Longitudinal effects of disaster-related experiences on concern and its impact on depressive symptoms among Fukushima nuclear power plant workers: The Fukushima NEWS project study

BACKGROUND

The 2011 Fukushima nuclear disaster affected the mental health of nuclear plant workers.

OBJECTIVE

The study aimed to explore the longitudinal relationship between workers' disaster-related experiences and concern, and the impact of concern on depressive symptoms over three years.

METHOD

A total of 1347 workers from Fukushima Daiichi and Daini nuclear power plants participated. Three types of concern (work, life, or health-related) and depressive symptoms were assessed from 2012 to 2014 using self-reporting concern questionnaires and the Center for Epidemiologic Studies Depression Scale (CES-D). The relationships between disaster-related experiences and concern and depressive symptoms (CES-D score ≥16) were analyzed using mixed-effects models, as were the associations between type of concern and depressive symptoms. Stratified analyses for all associations were performed according to work location in 2011.

RESULTS

Each type of concern was associated with different disaster-related experiences. Depressive symptoms were associated with job-related concern (β = 0.015, p < 0.011), life-related concern (β = 0.018, p = 0.002), and health-related concern (β = 0.018, p < 0.001), and these associations remained over two years. The associations were more evident in Daiichi plant workers, while Daini plant workers only exhibited significant associations with health-related concern.

CONCLUSIONS

Different disaster-related experiences affected plant workers' concern. The risk of depressive symptoms was significant among workers with any of the three types of concern, particularly for Daiichi plant workers. It is important to understand plant workers' concern and their experiences during the disaster to guide them towards mental health support and clinical interventions.

Longitudinal effects of disaster-related experiences on problem drinking among Fukushima nuclear plant workers

BACKGROUND

In the Fukushima nuclear power plant disaster of March 11, 2011, plant workers were exposed to various traumatic events and reported a subsequent increase in alcohol use. To determine the relationship between disaster-related experiences and problem drinking, we conducted a three-year follow-up study.

METHODS

Problem drinking among the nuclear plant workers was assessed annually from 2012-2014 using a modified version of the CAGE questionnaire that asked about current, rather than lifetime, drinking. A total of 1378 workers provided at least one CAGE response, and 2875 observations were used in the present analysis. Mixed-effects logistic regression models were used to analyze the relationship between disaster-related experiences and problem drinking over time.

RESULTS

The prevalence of problem drinking (CAGE score ≥2) increased over time. At the baseline assessment in 2012, a year after the disaster, plant workers who had experienced life-threatening danger and discrimination had significantly more symptoms of problem drinking, which persisted over the following 2 years. Although at baseline, plant workers who had experienced major property loss or the death of a colleague showed no significant differences in problem drinking symptoms from those without such experiences, over the next 2 years their problem drinking increased significantly.

CONCLUSIONS

Individuals who experienced life-threatening danger and discrimination during the Fukushima nuclear power plant disaster reported an increase in problem drinking. Although major property loss and the death of a colleague did not elevate problem drinking prevalence at baseline, it did so over the next 2 years. Different adverse effects of a natural disaster appear to differentially increase drinking behavior over time.

Continuous positive airway pressure alleviates insomnia in workers sleeping near other workers with sleep apnea after the Fukushima Nuclear Power Plant disaster

OBJECTIVES

To examine the efficacy of continuous positive airway pressure for improving the sleep of all individuals residing in a temporary shelter.

METHODS

Workers at a nuclear power plant using a gymnasium as temporary shelter were divided into two groups: 15 workers with obstructive sleep apnea received continuous positive airway pressure treatment, and 107 workers without obstructive sleep apnea received no treatment. We assessed subjective sleepiness among the workers with obstructive sleep apnea before and after continuous positive airway pressure treatment, and evaluated insomnia in all workers before and after workers with obstructive sleep apnea were given continuous positive airway pressure treatment.

RESULTS

Workers who received continuous positive airway pressure treatment reported significantly improved subjective sleepiness, but did not experience a significant change in insomnia symptoms. However, workers without obstructive sleep apnea reported significant improvements in their insomnia symptoms following the treatment of workers with obstructive sleep apnea.

CONCLUSIONS

Using continuous positive airway pressure to treat workers with obstructive sleep apnea residing in temporary shelters may help prevent adverse health consequences from insomnia among other individuals sleeping nearby.

Night shifts, insomnia, anxiety, and depression among Chinese nurses during the COVID-19 pandemic remission period: A network approach

Background

The outbreak of the COVID-19 pandemic imposed a heavy workload on nurses with more frequent night shifts, which led to higher levels of insomnia, depression, and anxiety among nurses. The study aimed to describe the symptom-symptom interaction of depression, anxiety, and insomnia among nurses and to evaluate the impact of night shifts on mental distress via a network model.

Methods

We recruited 4,188 nurses from six hospitals in December 2020. We used the Insomnia Severity Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Scale-7 to assess insomnia, depression, and anxiety, respectively. We used the gaussian graphical model to estimate the network. Index expected influence and bridge expected influence was adapted to identify the central and bridge symptoms within the network. We assessed the impact of night shifts on mental distress and compared the network structure based on COVID-19 frontline experience.

Results

The prevalence of depression, anxiety, and insomnia was 59, 46, and 55%, respectively. Nurses with night shifts were at a higher risk for the three mental disorders. "Sleep maintenance" was the central symptom. "Fatigue," "Motor," "Restlessness," and "Feeling afraid" were bridge symptoms. Night shifts were strongly associated with sleep onset trouble. COVID-19 frontline experience did not affect the network structure.

