municipality Kenya

This study evaluates the differences between risk predictors and risk perception regarding water pollution. Specifically, it focuses on the differences in risk perception between factory workers and lay people situated in textile industries near the River Sosiani in Eldoret, Kenya. The lay people are divided into two groups. The respondents living downstream are situated mostly in town centers and at the mid/lower parts of the river, and the respondents living upstream are mainly found at the upper parts of the River Sosiani. Data were obtained from 246 participants using questionnaires. Several factors influencing risk perception were selected to evaluate the degree of perceived risk amongst the groups. Descriptive statistics, mean score and correlation analyses, and multiple linear regression models were used to analyse the data. The one-way ANOVA results showed statistically different levels of risk perceptions amongst the groups. The partial and bivariate correlation analyses revealed the differences in scientific knowledge between respondents upstream and downstream. The multiple linear regression analysis showed that each group used different variables to determine risks in the region. In the factory group, 56.1% of the variance in risk perception is significantly predicted by sensorial factors, trust in the government’s capacity to manage water pollution and the impact of water pollution on human health. About 65.9% of the variance in risk perception of the downstream inhabitants is significantly predicted by sensorial factors, the possibility of industries generating water pollution, and previous experience with water pollution. For the respondents located upstream, age, sensorial factors, trust in the government and the possibility of being impacted by water pollution factors significantly predicted 37.05% of the variance in risk perception. These findings indicate that enhanced public participation in water governance amongst the residents of Eldoret town is needed, along with an understanding of the different characteristics of the respondents in the region during risk communication. This will boost awareness in the region and promote the adoption of better practices to minimise the adverse effects of water pollution faced by the region.

"Living in Contaminated Areas"-Consideration of Different Perspectives

Following large-scale nuclear power plant accidents such as those that occurred at Chernobyl (Ukraine) in 1986 and Fukushima Daiichi (Japan) in 2011, large populations are living in areas containing residual amounts of radioactivity. As a key session of the ConRad conference, experts were invited from different disciplines to provide state-of-the-art information on the topic of "living in contaminated areas." These experts provided their different perspectives on a range of topics including radiation protection principles and dose criteria, environmental measurements and dose estimation, maintaining decent living and working conditions, evidence of health risks, and social impact and risk communication. A short summary of these different perspectives is provided in this paper.

Individual factors influencing risk perceptions of hazardous chemicals in China

In view of the public concern about the possible risks posed by hazardous chemicals in China, the study on risk perceptions offer an important opportunity to assess the public's awareness of the risks of hazardous chemicals as well as to predict the public behaviors. More specifically, this paper discusses the individual factors that affect risk perceptions and protective actions with 1700 questionnaires six cities of China. It was found upon statistical analysis that only gender has a significant impact on risk perceptions of all demographic indicators; what is more, men have a higher level of risk perceptions than women. Upon further analysis, four factors are identified and analyzed which are thought to affect risk perceptions and protective actions. Furthermore, the logical relationships among various elements were analyzed with SEM model. Results: first, one psychological factor (responsibility) and two ability factors (knowledge, skills) can make positive effects on risk perceptions; second, one psychological factor (trust) exerts a negative effect on risk perceptions; third, while psychological factors do make positive effects on protective actions, no significant correlation is found between the ability factors and protective actions. Then it can be deduced that it is beneficial to build a trusting relationship between the public and the government as well as to strengthen the public's sense of responsibility.

