Estimated Dietary Intake of Radionuclides and Health Risks for the Citizens of Fukushima City,Tokyo, and Osaka after the 2011 Nuclear Accident

The radionuclides released from the Fukushima Daiichi nuclear power plant in 2011 pose a health risk. In this study, we estimated the 1st-year average doses resulting from the intake of iodine 131 (¹³¹I) and cesium 134 and 137 (¹³⁴Cs and ¹³⁷Cs) in drinking water and food ingested by citizens of Fukushima City (∼50 km from the nuclear power plant; outside the evacuation zone), Tokyo (∼230 km), and Osaka (∼580 km) after the accident. For citizens in Fukushima City, we considered two scenarios: Case 1, citizens consumed vegetables bought from markets; Case 2, citizens consumed vegetables grown locally (conservative scenario). The estimated effective doses of ¹³⁴Cs and ¹³⁷Cs agreed well with those estimated through market basket and food-duplicate surveys. The average thyroid equivalent doses due to ingestion of ¹³¹I for adults were 840 µSv (Case 1) and 2700 µSv (Case 2) in Fukushima City, 370 µSv in Tokyo, and 16 µSv in Osaka. The average effective doses due to ¹³⁴Cs and ¹³⁷Cs were 19, 120, 6.1, and 1.9 µSv, respectively. The doses estimated in this study were much lower than values reported by the World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation, whose assessments lacked validation and full consideration of regional trade in foods, highlighting the importance of including regional trade. The 95th percentile effective doses were 2–3 times the average values. Lifetime attributable risks (LARs) of thyroid cancers due to ingestion were 2.3–39×10⁻⁶ (Case 1) and 10–98×10⁻⁶ (Case 2) in Fukushima City, 0.95–14×10⁻⁶ in Tokyo, and 0.11–1.3×10⁻⁶ in Osaka. The contributions of LARs of thyroid cancers due to ingestion were 7.5%–12% of all exposure (Case 1) and 12%–30% (Case 2) in Fukushima City.     

Evaluation of Risk Perception and Risk-Comparison Information Regarding Dietary Radionuclides after the 2011 Fukushima Nuclear Power Plant Accident

In the wake of the 2011 Fukushima Daiichi Nuclear Power Station accident, to facilitate evidence-based risk communication we need to understand radiation risk perception and the effectiveness of risk-comparison information. We measured and characterized perceptions of dread risks and unknown risks regarding dietary radionuclides in residents of Fukushima, Tokyo, and Osaka to identify the primary factors among location, evacuation experience, gender, age, employment status, absence/presence of spouse, children and grandchildren, educational background, humanities/science courses, smoking habits, and various types of trustworthy information sources. We then evaluated the effects of these factors and risk-comparison information on multiple outcomes, including subjective and objective understanding, perceived magnitude of risk, perceived accuracy of information, backlash against information, and risk acceptance. We also assessed how risk-comparison information affected these multiple outcomes for people with high risk perception. Online questionnaires were completed by people (n = 9249) aged from 20 to 69 years in the three prefectures approximately 5 years after the accident. We gave each participant one of 15 combinations of numerical risk data and risk-comparison information, including information on standards, smoking-associated risk, and cancer risk, in accordance with Covello’s guidelines. Dread-risk perception among Fukushima residents with no experience of evacuation was much lower than that in Osaka residents, whereas evacuees had strikingly higher dread-risk perception, irrespective of whether their evacuation had been compulsory or voluntary. We identified location (distance from the nuclear power station), evacuation experience, and trust of central government as primary factors. Location (including evacuation experience) and trust of central government were significantly associated with the multiple outcomes above. Only information on “cancer risk from radiation and smoking risk” enhanced both subjective and objective understanding without diminishing trust in all participants and in the high dread-risk perception group; use of other risk-comparison information could lead the public to overestimate risk.     