Conclusion

"Sleep maintenance," "Fatigue," "Motor," and "Restlessness" were important in maintaining the symptom network of anxiety, depression, and insomnia in nurses. Further interventions should prioritize these symptoms.

Type and duration of emergency recovery work and its longitudinal effects on mental health symptoms among Fukushima Daiichi Nuclear Power Plant workers: The Fukushima NEWS project study

BACKGROUND

The Fukushima Nuclear Energy Workers' Support study showed the Fukushima nuclear disaster caused psychological distress in the workers, with higher rates of post-traumatic stress responses (PTSR). To understand how the type and duration of emergency recovery work performed immediately following this disaster impacted workers' psychological status, a longitudinal analysis was conducted with 4-year follow-up data since 2011.

METHOD

Fukushima Daiichi nuclear power plant workers were assessed annually with general psychological distress (GPD) and PTSR questionnaires between 2011 and 2014. Combined, 697 Fukushima Daiichi plant workers provided baseline GPD and PTSR in 2011 and their record of working days for approximately one month immediately following the disaster. The relationship between type of emergency recovery work, working days immediately following the disaster, and psychological distress over four years was analyzed using a mixed effects logistic regression model.

RESULTS

At baseline, GPD and PTSR scores were significantly higher in nuclear power plant workers who worked 3-5 days immediately following the disaster compared to those who worked only 0-2, particularly in the field engineer subgroup. The effect of working days on GPD remained for over a year, and the impact on PTSR remained significant throughout the four years of observation after the disaster.

CONCLUSIONS

The Fukushima Daiichi plant field engineers showed significantly higher psychological distress than other workers. The impact of emergency recovery work on psychological distress persisted for over one year, but PTSR in field engineer workers remained significantly elevated four years after the disaster.

Mental Health Consequences of the Three Mile Island, Chernobyl, and Fukushima Nuclear Disasters: A Scoping Review

Many individuals who were affected by the Great East Japan earthquake and tsunami and the subsequent Fukushima Daiichi Nuclear Power Plant accident continue to face a challenging recovery. We reviewed the long-term mental health consequences of three major nuclear power plant accidents: the Three Mile Island (TMI, 1979), Chernobyl (1986), and Fukushima (2011) nuclear disasters. We examined the relevant prospective cohort studies and before-and-after studies that covered more than two timepoints, searching four databases (PubMed, Ichushi, PsyArticles, and PTSDPub). We identified a total of 35 studies: TMI, n = 11; Chernobyl, n = 6; and Fukushima, n = 18. The smaller numbers of early-phase studies (within 6 months) of the Chernobyl and Fukushima disasters may also indicate the chaotic situation at those timepoints, as large-scale interviews were conducted in the early phase after the TMI disaster. Although the patterns of effects on mental health outcomes were diverse, more than half of the participants in the studies we evaluated were categorized into low or under-threshold symptom groups in all three disasters. Across the three disasters, the radiation exposure level estimated by the proximity and stigma were the common risk factors for mental health outcomes. Our findings will contribute to a comprehensive understanding of the impact of the worst nuclear accidents in history on the affected individuals' mental health, and our results illustrate the longitudinal consequences of such disasters.

The psychological consequences of (perceived) ionizing radiation exposure: a review on its role in radiation-induced cognitive dysfunction

PURPOSE

Exposure to ionizing radiation following environmental contamination (e.g., the Chernobyl and Fukushima nuclear accidents), radiotherapy and diagnostics, occupational roles and space travel has been identified as a possible risk-factor for cognitive dysfunction. The deleterious effects of high doses (≥1.0 Gy) on cognitive functioning are fairly well-understood, while the consequences of low (≤0.1 Gy) and moderate doses (0.1-1.0 Gy) have been receiving more research interest over the past decade. In addition to any impact of actual exposure on cognitive functioning, the persistent psychological stress arising from perceived exposure, particularly following nuclear accidents, may itself impact cognitive functioning. In this review we offer a novel interdisciplinary stance on the cognitive impact of radiation exposure, considering psychological and epidemiological observations of different exposure scenarios such as atomic bombings, nuclear accidents, occupational and medical exposures while accounting for differences in dose, rate of exposure and exposure type. The purpose is to address the question that perceived radiation exposure - even where the actual absorbed dose is 0.0 Gy above background dose - can result in psychological stress, which could in turn lead to cognitive dysfunction. In addition, we highlight the interplay between the mechanisms of perceived exposure (i.e., stress) and actual exposure (i.e., radiation-induced cellular damage), in the generation of radiation-induced cognitive dysfunction. In all, we offer a comprehensive and objective review addressing the potential for cognitive defects in the context of low- and moderate-dose IR exposures.

CONCLUSIONS

Overall the evidence shows prenatal exposure to low and moderate doses to be detrimental to brain development and subsequent cognitive functioning, however the evidence for adolescent and adult low- and moderate-dose exposure remains uncertain. The persistent psychological stress following accidental exposure to low-doses in adulthood may pose a greater threat to our cognitive functioning. Indeed, the psychological implications for instructed cohorts (e.g., astronauts and radiotherapy patients) is less clear and warrants further investigation. Nonetheless, the psychosocial consequences of low- and moderate-dose exposure must be carefully considered when evaluating radiation effects on cognitive functioning, and to avoid unnecessary harm when planning public health response strategies.

Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak

Hospital staff are at the frontline in the COVID‐19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID‐19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.