Is internet a missed opportunity? Evaluating radon websites from a stakeholder engagement perspective

Exposure to indoor radon, a naturally occurring radioactive gas, is one of the main causes of lung cancer worldwide. Although radon tests are easily accessible in most countries, and protective actions are effective and relatively easy to apply, the levels of radon testing and subsequent home remediation remain lower than aimed for. Public engagement, particularly through internet, may contribute to addressing this value-action gap. Given their role as common interaction points between citizens and public services, this research analyzed radon websites from a stakeholder engagement perspective. The rich database assembled, of websites in eight European countries with highly radon prone areas, provides for the empirical novelty of the study. The website evaluation relied on internet communication metrics adapted for radon risk mitigation. This included availability of radon information, accessibility, stakeholder interaction, dialogue, responsiveness, content and design, and transparency and openness. Unexpectedly, results show that availability of radon information on the internet in radon prone areas is often limited and poor, as for instance only three internet pages dedicated to radon have been found. Radon websites should be improved with consistent information supported by engaging stories, provide for personalized features, support stakeholder feedback and dialogue, and include the use of social media. We conclude by consolidating the analysis into a list of recommendations for health communication practitioners, which should support radon risk mitigation, and contribute to improving public health, particularly decreasing the numbers of lung cancers. The effect of radon information available on internet pages on changing protective behaviors is suggested for future research.

Determinants and supporting factors for rebuilding nursing workforce in a post-disaster setting

BACKGROUND

The workforce shortage is one of the major issues associated with the recovery of Minamisoma City in Fukushima Prefecture, after the Great East Japan Earthquake and the subsequent accidents at the Fukushima Daiichi Nuclear Power Plants in March 2011. While the radiation risks are often discussed as a major factor of evacuation, little is known about the actual reasons why the residents chose to evacuate, and what enables them to return. This study aims to find the essential factors for rebuilding the workforce in a post-disaster setting by analysing the residents' decisions about evacuation and the return to Minamisoma. In particular, we focus on the experiences of nurses as an example of healthcare workers, who play an important role in the disaster recovery.

METHODS

The data were obtained through qualitative interviews in a semi-structured form with 25 nurses from four hospitals in Minamisoma City. The interview questions focused on the reasons of their decisions on evacuation and return. The data were analysed by a thematic approach to investigate the major factors which led them to evacuate and enabled them to return afterwards, as well as the support they needed to resettle.

RESULTS

Nearly two-thirds of the interviewees chose to evacuate from Minamisoma with their family. Family conditions seem to be the predominant factor that influenced their decisions. In particular, having small children was a strong cause for evacuation. After a certain period of time, the nurses that evacuated were then faced with another decision about returning to the area; once again, having children, as well as other life factors, such as livelihoods, job opportunities and emotional attachment to the work, influenced this decision. On the other hand, radiation risk was a minor factor. Therefore, we analyse that improved support considering their life situations would contribute to the better retention of the nurses.

CONCLUSIONS

We suggest measures such as parenting supports, ensuring job opportunities after return, and psychological support in the workplace as possible solutions for higher job retention.

Towards a strategic research agenda for social sciences and humanities in radiological protection

Reflecting a change in funding strategies for European research projects, and a commitment to the idea of responsible research and innovation in radiological protection (RP), a collective of research institutes and universities have developed a prospective Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiological protection. This is the first time such a research agenda has been proposed. This paper identifies six research lines of interest and concern: (1) Effects of social, psychological and economic aspects on RP behaviour; (2) Holistic approaches to the governance of radiological risks; (3) Responsible research and innovation in RP; (4) Stakeholder engagement and participatory processes in RP research, development, policy and practice; (5) Risk communication; and (6) RP cultures. These topics were developed through broad stakeholder consultation, in conjunction with activities carried out in the framework of various projects and initiatives (EU H2020 CONCERT programme, the EU FP7 projects OPERRA, PREPARE and EAGLE, the 2015-2018 RICOMET series of conferences, and the 2014 and 2016 International Symposia on Ethics of Environmental Health); as well as through dialogues with members of the European radiation protection research communities. The six research lines open opportunities to integrate a range of key social and ethical considerations into RP, thereby expanding research opportunities and programmes and fostering collaborative approaches to research and innovation.