Absorption of Radionuclides from the Fukushima Nuclear Accident by a Novel Algal Strain

Large quantities of radionuclides have leaked from the Fukushima Daiichi Nuclear Power Plant into the surrounding environment. Effective prevention of health hazards resulting from radiation exposure will require the development of efficient and economical methods for decontaminating radioactive wastewater and aquatic ecosystems. Here we describe the accumulation of water-soluble radionuclides released by nuclear reactors by a novel strain of alga. The newly discovered green microalgae, Parachlorella sp. binos (Binos) has a thick alginate-containing extracellular matrix and abundant chloroplasts. When this strain was cultured with radioiodine, a light-dependent uptake of radioiodine was observed. In dark conditions, radioiodine uptake was induced by addition of hydrogen superoxide. High-resolution secondary ion mass spectrometry (SIMS) showed a localization of accumulated iodine in the cytosol. This alga also exhibited highly efficient incorporation of the radioactive isotopes strontium and cesium in a light-independent manner. SIMS analysis showed that strontium was distributed in the extracellular matrix of Binos. Finally we also showed the ability of this strain to accumulate radioactive nuclides from water and soil samples collected from a heavily contaminated area in Fukushima. Our results demonstrate that Binos could be applied to the decontamination of iodine, strontium and cesium radioisotopes, which are most commonly encountered after nuclear reactor accidents.     

Internal Radiation Exposure Dose in Iwaki City,Fukushima Prefecture after the Accident at Fukushima Dai-ichi Nuclear Power Plant

As a result of the accident at the Fukushima Daiichi Nuclear Power Plant (FNPP) on 11 March 2011, a huge amount of radionuclides, including radiocesium, was released and spread over a wide area of eastern Japan. Although three years have passed since the accident, residents around the FNPP are anxious about internal radiation exposure due to radiocesium. In this study, we screened internal radiation exposure doses in Iwaki city of Fukushima prefecture, using a whole-body counter. The first screening was conducted from October 2012 to February 2013, and the second screening was conducted from May to November 2013. Study participants were employees of ALPINE and their families who underwent examination. A total of 2,839 participants (1,366 men and 1,473 women, 1–86 years old) underwent the first screening, and 2,092 (1,022 men and 1,070 women, 1–86 years old) underwent the second screening. The results showed that 99% of subjects registered below 300 Bq per body in the first screening, and all subjects registered below 300 Bq per body in the second screening. The committed effective dose ranged from 0.01–0.06 mSv in the first screening and 0.01–0.02 mSv in the second screening. Long-term follow-up studies are needed to avoid unnecessary chronic internal exposure and to reduce anxiety among the residents by communicating radiation health risks.     

Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant

The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP.     

Radiation Dose Reduction Efficiency of Buildings after the Accident at the Fukushima Daiichi Nuclear Power Station

Numerous radionuclides were released from the Fukushima Daiichi Nuclear Power Station (F1-NPS) in Japan following the magnitude 9.0 earthquake and tsunami on March 11, 2011. Local residents have been eager to calculate their individual radiation exposure. Thus, absorbed dose rates in the indoor and outdoor air at evacuation sites in the Fukushima Prefecture were measured using a gamma-ray measuring devices, and individual radiation exposure was calculated by assessing the radiation dose reduction efficiency (defined as the ratio of absorbed dose rate in the indoor air to the absorbed dose rate in the outdoor air) of wood, aluminum, and reinforced concrete buildings. Between March 2011 and July 2011, dose reduction efficiencies of wood, aluminum, and reinforced concrete buildings were 0.55±0.04, 0.15±0.02, and 0.19±0.04, respectively. The reduction efficiency of wood structures was 1.4 times higher than that reported by the International Atomic Energy Agency. The efficiency of reinforced concrete was similar to previously reported values, whereas that of aluminum structures has not been previously reported. Dose reduction efficiency increased in proportion to the distance from F1-NPS at 8 of the 18 evacuation sites. Time variations did not reflect dose reduction efficiencies at evacuation sites although absorbed dose rates in the outdoor air decreased. These data suggest that dose reduction efficiency depends on structure types, levels of contamination, and evacuee behaviors at evacuation sites.     

Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Background

Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees.

Methods

A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation''s impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression.

Results

Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04–3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34–1.76) to 2.88 (95% CI: 1.74–4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07–3.49).

Conclusion

High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.     

Dietary Sodium Intake: Knowledge,Attitudes and Practices in Shandong Province,China, 2011

Objective

To investigate the knowledge, attitudes and practices (KAP) for dietary sodium intake among adult residents of Shandong Province, China

Methods

In 2011, we conducted a cross sectional survey among a representative sample of 15,350 adults aged 18 to 69 years using a standardized questionnaire to assess their KAP for sodium. Variation in the KAPs by gender, and residence location were compared using the Chi-square tests. Predictors for the ‘intention to’ and ‘currently taking action to’ reduce sodium intake were determined by multivariate logistic regression with adjustment for confounding factors.

