The Fukushima Daiichi Nuclear Power Plant accident and school bullying of affected children and adolescents: the need for continuous radiation education

Associations of Well-Being With Psychological and Socioeconomic Status After the Fukushima Nuclear Disaster

OBJECTIVE

This study exploratively analyzed the associations of well-being with psychological characteristics, socioeconomic status (SES), and the number of relocations after the Fukushima nuclear disaster.

METHODS

Using a cross-sectional study design, an online questionnaire survey was administered to 416 residents of Fukushima and Tokyo each aged 20-59 years (832 in total) between August 25 and 26, 2018, which was 7 and a half years after the disaster. Categorical factor analysis and multiple regression analysis were performed to investigate associations of 5 well-being scales (positive emotion, negative-free emotion, life satisfaction and general happiness, positive characteristics, and positive functioning) with psychological characteristics, SES, and the number of relocations.

RESULTS

Four of the well-being scales, except for negative-free emotion, were strongly associated with each other and showed similarities in the strength of their associations with psychological characteristics and SES. Among the items surveyed, psychological distress, mindfulness, and marital status were strongly associated with well-being among Fukushima residents. Contrarily, radiation risk perception or the number of relocations were not significantly associated with well-being.

CONCLUSIONS

Focusing on psychological distress is expected to have a significant impact on improving well-being after the disaster. In addition, assistance in avoiding unintended family separation may be helpful.

Could school climate moderate the relationship between school bullying patterns and academic burnout in Chinese adolescents: A large cross-sectional study

OBJECTIVES

Students who are bullied not only affect academic performance, but also produce a range of psychological problems. The purpose of the present study was to investigate the association between school bullying and academic burnout among Chinese students, assuming school climate to play a moderating role in the aforementioned relationship. This study provides corresponding intervention strategies and reference data for the prevention and treatment of bullying in schools.

METHODS

The data was obtained by a cross-sectional survey of 20,730 Chinese students from 23rd May to 23rd June 2022. Multiple linear regressions and Latent Profile Analysis (LPA) were used to examine the hypotheses.

RESULTS

This study revealed that all dimensions of school bullying and school bullying level (β = -0.09; 95 % CI, -4.946, -3.833) were associated with academic burnout. Verbal bullying (β = 0.15; 95 % CI, 1.689, 1.972) had the strongest association with academic burnout, followed by social (β = 0.14; 95 % CI, 1.496, 1.779) and physical bullying (β = 0.13; 95 % CI, 1.451, 1.734), while cyber bullying (β = 0.08; 95 % CI, 0.847, 1.127) had the weakest association with academic burnout. In addition, school climate can moderate the association between school bullying and academic burnout. Students who experienced school bullying and in bad school climate showed elevated levels of academic.

LIMITATIONS

This study used cross-sectional data, preventing us from drawing conclusions about causation.

CONCLUSIONS

The findings suggested that creating a harmonious school climate and reducing school bullying may effectively alleviate academic burnout caused by school climate and school bullying.

Negative Aspects of Self-Imposed Evacuation among Mothers of Small Children Following Japan's Fukushima Daiichi Nuclear Power Station Accident

This study clarified the negative aspects of the self-imposed evacuation of mothers of small children seeking to avoid radiation exposure from the Fukushima Daiichi Nuclear Power Station accident on 11 March 2011. We conducted semi-structured interviews with 27 mothers, employing open-ended inquiries based on an interview guide. Our analysis of their responses using the Ka-Wakita-Jiro (KJ) method categorized the results into eight distinct groups comprising 142 labels. These categories included continued anxiety about the health effects of radiation, differences in risk perception, changes in spousal relationships, the inability to make friends and find support, living as a single parent, financial concerns, the unfamiliar feel of the area to which they evacuated, and uncertainty about the future. Despite their hardships, the mothers continued their self-imposed evacuation to avoid radioactivity. Our findings underscore that their anxieties about radiation exposure persisted even after self-imposed evacuation, leading to deteriorated relationships with key individuals who would have been involved in raising their children. These results offer valuable insights into the challenges experienced by the indirect victims of the nuclear accident, such as the mothers of small children.