Comparison of radiation risk perception and knowledge of radiation between Indonesian and Japanese dental students

The purpose of the study was to obtain basic data to identify problems in radiation education in a situation where confidence in nuclear power has fluctuated over time and fear of nuclear power has increased globally due to nuclear power plant disasters at Chernobyl and Fukushima. We conducted a questionnaire survey on understanding and risk perception of radiation and atomic power, before and after lectures, for 107 Japanese and 137 Indonesian dental students. Thirty-six phrases were extracted from two supplementary texts about radiation created by the Japanese Ministry of Education, Culture, Sports, Science and Technology, and 30 events commonly used in research on risk perception were used. The students were asked to rate their level of understanding of 36 phrases and risk perception of 30 events. Moreover, the students were asked to answer 6 general questions about radiation. For Japanese students, understanding of radiation increased and risk perception for both nuclear power and X-rays decreased after lectures (p < 0.05). Concerning nuclear power, the risk-value declined as the level of understanding increased (p < 0.01). However, for Indonesian students, who had lectures on only radiation excluding nuclear power in dental radiology, risk perception increased for X-ray after lectures (p < 0.05). This indicates that thought and custom, in the absence of knowledge, are influenced by lectures. In general, it is said that increase in knowledge will lower risk perception, but even if radiation education is imparted, risk perception may rise if the lectures are not understood properly. It was concluded that educators need to incorporate sufficient knowledge in their teachings, and correct thinking, to mitigate the risk of future radiation education giving the opposite of the intended effect.

Educating about radiation risks in high schools: towards improved public understanding of the complexity of low-dose radiation health effects

The levels of stochastic health effects following exposure to low doses of ionising radiation are not well known. A consequence of the uncertainty is that any radiation exposure is met with deep concern-both by the public and by scientists who disagree about how the partly conflicting results from low-dose studies should be interpreted. The concern is not limited to ionising radiation but is inherent to other areas of modern technologies such as biotechnology or electromagnetic fields. The everyday presence of advanced technologies confronts people with the necessity to take decisions and there is an ongoing debate regarding both the nature and magnitude of potential risks and how education efforts may empower peoples´ decision-making. In the field of radiation research there are different opinions regarding the optimal education methods, spanning from the idea that peoples' fears will be eliminated by introducing dose thresholds below which the risk is assumed to be zero, to suggestions of concentrating research efforts in an attempt to eliminate all uncertainties regarding the effects of low doses. The aim of this paper was to present our approach which is based on developing an education program at the secondary school level where students learn to understand the role of science in society. Teaching about radiation risk as a socio-scientific issue is not based on presenting facts but on showing risks in a broader perspective aiming at developing students' competency in making decisions based on informed assessment. We hope to stimulate and encourage other researchers to pursue similar approaches.

RADON RISK COMMUNICATION IN BULGARIA

The main purpose of this paper is to analyse the activities for Radon Risk Communication under the National Radon Program and to outline the main objectives in the new Radon Action Plan for developing a communication strategy. The preliminary activities were implemented under the National Radon Program. Survey via the Internet for assessment of perceptions and the level of knowledge regarding radon was conducted as a benchmark for evaluation of public awareness. The main channels which were used to inform the population were publications on websites, magazines, in TV interviews and radio (local), seminars, from which the most widely used were local seminars. On the basis of this, six objectives are proposed for a new radon action plan: to obtain wide organisational support and to determine the need of risk communication; to develop goals for risk communication with key messages to different target groups; to form and to train the communication team; to evaluate the stakeholders and the communication channels; to develop plans with different organisations for different focus groups; to evaluate the radon risk communication programme.

Level of perception of technical terms regarding the effect of radiation on the human body by residents of Japan

Background

This study aimed to examine the level of perception of the technical terms related to the effect of radiation on the human body among residents of the six prefectures of Miyagi, Fukushima, Tokyo, Aichi, Hiroshima, and Nagasaki in Japan. Miyagi and Fukushima were selected as devastated area by Great East Japan Earthquake. Tokyo and Aichi were selected as control. Hiroshima and Nagasaki were selected as the A-bombed area.

Methods

A total of 1030 respondents, 172, 173, 171, 173, 171, and 170, respectively, were surveyed. Differences in the recognition level of technical terms related to the effect of radiation on the human body among residents of the six prefectures were assessed.