Results

KAPs for dietary sodium intake among urban residents was generally more favorable than among rural residents. Women were likely to have more favorable KAPs than men. About four fifth of subjects reported that they favored a low sodium diets. However, 31% reported that consumption of less sodium results in less physical strength. Overall, 70% indicated their intention to reduce sodium intake, although only 39 % reported that they had taken action to reduce sodium. Multiple logistic regression analyses indicated that favorable actions to dietary sodium reduction were more likely to occur among those who were aware of the link between sodium and hypertension, and less likely among those who had unfavorable attitudes towards dietary sodium reduction.

Conclusion

Increasing knowledge levels about the benefits of sodium reduction will be a key success factor for effective sodium reduction initiatives and is linked to favorable behavioral change. Emphasis should be placed on the rural area.     

A Comparative Analysis of Accident Risks in Fossil,Hydro, and Nuclear Energy Chains

This study presents a comparative assessment of severe accident risks in the energy sector, based on the historical experience of fossil (coal, oil, natural gas, and LPG [Liquefied Petroleum Gas]) and hydro chains contained in the comprehensive Energy-related Severe Accident Database (ENSAD), as well as Probabilistic Safety Assessment (PSA) for the nuclear chain. Full energy chains were considered because accidents can take place at every stage of the chain. Comparative analyses for the years 1969–2000 included a total of 1870 severe (≥ 5 fatalities) accidents, amounting to 81,258 fatalities. Although 79.1% of all accidents and 88.9% of associated fatalities occurred in less developed, non-OECD countries, industrialized OECD countries dominated insured losses (78.0%), reflecting their substantially higher insurance density and stricter safety regulations. Aggregated indicators and frequency-consequence (F-N) curves showed that energy-related accident risks in non-OECD countries are distinctly higher than in OECD countries. Hydropower in non-OECD countries and upstream stages within fossil energy chains are most accident-prone. Expected fatality rates are lowest for Western hydropower and nuclear power plants; however, the maximum credible consequences can be very large. Total economic damages due to severe accidents are substantial, but small when compared with natural disasters. Similarly, external costs associated with severe accidents are generally much smaller than monetized damages caused by air pollution.     

Screening Level Assessment of Risks Associated with Dietary Exposure to Selected Heavy Metals,Polycyclic Aromatic Hydrocarbons,and Radionuclides in Kuwait

To assess the health risks associated with dietary exposure of the Kuwait population, two market baskets comprising 146 food items, which represented the diets of various age groups of the Kuwaiti population, were collected twice, once in the winter of 1997 and again in the summer of 1998, to account for seasonal variation. These food items were analyzed for their heavy metals, polycyclic aromatic hydrocarbons (PAHs) and selected radionuclides contents. Probabilistic risk assessments using the Monte Carlo simulation technique were conducted for Cd, Pb, PAHs, ¹³⁷Cs, ⁹⁰Sr, and ²²⁶Ra. The data obtained showed that high Cd and Pb exposures, which exceeded the World Health Organization's (WHO's) standards are encountered among young children. Exposures to PAHs of the different age groups of the Kuwaiti population were not unusually high at the higher percentiles. On the other hand, dietary exposures to ⁹⁰Sr were all below WHO standards for all percentile and age groups. Exposures to ¹³⁷Cs were slightly above the WHO standard at the 90^th percentile for most age groups, and ²²⁶Ra exposures were all well above WHO standards at the upper percentiles for all age groups, but still below the United States Food and Drug Administration's (USFDA's) intervention levels.     

Analysis of Plasma Protein Concentrations and Enzyme Activities in Cattle within the Ex-Evacuation Zone of the Fukushima Daiichi Nuclear Plant Accident