Nuclear Radiation Knowledge and Anxiety Levels among Residents around a Nuclear Power Plant in Liaoning Province, China

Awareness of radiation-related knowledge (RRK) and nuclear energy-related knowledge (NERK) among residents around a nuclear power plant (NPP), as well as their concerns about a NPP, were investigated. A face-to-face survey was conducted among 1,775 residents within 30 km around the NPP in Liaoning Province, China. A single-item Likert scale, Spearman's/Pearson's correlation coefficients, Student's t-test, ANOVA, and multiple-linear regression analysis were employed. Awareness of RRK and NERK among residents around the NPP was 27.7% and 36.6%, respectively. The anxiety level of respondents was negatively corelated with the distance from their residence to the NPP and age. Also, 55.6% of respondents thought that the publicity about nuclear energy/NPPs was insufficient, and 82.7% of respondents wanted to know relevant information about NPPs. Awareness of RRK and NERK among residents around the NPP was relatively low, which was related to education, occupation, and income. The anxiety level among residents was related to distance and age. The public was eager to know about RRK and NERK. These findings indicate that the publicity and education of RRK and NERK among residents around the NPP should be strengthened.

What's better for our health? Conducting protective actions during a nuclear emergency or accepting a certain radiation dose?

The threat caused by ionising radiation has resulted in the establishment of strict radiation protection guidelines. This is especially true for severe nuclear power plant (NPP) accident scenarios, which may involve the release of significant amounts of ionising radiation. However, we believe that the fine balance between the benefit of a certain protective action (e.g. evacuation) and its risks is not always accounted for properly. Deaths and mental health problems have been associated with protective actions (e.g. evacuation) implemented in the response to the Fukushima Daiichi (NPP) accident in 2011. The protective actions were implemented consistent with international recommendations, to reduce radiation-induced health effects, even though the off-site effective doses were too low to indicate that there would be any discernible radiation-induced health effects. In this paper, we will provide a first step for the development of tools to evaluate the risk of protective actions versus the radiation-induced health risk. Over 50 papers were selected as useful from more than 600 reviewed papers to characterise the health impact of protective actions taken during different emergencies (including, technical and natural emergencies). An analysis was performed comparing the radiation-induced health effects averted by protective actions with the health effects associated with the protective actions. We concentrated our analysis on deaths and mental health problems associated with protective actions compared with the inferred radiation-induced deaths averted by the protective actions. Our analysis is stated in terms of absolute risk (cases per 1000) of health effects to allow for a direct comparison. It indicates that taking protective actions consistent with dose criteria typically used in many countries could result in more excess deaths than the inferred radiation-induced deaths prevented, as well as resulting in mental health problems. We identified that residents of facilities for long stays and the elderly are particularly vulnerable and a significant number of the deaths among the general public are associated with a lack of emergency preparedness provisions.

Contribution of radiation education to anxiety reduction among Fukushima Daiichi Nuclear Power Plant workers: a cross sectional study using a text mining method

The purpose of this study is to investigate the frequency of education, knowledge of radiation and workplace anxiety of Fukushima Daiichi Nuclear Power Plant (FDNPP) workers and to analyze what type of words are used for anxiety with a text mining method. An original questionnaire survey was given to FDNPP workers, and a text mining method was used to extract information from free-entry fields. The questionnaires were collected from 1135 workers (response rate: 70.8%). It was found that when workers receive education on radiation, the increased knowledge helps to reduce their anxiety. Among the 1135 workers, 92 of 127 completed the free-entry field with valid entries. Seventy-one words were extracted by the text mining method. The words used differed depending on the degree of anxiety. The text mining method revealed information about the presence or absence of radiation anxiety and the subjects' working environment and background.

Trajectory and factors of radiation risk perception of students aged 10-12 years at the time of the Fukushima Daiichi Nuclear Power Station accident

Various studies have investigated radiation risk perceptions after the accident at the Fukushima Daiichi Nuclear Power Station. However, student surveys are limited. This study aimed to investigate the perception of radiation risk among students aged 18-20 years who were in the 5th and 6th grades of elementary school at the time of the accident. We surveyed students in the Fukushima Prefecture and outside the prefecture. Out of all the data, 59% of the respondents were living in the Fukushima Prefecture at the time of the accident and 41% outside the prefecture. Trajectory analysis showed that changes in anxiety levels over time since 2011 could be divided into five classes: (a) the anxiety was the highest, and this tendency persisted. (b) High at the beginning, but decreased more quickly than class 1. (c) High at the beginning, but it diminished quickly. (d) Not high, but did not diminish easily in later years. (e) Low from the beginning, and persisted. Multinomial logistic analysis showed that among students living outside the prefecture at the time of the accident, a significantly higher proportion was in groups 4 and 5 than in group 2. A significant proportion of boys were present in groups 3, 4 and 5. A significant proportion of students whose current educational institutions were inside the prefecture were present in group 3. The level of anxiety was associated with the academic course, but not with subjective knowledge of radiation. In contrast, in the qualitative analysis of the free text, 31% considered 'knowledge about radiation' as the reason for the reduction in anxiety level. At the time of the investigation, most young people were not anxious about radiation. However, approximately 20% still had strong anxiety. We established that continuous risk communication is necessary. Furthermore, that stabilization and support related to life in general is important.