Results

The highest recognition levels were reported by the respondents from Fukushima (17 items). Those from Miyagi scored the second highest recognition levels (10 out of the 17 terms); the second highest recognition levels for the remaining seven terms were marked by the respondents of Tokyo. Respondents in the Tohoku region had a better recognition for the technical terminology relevant to the effect of radiation on the human body.

Conclusions

Our findings indicate a need for continued, comprehensive risk communication pertaining to health hazards of radiation exposure in Tohoku region. Concerted efforts by central/local governments and other stakeholders are required to allay the anxiety/stress related to radiation exposure among the residents.

Are dietary reports in a case-control study on thyroid cancer biased by risk perception of Chernobyl fallout?

BACKGROUND

In retrospective case-control studies performed following nuclear tests or nuclear accidents, individual thyroid radiation dose reconstructions are based on fallout and meteorological data from the residential area, demographic characteristics, and lifestyle as well as dietary information. Collecting the latter is a controversial step, as dietary declarations may be affected by the subjects' beliefs about their risk behavior. This report analyses the potential for such bias in a case-control study performed in eastern France.

METHODS

The study included 765 cases of differentiated thyroid carcinoma matched with 831 controls. Risk perceptions and beliefs of cases and controls were compared using Chi² tests and differences in dietary reports were analyzed using a two-way ANOVA.

RESULTS

In general, atmospheric pollution and living near a nuclear power plant were the two major risks that may influence thyroid cancer occurrence cited by cases and controls. When focusing in particular on the consequences of the Chernobyl accident, cases were more likely to think that the consequences were responsible for thyroid cancer occurrence than controls. Vegetable consumption during the two months after the Chernobyl accident was correlated with the status of subjects, but not to their beliefs. Conversely, consumption of fresh dairy products was not correlated with the status or beliefs of subjects.

CONCLUSION

We found no evidence of systematic bias in dietary reports according to the status or beliefs held by subjects about the link between thyroid cancer occurrence and Chernobyl fallout. As such, these dietary reports may be used in further studies involving individual dosimetric reconstructions.

The Hiroshima/Nagasaki Survivor Studies: Discrepancies Between Results and General Perception

The explosion of atom bombs over the cities of Hiroshima and Nagasaki in August 1945 resulted in very high casualties, both immediate and delayed but also left a large number of survivors who had been exposed to radiation, at levels that could be fairly precisely ascertained. Extensive follow-up of a large cohort of survivors (120,000) and of their offspring (77,000) was initiated in 1947 and continues to this day. In essence, survivors having received 1 Gy irradiation (∼1000 mSV) have a significantly elevated rate of cancer (42% increase) but a limited decrease of longevity (∼1 year), while their offspring show no increased frequency of abnormalities and, so far, no detectable elevation of the mutation rate. Current acceptable exposure levels for the general population and for workers in the nuclear industry have largely been derived from these studies, which have been reported in more than 100 publications. Yet the general public, and indeed most scientists, are unaware of these data: it is widely believed that irradiated survivors suffered a very high cancer burden and dramatically shortened life span, and that their progeny were affected by elevated mutation rates and frequent abnormalities. In this article, I summarize the results and discuss possible reasons for this very striking discrepancy between the facts and general beliefs about this situation.

IMPORTANCE OF ENGAGING IN DIALOGUE WITH THE POPULATION AFTER A NUCLEAR ACCIDENT

Human behaviour is primarily driven by perceptions and this is particularly important in the aftermath of a nuclear accident. One of the main lessons we can draw from the Chernobyl and Fukushima accidents is that once the acute phase of the accident is over, it is important to engage in dialogue with the affected population. Science-based government measures, imposed from above, give rise to much opposition. Examples of this are the aversion of having to live in a contaminated territory, the reluctance of consumers to buy even slightly contaminated food and the opposition of most evacuees to return to their old homes. The continuing controversy within the scientific community about low-dose risks, which results in conflicting messages to the population, is also not very helpful. A way to deal with these problems is by empowering the affected population by establishing a kind of formal consultation structure funded by the authorities but operated by the local community. This will give the population the feeling of having some control over the situation. Such a participatory approach is very demanding for the authorities, but is likely to change the state of mind of the affected people from victims to survivors.