The effect of the Fukushima Daiichi Nuclear Power Plant (FNPP) accident on humans and the environment is a global concern. We performed biochemical analyses of plasma from 49 Japanese Black cattle that were euthanized in the ex-evacuation zone set within a 20-km radius of FNPP. Among radionuclides attributable to the FNPP accident, germanium gamma-ray spectrometry detected photopeaks only from ¹³⁴Cs and ¹³⁷Cs (radiocesium) commonly in the organs and in soil examined. Radioactivity concentration of radiocesium was the highest in skeletal muscles. Assuming that the animal body was composed of only skeletal muscles, the median of internal dose rate from radiocesium was 12.5 μGy/day (ranging from 1.6 to 33.9 μGy/day). The median of external dose rate calculating from the place the cattle were caught was 18.8 μGy/day (6.0–133.4 μGy/day). The median of internal and external (total) dose rate of the individual cattle was 26.9 μGy/day (9.1–155.1 μGy/day). Plasma levels of malondialdehyde and superoxide dismutase activity were positively and glutathione peroxidase activity was negatively correlated with internal dose rate. Plasma alanine transaminase activity and percent activity of lactate dehydrogenase (LDH)-2, LDH-3 and LDH-4 were positively and LDH-1 was negatively correlated with both internal and total dose rate. These suggest that chronic exposure to low-dose rate of ionizing radiation induces slight stress resulting in modified plasma protein and enzyme levels.     

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

BackgroundPublic health action to reduce dietary salt intake has driven substantial reductions in coronary heart disease (CHD) over the past decade, but avoidable socio-economic differentials remain. We therefore forecast how further intervention to reduce dietary salt intake might affect the overall level and inequality of CHD mortality.MethodsWe considered English adults, with socio-economic circumstances (SEC) stratified by quintiles of the Index of Multiple Deprivation. We used IMPACT_SEC, a validated CHD policy model, to link policy implementation to salt intake, systolic blood pressure and CHD mortality. We forecast the effects of mandatory and voluntary product reformulation, nutrition labelling and social marketing (e.g., health promotion, education). To inform our forecasts, we elicited experts’ predictions on further policy implementation up to 2020. We then modelled the effects on CHD mortality up to 2025 and simultaneously assessed the socio-economic differentials of effect.ResultsMandatory reformulation might prevent or postpone 4,500 (2,900–6,100) CHD deaths in total, with the effect greater by 500 (300–700) deaths or 85% in the most deprived than in the most affluent. Further voluntary reformulation was predicted to be less effective and inequality-reducing, preventing or postponing 1,500 (200–5,000) CHD deaths in total, with the effect greater by 100 (−100–600) deaths or 49% in the most deprived than in the most affluent. Further social marketing and improvements to labelling might each prevent or postpone 400–500 CHD deaths, but minimally affect inequality.ConclusionsMandatory engagement with industry to limit salt in processed-foods appears a promising and inequality-reducing option. For other policy options, our expert-driven forecast warns that future policy implementation might reach more deprived individuals less well, limiting inequality reduction. We therefore encourage planners to prioritise equity.     

Dietary Intake of Arsenic, Cadmium, Mercury, and Lead by the Population of Catalonia, Spain

The concentrations of arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) were determined in samples of food items widely consumed by the population of Catalonia, Spain. All samples were randomly acquired in 12 cities of Catalonia between March and June of 2006 and analyzed by inductively coupled plasma mass spectrometry. The dietary intake of these elements was estimated for various age–gender groups of population: children, adolescents, adults, and seniors. In order to determine the temporal trend on the dietary exposure to As, Cd, Hg, and Pb, the current results were compared with those of a previous survey (2000). In the present market basket study, for a standard male adult of 70-kg body weight living in Catalonia, the dietary intakes of As, Cd, Hg, and Pb were 261.01, 9.80, 12.61, and 45.13 μg/day, respectively, while in the 2000 survey, these intakes were 223.59, 15.73, 21.22, and 28.37 μg/day, for As, Cd, Hg, and Pb, respectively. For As, the only food groups currently contributing with measurable amounts to intake of total As were fish and shellfish and cereals, while for Cd the highest contribution to total intake corresponded to pulses, tubers, and cereals. For Hg, the contribution was only due to fish and shellfish, while cereals were the group with the highest contribution to total Pb intake. The estimated intakes of As, Cd, Hg, and Pb are notably lower than the respective provisional tolerable weekly intakes, which indicate that these intakes should not mean additional health risks for the consumers.     

Mild Obesity,Physical Activity,Calorie Intake,and the Risks of Cervical Intraepithelial Neoplasia and Cervical Cancer

Objective

We investigated whether obesity, physical activity, and calorie intake are associated with the risks of cervical intraepithelial neoplasia (CIN) and cervical cancer.

Methods

We enrolled 1125 women (age, 18–65 years) into a human papillomavirus cohort study established from 2006 to 2012. Multinomial logistic regression models were used to estimate crude and multivariate odds ratios (ORs) and the corresponding 95% confidence intervals (95% CIs), and to assess whether body mass index (BMI), height, weight, total calorie intake, and physical activity were associated with the risks of CIN and cervical cancer.