Overall health information exposure, its barriers and impacts on attitude toward healthcare among cancer patients. The long-term aftermath of the 2011 triple disaster in Fukushima, Japan: A single institution cross-sectional study

Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients-5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.

Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 1: psychological consequences

To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey-large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.

Analysis of direction of association between radiation risk perception and relocation using a random-intercept and cross lagged panel model: The Fukushima Health Management Survey

In the aftermath of a nuclear disaster, a person's radiation risk perception can harm their sociopsychological health. Although there are reports of an association between radiation risk perception and relocation, the direction of this association has not been clarified yet. In this study, we used a random-intercept and cross lagged panel model (RI-CLPM) to investigate the association and its direction between radiation risk perception and the prefectural-level relocation (i.e., inside/outside of Fukushima Prefecture). We did this by using five waves of longitudinal surveys between 2011 fiscal year and 2015 fiscal year among the people affected by the Fukushima disaster in 2011. We included 90,567 participants aged ≥15 years during the time of the disaster who responded to the questionnaire at least once. RI-CLPM was applied to examine the reciprocal relationship between radiation risk perception and locations. We used two radiation risk perception indicators (i.e., genetic effect and delayed effect) and two handling methods on missing data (i.e., listwise deletion and full information maximum likelihood estimation) as sensitive analyses. The effects of radiation risk perception on relocation were found to be negligibly small. Living inside Fukushima Prefecture reduced radiation risk perception irrespective of the difference of indicators or methods, highlighting that radiation risk perception did not dominantly govern whether people were living inside Fukushima Prefecture, but that the locations also affected radiation risk perception. This was the first study to reveal the direction of the association between radiation risk perception and relocation in the aftermath of nuclear disasters.

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Directionality between radiation risk perception and relocation is ambiguous.

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We analyzed the bidirectionality after the Fukushima disaster in Japan.

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The effects of radiation risk perception on relocation are negligibly small.

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Living inside Fukushima Prefecture reduces radiation risk perception.

Usefulness of the whole-body counter for infants and small children (BABYSCAN) as a risk communication tool after the Fukushima Daiichi nuclear power plant incident

Responding to the radiation-related concerns of parents/guardians with infants/small children is an important public health issue for regional recovery after radioactive contamination. This study summarizes the results of a systematic internal contamination screening of infants/small children, aged 0-6 years, using BABYSCAN and individual counselling sessions with physicians about radiation concerns from 2014 to 2018 in Minamisoma City. Of 3,114 participants, no one was found to have internal contamination with radioactive caesium with a detection limit of 50 Bq/body. The questionnaire survey showed a decreasing trend of concerns about food contamination and playing outside as possible causes of internal contamination over time. Because people's concerns were diverse in counselling sessions, individual responses are required. This study showed that examinations using BABYSCAN provide an opportunity for direct dialogue between the parents/guardians of infants/small children and experts. This can be considered a model case for risk communication conducted by the local government after a radioactive contamination incident.

Relationship Between Use of Media and Radiation Anxiety Among the Residents of Fukushima 5.5 Years After the Nuclear Power Plant Accident

OBJECTIVE

We aimed to investigate the relationships between use of media to obtain information on radiation and radiation anxiety among community residents in Fukushima, 5.5 years after the nuclear power plant accident.

METHODS

A questionnaire survey was administered between August and October 2016 to 2000 randomly sampled residents in Fukushima prefecture. Radiation anxiety toward health and regarding discrimination and prejudice were assessed with 4- and 3-item scales, respectively. Participants nominated their most-used media for acquiring information on radiation by choosing up to 3 sources from 12 information sources listed (eg, local newspaper, TV news, websites, social networking sites [SNS], local government newsletter, word of mouth). We investigated associations of most-used media types and radiation anxiety, controlling for sociodemographic characteristics and anxiety regarding radiation's health effects immediately after the accident, using multivariate linear regression analyses.