Current State and Problems of Radiation Risk Communication: Based on the Results of a 2012 Whole Village Survey

Purpose:

The entire village of Iitate was contaminated by radioactive material from the Fukushima Daiichi Nuclear Power Plant; even today, the residents remain evacuated. For the villagers, risk communication is an important element of recovery and maintaining health. This analysis focuses on the problem of radiation, presents results from a questionnaire of villagers, and examines methods for future risk communication activities.

Subjects and Methods:

In May 2012, anonymous surveys were sent to 2914 heads of households whose addresses were registered in Iitate. Their understanding of radiation and information needs were extracted from the answers.

Results and Discussion:

There were 1755 valid responses (61.4%). In relation to understanding, the most frequent answer was “There are numerous opinions and I do not know which one is true” (72.2%), followed by “I definitely want opportunities to learn more about how radiation is created” (41.6%). Residents felt that they could not determine which of the available information was reliable. The 60s+ age group responded more than younger age groups that “I do not have much information and do not know much about it,” “I do not know much about it, so I want to learn more,” and “I definitely want opportunities to learn more about how radiation is created.” Among information needs, “publications” (50.2%) and “community associations” (45.9%) received many responses; residents want study groups to be held at places and through media that give them regular opportunities to connect with each other. Residents in their 20s and 30s preferred “publications,” while those in their 40s, 50s, and 60s+ were more likely to request “community associations” and “resident meetings.” In addition, we found gender differences in both understanding and information needs. These results indicate that radiation and health risk communication should be addressed in a way that aligns with residents’ needs by age and gender.

Perception of low dose radiation risks among radiation researchers in Korea

Expert’s risk evaluation of radiation exposure strongly influences the public’s risk perception. Experts can inform laypersons of significant radiation information including health knowledge based on experimental data. However, some experts’ radiation risk perception is often based on non-conclusive scientific evidence (i.e., radiation levels below 100 millisievert), which is currently under debate. Examining perception levels among experts is important for communication with the public since these individual’s opinions have often exacerbated the public’s confusion. We conducted a survey of Korean radiation researchers to investigate their perceptions of the risks associated with radiation exposure below 100 millisievert. A linear regression analysis revealed that having ≥ 11 years’ research experience was a critical factor associated with radiation risk perception, which was inversely correlated with each other. Increased opportunities to understand radiation effects at < 100 millisievert could alter the public’s risk perception of radiation exposure. In addition, radiation researchers conceived that more scientific evidence reducing the uncertainty for radiation effects < 100 millisievert is necessary for successful public communication. We concluded that sustained education addressing scientific findings is a critical attribute that will affect the risk perception of radiation exposure.

Risk Communication Strategies: Lessons Learned from Previous Disasters with a Focus on the Fukushima Radiation Accident

PURPOSE OF THE REVIEW

It has been difficult to both mitigate the health consequences and effectively provide health risk information to the public affected by the Fukushima radiological disaster. Often, there are contrasting public health ethics within these activities which complicate risk communication. Although no risk communication strategy is perfect in such disasters, the ethical principles of risk communication provide good practical guidance.

FINDINGS

These discussions will be made in the context of similar lessons learned after radiation exposures in Goiania, Brazil, in 1987; the Chernobyl nuclear power plant accident, Ukraine, in 1986; and the attack at the World Trade Center, New York, USA, in 2001. Neither of the two strategies is perfect nor fatally flawed. Yet, this discussion and lessons from prior events should assist decision makers with navigating difficult risk communication strategies in similar environmental health disasters.