Results

Cervical cancer risk was positively associated with BMI and inversely associated with physical activity. When compared with women with a normal BMI (18.5–23 kg/m²), the multivariate ORs (95% CIs) for those overweight (23–25 kg/m²) and mild obesity (≥25 kg/m²) were 1.25 (0.79–2.00) and 1.70 (1.10–2.63), respectively. When compared with women with the lowest tertile of physical activity (<38.5 MET-hours/week), the ORs (95% CIs) for cervical cancer were 0.95 (0.61–1.48) and 0.61 (0.38–0.98) for women with medium physical activity (38.5–71.9 MET-hours/week) and those with high physical activity (72 MET-hours/week), respectively (p for linear trend  = 0.03). The CIN2/3 risk was inversely associated with physical activity after adjustment for confounders. Compared with women with low physical activity (< 38.5 MET-hours/week), the ORs (95% CIs) for CIN2/3 were 0.64 (0.40–1.01) and 0.58 (0.36–0.93) for the medium and high physical activity groups, respectively (p for linear trend  = 0.02). Total calorie intake was not statistically associated with the risks of CIN and cervical cancer after adjustment for confounders.

Conclusion

Our results indicate that in addition to screening for and treatment of CIN, recommendations on the maintenance of an appropriate BMI with an emphasis on physical activity could be an important preventive strategy against the development of cervical cancer.     

Association of the Estimated 24-H Urinary Sodium Excretion with Albuminuria in Adult Koreans: The 2011 Korea National Health and Nutrition Examination Survey

Background

Sodium intake and albuminuria have important roles in blood pressure and renal progression. Although their relationship has been reported, the results have not been consistent and all studies have examined small populations.

Objective

This study investigated the role of the estimated 24-h urinary sodium excretion as a marker of sodium intake and albuminuria.

Design

This investigation included 5,187 individuals age 19 years and older from a cross-sectional, nationally representative, stratified survey: The Korea National Health and Nutrition Examination Survey (KNHANES V-2), in 2011. Albuminuria was defined as a urinary albumin/creatinine ratio ≥30 mg/g. The 24-h urinary sodium excretion was estimated from a spot urine.

Results

On classifying our participants into quartiles based on the estimated 24-h urinary sodium excretion, the prevalence of albuminuria increased with the 24-h urinary sodium excretion (5.3, 5.7, 7.5, and 11.8% in the first through fourth quartiles, respectively, p for trend <0.001). Even after adjusting for age, sex, diabetes, obesity, and hypertension, the significance persisted. In a multiple logistic regression analysis, the second and third quartiles of the estimated 24-h urinary sodium excretion were not associated with the presence of albuminuria with the first quartile as a control. However, the fourth quartile was significantly associated with the presence of albuminuria (odds ratio 1.61 [95% confidence interval 1.71–2.21], p = 0.003) after adjusting for age, sex, diabetes, obesity, and hypertension.

Conclusions

These findings suggest that salt intake is associated with the presence of albuminuria in the general Korean adult population.     

Analysis of the Maternal and Child Health Care Status in Suizhou City,Hubei Province,China, from 2005 to 2011

Background

Improving the health and well-being of women and children has long been a common goal throughout the world. From 2005 to 2011, Suizhou City had an annual average of 22,405 pregnant and parturient women (1.04% of the population) and 98,811 children under 5 years old (4.57% of the population). Understanding the status of maternal and child health care in Suizhou City during such period can provide the local health administrative department valid scientific bases upon which to construct effective policies.

Methods

Various types of annual reports on maternal and child health care were collected and analyzed retrospectively.

Results

Mortality rates for infants and children under 5 years showed a declining trend, while the rates of newborn home visiting, maternal health service coverage, and children health systematic management increased annually in Suizhou City from 2005 to 2011. The incidence of birth defect increased from 2.42‰ in 2005 to 3.89‰ in 2011. The maternal mortality ratio (MMR) fluctuated from 8.39/100,000 to 28.77/100,000, which was much lower than the national MMR (30.0/100,000 in 2010). The rates of hospitalized delivery and births attended by trained health personnel for pregnant women increased to more than 90% in the past five years.

Conclusions

The improvements in maternal and child health care work in Suizhou City are worthy of recognition. Thus, the government should continue to increase funding in these areas to promote the complete enhancement of the maternal and child health care system.