RESULTS

Valid responses were obtained from 790 (39.5%) residents. Acquiring information about radiation by word of mouth was related to higher radiation anxiety toward health. Regarding radiation anxiety concerning discrimination and prejudice, SNS use was related to higher anxiety, whereas acquiring information through Nippon Hoso Kyokai (NHK) TV news was related to lower anxiety.

CONCLUSIONS

Interpersonal interactions rather than gaining information from media - characterized by unidirectional information exchange - may increase radiation anxiety.

Parental Recognition of Bullying and Associated Factors Among Children After the Fukushima Nuclear Disaster: A 3-Year Follow-Up Study From the Fukushima Health Management Survey

This study examined parental recognition of bullying victimization and associated factors among evacuated children after the 2011 Fukushima Daiichi Nuclear Power Plant accident, using a 3-year follow-up data (wave 1: January 2012; wave 2: January 2013; wave 3: February 2014). The sample included the caregivers of 2,616 children in the first-sixth grades of elementary school, who lived in one of the 13 municipalities that were the target areas of the Mental Health and Lifestyle Survey, conducted as part of the Fukushima Mental Health Management Survey. Across 3 years, around 80% of caregivers responded "not true," 15% responded "somewhat true," and 5% responded "certainly true" in response to a question about bullying victimization of their children. Being male was significantly associated with the parental recognition of bullying victimization at wave 1 and wave 3. At wave 1, experiencing the nuclear plant explosion was significantly associated with parental recognition of bullying victimization. Moreover, age at wave 3 was negatively associated with parental recognition of bullying victimization. Our findings will be helpful for establishing community- and school-based mental health care for children, parents, and teachers.

Risk perceptions regarding radiation exposure among Japanese schoolteachers living around the Sendai Nuclear Power Plant after the Fukushima accident

In response to the Fukushima Daiichi nuclear power plant disaster, the Nuclear Regulation Authority of Japan issued the new “Nuclear Emergency Response Guideline.” However, there is a perception that scientific information about the health impact of radiation exposure has not been adequately shared among the local government staffs, including schoolteachers. We contacted schoolteachers at all 120 schools within the Urgent Protective Action Planning Zone of the Sendai Nuclear Power Plant, Kagoshima prefecture, in 2017. We invited them to take part in a written survey to clarify their concerns and risk perceptions regarding the effects of radiation exposure on health. Five hundred and fifty schoolteachers’ replies were included in the analysis. The results revealed that 355 schoolteachers had concerns about the health effects of radiation exposure due to working within the Urgent Protective Action Planning Zone. A logistic regression analysis revealed that sex (OR = 2.26, 95% CI: 1.49–3.45, p < 0.001), age (OR = 3.39, 95% CI: 2.10–5.47, p < 0.001), reluctance to undergo a radiological examination at a hospital (OR = 1.91, 95% CI: 1.23–2.88, p = 0.004), place of work (OR = 2.18, 95% CI: 1.46–3.27, p < 0.001), and anxiety about having to address questions about radiation from students (OR = 4.66, 95% CI: 2.83–7.67, p < 0.001) were independently associated with schoolteachers’ concerns about the health effects of radiation exposure due to working in the area around the nuclear power plant. Therefore, it is important to respond to these concerns in order to establish a meaningful education program for school children on radiation and its health effects.

Reduction of radiation-related anxiety promoted wellbeing after the 2011 disaster: 'Fukushima Health Management Survey'

After the Fukushima disaster in 2011, affected residents experienced increased radiation-related anxiety and reduced subjective wellbeing. We investigated whether reduction of radiation-related anxiety promoted wellbeing among evacuees in Fukushima and assessed the role of mental health distress as a mediator. We used data from questionnaire surveys of evacuees in the 2011 and 2012 fiscal years (N = 34 312). We used radiation risk perception as an indicator of radiation-related anxiety and the frequency of laughter as an indicator of wellbeing. We measured changes in radiation risk perception from 2011 and 2012, and the frequencies of laughter and mental health distress (Kessler 6-item scale) in 2012, and investigated associations between radiation risk perception and frequency of laughter with and without covariates of mental health distress. Perceived genetic risk in 2011 had a significant inverse association with the frequency of laughter. Lowering of radiation risk perception was significantly associated with the frequency of laughter in the absence of covariates of mental health distress, but not in their presence. Lowering of radiation risk perception was also significantly associated with low mental health distress. Reduction of radiation-related anxiety promoted wellbeing via alleviation of mental health distress.