Risk communication in the case of the Fukushima accident: Impact of communication and lessons to be learned

Risk communication about the Fukushima Daiichi nuclear power plant accident in 2011 was often not transparent, timely, clear, nor factually correct. However, lessons related to risk communication have been identified and some of them are already addressed in national and international communication programmes and strategies. The Fukushima accident may be seen as a practice scenario for risk communication with important lessons to be learned. As a result of risk communication failures during the accident, the world is now better prepared for communication related to nuclear emergencies than it was 5 years ago The present study discusses the impact of communication, as applied during the Fukushima accident, and the main lessons learned. It then identifies pathways for transparent, timely, clear and factually correct communication to be developed, practiced and applied in nuclear emergency communication before, during, and after nuclear accidents. Integr Environ Assess Manag 2016;12:683-686. © 2016 SETAC.

Improved communication, understanding of risk perception and ethics related to ionising radiation

In Europe today, institutions, media and the general public exchange information about ionizing radiation and associated risks. However, communication about ionising radiation with the general public has to be further improved, as has been previously highlighted by international responses to the 2011 accident in Japan. This article reports the main activities and findings in this field from the following three FP7 projects: EAGLE, PREPARE and OPERRA and discussed by a broad spectrum of stakeholders at the conference RICOMET 2015. These projects, among other aims, also investigate how communication about ionising radiation in different fields could be improved and harmonised, how radiological risks are perceived, how to encourage ethical considerations in all fields of nuclear applications and what kind of transdisciplinary research is needed. The projects relate to several domains; the first relates to education, training and communication, the second to nuclear emergency preparedness and response, and the third to research and development in the radiation protection field. Incorporation of stakeholder engagement activities such as the RICOMET conference broadens social and ethical aspects and takes them into account during coordination activities as well as during core scientific and nuclear research and development performed in the projects. These activities offered opportunities for moving closer to a citizen-centred ideal of risk communication in particular and nuclear research and development in general.

How did media present the radiation risks after the Fukushima accident: a content analysis of newspapers in Europe

Any activity that might result in exposure of a population to contaminants requires communication of the associated risks. This communication is complicated by several factors including public perceptions, distrust, uncertainties in risk assessment and news media. These factors are especially prominent in communication of risks from ionizing radiation. A number of guidelines about the communication of risks related to radiation exposures have been made by national and international authorities and other stakeholders. The present paper investigates whether those guidelines were followed and evaluates how the radiation risk related information was presented in European newspapers and Russia in the aftermath of the Fukushima accident. It examines the use of measurement units and risk comparisons, the quality of the statements on radiation risk related issues and the use of visual materials in 1340 newspaper articles from Belgium, Italy, Norway, Russia, Slovenia and Spain. Our results indicated several misinterpretations and misrepresentations of radiological risks in the newspaper articles. We also show an inconsistency in the information that was reported with advice provided to risk communicators (e.g. authorities and experts) in the guidelines. The results suggest that risk communicators should improve their communication practices regarding radiological risks, in order to improve emergency management response.

Like a bridge over troubled water--Opening pathways for integrating social sciences and humanities into nuclear research

Research on nuclear technologies has been largely driven by a detachment of the 'technical content' from the 'social context'. However, social studies of science and technology--also for the nuclear domain--emphasize that 'the social' and 'the technical' dimensions of technology development are inter-related and co-produced. In an effort to create links between nuclear research and innovation and society in mutually beneficial ways, the Belgian Nuclear Research Centre started fifteen years ago a 'Programme of Integration of Social Aspects into nuclear research' (PISA). In line with broader science-policy agendas (responsible research and innovation and technology assessment), this paper argues that the importance of such programmes is threefold. First, their multi-disciplinary basis and participatory character contribute to a better understanding of the interactions between science, technology and society, in general, and the complexity of nuclear technology assessment in particular. Second, their functioning as (self -)critical policy supportive research with outreach to society is an essential prerequisite for policies aiming at generating societal trust in the context of controversial issues related to nuclear technologies and exposure to ionising radiation. Third, such programmes create an enriching dynamic in the organisation itself, stimulating collective learning and transdisciplinarity. The paper illustrates with concrete examples these claims and concludes by discussing some key challenges that researchers face while engaging in work of this kind.

The Radiation Problem and Its Solution from a Health Communication Perspective

This paper observes both foreign and national discussions on preexisting radiation communication and attempts to find out what it takes to ensure that discussion concerning radiation leads to participation of and trust-building with members of society while considering cultural aspects. When analyzing Korean studies on health risk communication concerning radiation which utilize the frame of foreign literature, Korean studies can be categorized into one of the following themes: different risk perceptions between experts and the general public, discussion on the effects of the framing of radiation messages and media coverage, and research discussing the social implications of the dangers of radiation and the need for effective communication. These study results can be better explained when integrated with Korean social cultural dimensions. The "boiling pot effect" towards risk issues, egalitarian perceptions, escalation of ideological opposition and biased reasoning, and so on are especially major influences. Communication addressing radiological risks must foremost be open and able to mitigate distrust, must give the general public a chance to judge for themselves to prevent stigmatization, and, through the use of media and public education, must make efforts to prevent the proliferation of needless anxiety. Using literature research, this paper discusses possible ways to improve the effect of future health risk communication concerning radiation.

The disproportionate risk burden of CT scanning on females and younger adults in Australia: a retrospective cohort study

OBJECTIVES

To explore the interaction of computed tomography (CT) use, dose and radiation risk of Australian Medicare-funded CT scanning and the impact on cancer incidence and mortality.

METHODS

This retrospective cohort study used records of Medicare subsidised CT scans in Australia (2006/07 to 2011/12) and Australian CT dosimetry. The annual number, rate and adjusted likelihood of CT were determined for gender, age and examination type. Incident cancer and cancer-related mortality attributable to CT in Australia were estimated using lifetime attributable risk coefficients, dosimetry and scan numbers.

RESULTS

The number of CT scans increased by 36% from 2006/07 to 2011/12. Only patients aged 0-4 years did not present an increase in CT scanning rates. Females were 11% more likely to be scanned than males. Head, abdomen/pelvis and spine CT scans were the most likely areas scanned. Females were attributed 61% of both incident cancers and cancer-related mortality from 55% of scans performed. Patients aged 15-44 years were attributed 37% of incident cancers and 30% of cancer-related mortality from 26% of CT scans.

CONCLUSIONS

CT in Australia is increasing, including in groups at higher risk from ionising radiation. This presents a complex set of risk/benefit considerations for clinicians and policy makers.

An Exploratory Analysis of Public Awareness and Perception of Ionizing Radiation and Guide to Public Health Practice in Vermont

Exposure to ionizing radiation has potential for acute and chronic health effects. Within the general public of the United States, there may be a discrepancy between perceived and actual health risks. In conjunction with the Vermont Department of Health, a survey designed to assess public perception and knowledge of ionizing radiation was administered at 6 Vermont locations (n = 169). Descriptive and inferential statistical analyses were conducted. Eighty percent of respondents underestimated the contribution of medical imaging tests to total ionizing radiation exposure. Although only thirty-nine percent of participants were confident in their healthcare professional's knowledge of ionizing radiation, most would prefer to receive information from their healthcare professional. Only one-third of individuals who received a medical imaging test in the past year were educated by their healthcare professional about the risks of these tests. Those who tested their home for radon were twice as likely to choose radon as the greatest ionizing radiation risk to self. Although respondents had an above-average education level, there were many misperceptions of actual risks of exposure to ionizing radiation, particularly of medical imaging tests. Educating healthcare professionals would therefore have a profound and positive impact on public understanding of ionizing radiation.

Units related to radiation exposure and radioactivity in mass media: the Fukushima case study in Europe and Russia

Using an analysis of the way European newspapers covered the Fukushima nuclear accident, this article explores how the mass media transmit information about radiation risks from experts to the general public. The study applied a media content analysis method on a total of 1340 articles from 12 leading newspapers in 6 countries: Belgium (N = 260), Italy (N = 270), Norway (N = 133), Russia (N = 172), Slovenia (N = 190) and Spain (N = 315). All articles analysed were selected as being directly or indirectly related to the Fukushima accident by containing the word 'nuclear' and/or 'Fukushima' and were published between the 11th March and the 11th May 2011. The data presented here focus specifically on a cross-cultural comparison of the way the media use quantitative units. Results suggest that although experts are accustomed to communicating about radiological risks in technical language, often using quantitative units to describe the risks, mass media do not tend to use these units in their reporting. Although the study found a large variation in the measurement units used in different countries, it appeared that journalists in all the analysed countries preferred to describe radioactivity by comparing different radiation exposures, rather than reporting the actual measured units. The paper concludes with some practical guidelines for sound public communication about radiation risks.

Cohort study of Western Australia computed tomography utilisation patterns and their policy implications

Background

Computed tomography (CT) scanning is a relatively high radiation dose diagnostic imaging modality with increasing concerns about radiation exposure burden at the population level in scientific literature. This study examined the epidemiology of adult CT utilisation in Western Australia (WA) in both the public hospital and private practice settings, and the policy implications.

Methods

Retrospective cohort design using aggregate adult CT data from WA public hospitals and Medical Benefits Schedule (MBS) (mid-2006 to mid-2012). CT scanning trends by sex, age, provider setting and anatomical areas were explored using crude CT scanning rates, age-standardised CT scanning rates and Poisson regression modelling.

Results

From mid-2006 to mid-2012 the WA adult CT scanning rate was 129 scans per 1,000 person-years (PY). Females were consistently scanned at a higher rate than males. Patients over 65 years presented the highest scanning rates (over 300 scans per 1,000 PY). Private practice accounted for 73% of adult CT scans, comprising the majority in every anatomical area. In the private setting females predominately held higher age-standardised CT scanning rates than males. This trend reversed in the public hospital setting. Patients over 85 years in the public hospital setting were the most likely age group CT scanned in nine of ten anatomical areas. Patients in the private practice setting aged 85+ years were relatively less prominent across every anatomical area, and the least likely age group scanned in facial bones and multiple areas CT scans.

Conclusion

In comparison to the public hospital setting, the MBS subsidised private sector tended to service females and relatively younger patients with a more diverse range of anatomical areas, constituting the majority of CT scans performed in WA. Patient risk and subsequent burden is greater for females, lower ages and some anatomical areas. In the context of a national health system, Australia has various avenues to monitor radiation exposure levels, improve physician training and modify funding mechanisms to ensure individual and population medical radiation exposure is as low as reasonably achievable.

Non-cancer morbidity among Estonian Chernobyl cleanup workers: a register-based cohort study

OBJECTIVE

To examine non-cancer morbidity in the Estonian Chernobyl cleanup workers cohort compared with the population sample with special attention to radiation-related diseases and mental health disorders.

DESIGN

Register-based cohort study.

SETTING

Estonia.

PARTICIPANTS

An exposed cohort of 3680 men (cleanup workers) and an unexposed cohort of 7631 men (population sample) were followed from 2004 to 2012 through the Population Registry and Health Insurance Fund database.

METHODS

Morbidity in the exposed cohort compared with the unexposed controls was estimated in terms of rate ratio (RR) with 95% CIs using Poisson regression models.

RESULTS

Elevated morbidity in the exposed cohort was found for diseases of the nervous system, digestive system, musculoskeletal system, ischaemic heart disease and for external causes. The most salient excess risk was observed for thyroid diseases (RR=1.69; 95% CI 1.38 to 2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to 2.09) and selected alcohol-related diagnoses (RR=1.25; 95% CI 1.12 to 1.39). No increase in morbidity for stress reactions, depression, headaches or sleep disorders was detected.

CONCLUSIONS

No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases. Increased alcohol-induced morbidity may reflect alcohol abuse, and could underlie some of the higher morbidity rates. Mental disorders in the exposed cohort were probably under-reported. The future challenge will be to study mental and physical comorbidities in the Chernobyl cleanup workers cohort.