Fukushima: lecciones japonesas para la Salud Pública colombiana. Reporte de caso / Fukushima: japanese lessons to colombian Public Health

Resumen Introducción: Durante el 21o. Congreso Mundial de Epidemiología, organizado por la Asociación Internacional de Epidemiología (IEA) en Saitama-Japón en agosto de 2017, se aceptó invitación de los organizadores para visitar la Planta Nuclear # 1 de Fukushima. Objetivo: Explorar la situación operacional y de salud pública en el área de la prefectura de Fukushima y su planta nuclear #1, sitio afectado por el terremoto y tsunami de 2011. Métodos: Salida de inspección de campo (Inspection Tour) y encuentro con representantes de TEPCO (Tokyo Energy Power Company) en área de control; explicación didáctica de antecedentes y situación actual zonal, e instrucciones (briefing) para acceso. Visita con explicación de zonas de atención de salud y trabajos realizados. Recorrido en autobús especialmente adaptado al perímetro de cada reactor, portando dosímetro individual. Reunión final para resolución de dudas e inquietudes y lecciones del caso. Resultados: Visita y reuniones ejecutadas; exposición personal = 0,01 mSv/h. Radiación por zonas de reactor: central=230 mSv/h; paredes=40 mSv/h; planta=0,26 mSv/h, periferia=0,26 mSv/h. Zona de exclusión=20 km. Políticas de salubridad basadas en limpieza y remoción de fuentes de contaminación; aislamiento de aguas y bombeo de fuentes subterráneas; prevención y contención de escapes. Conclusión: La prevención lo es todo en asuntos industriales, sean nucleares o no; la colaboración interpersonal e interagencias es esencial en el manejo a muy largo plazo de desastres similares; debe evitarse incorporar técnicas o tecnologías industriales desconocidas o foráneas sin antes valorar su costo, alcance y posibles riesgos de salud individual, pública o medio-ambiental.

Abstract Introduction. During the 21st. International Epidemiology Association (IEA) World Congress of Epidemiology at Saitama (Japan), celebrated in August 2017, an invitation from its organizers to visit Fukushima Nuclear Plant # 1 was accepted. Objective: To explore operational and public health situation at the area of the Fukushima Prefecture and its nuclear plant #1, place affected by the 2011 earthquake and tsunami. Methods. Inspection tour and appointment with representatives of TEPCO (Tokyo Energy Power Company) at the control area; explanation on background and actual situation, and briefing before access. Guided visit to areas dedicated to healthcare and workers' attention, and work done. Tour by specially adapted autobus to the perimeter of each reactor, using individual dosimeter. Final meeting to solve questions and lessons of this case. Results. Visit and meetings were executed; individual exposure = 0,01 mSv. Radioactivity by reactor zones: central (inside) =230 mSv/h; walls =40 mSv/h; plant =0,26 mSv/h, perimeter =0,26 mSv/h. Exclusion zone =20 km. Public Health policies in place based upon cleansing and removal of sources of contamination; water isolation and subterranean sources pumping; prevention and containment of leaks. Conclusion. About industrial issues, prevention is everything, whether they be nuclear or not; interpersonal / interagencies' cooperation is paramount when dealing with similar disasters at a very long term; unknown or poorly understood industrial techniques or technologies should be avoided before a proper evaluation of their risk/benefit balance, scope and possible health risks to subjects, communities or environment.

Influence of Ectomycorrhizal Colonization on Cesium Uptake by Pinus densiflora Seedlings

Radionuclides were deposited at forest areas in eastern parts of Japan following the Fukushima Daiichi Nuclear Power Plant incident in March 2011. Ectomycorrhizal (EM) fungi have important effects on radiocaesium dynamics in forest ecosystems. We examined the effect of colonization by the EM fungus Astraeus hygrometricus on the uptake of cesium (Cs) and potassium (K) by Pinus densiflora seedlings. Pine seedlings exhibited enhanced growth after the EM formation due to the colonization by A. hygrometricus. Additionally, the shoot Cs concentration increased after the EM formation when Cs was not added to the medium. This suggests that A. hygrometricus might be able to solubilize Cs fixed to soil particles. Moreover, the shoot K concentration increased significantly after the EM formation when Cs was added. However, there were no significant differences in the root K concentration between EM and non-EM seedlings. These results suggest that different mechanisms control the transfer of Cs and K from the root to the shoot of pine seedlings.

Increased risk of thyroid cancer in female residents nearby nuclear power plants in Korea: was it due to detection bias?

BACKGROUND: The Korea Radiation Effect & Epidemiology Cohort METHODS: Using the KREEC-R raw data, we calculated age standardized rates (ASRs) of female thyroid cancer and re-analyzed the results of survey on the use of medical services. We also marked the administrative districts of residents who received the Radiation Health Research Institute (RHRI) health examinations and those in which thyroid cancer case occurred as per the Chonnam National University Research Institute of Medical Sciences (RIMS) final report on maps where the locations of NPPs and 5 km-radii around them were also indicated. And we compared the incidence rates of Radiation-induced cancer measured between the first period when RHRI health examinations were not yet implemented, and the second period when the RHRI health examinations were implemented. RESULTS: The ASR for the far-distance group, which comprised residents living in areas outside the 30 km radius of the NPPs, increased rapidly after 2000; however, that of the exposed group, which comprised residents living within a 5 km radius of the NPPs, started to increase rapidly even before 1995. The frequencies of the use of medical services were significantly higher in the intermediate proximate group, which comprised residents living within a 5–30 km radius of the NPPs, than in the exposed group in women. In case of female thyroid cancer, the second period ASR was higher than the first period ASR, but in case of female liver cancer and female stomach cancer no significant difference were observed between the periods. On map, many administrative districts of residents who received RHRI health examinations and most administrative districts in which thyroid cancer case occurred on RIMS final report were outside 5 km-radii around NPPs. CONCLUSIONS: We could not find any evidence supporting the assertion that detection bias influenced the increased risks of female thyroid cancer observed in the exposed group of the KREEC-R study, as opposed to the control group.

Radiation Safety in Nuclear Medicine Procedures / 대한핵의학회잡지

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

Thyroid Cancer: We Need a Carcinogen-specific Genome Study

No abstract available.

Can screening effects explain increased risk of thyroid cancer among population living near nuclear power plants in Korea?

No abstract available.

Can screening effects explain increased risk of thyroid cancer among population living near nuclear power plants in Korea?

No abstract available.

Cancer Risk in Adult Residents near Nuclear Power Plants in Korea: A Cohort Study of 1992-2010

This study evaluated cancer risk for adult residents near Nuclear Power Plants (NPPs) in Korea through a valid prospective cohort study during 1992-2010. The study cohort was composed of 11,367 adults living within a five km radius from the NPPs for the exposed and 24,809 adults for the non-exposed or reference cohort set at two different levels of proximity; 5-30 km radius and more than 30 km radius away from NPPs. In 303,542.5 person-years of follow-up, a total of 2,298 cancer cases of all sites, or 1,377 radio-inducible cancers diagnosed during 1992-2008 were ascertained. Multiple adjusted hazard ratios and 95% confidence intervals were estimated using multivariate Cox proportional hazard model. There were no epidemiological evidence for increased risk of cancer due to radiation from NPPs. Radiological study results or surveillance data of radiation doses around NPPs could be well documented for risk estimation of radio-inducible cancers, instead of epidemiological study results of the long-time required. Continuous surveillance of quantitative measures of dose levels around NPPs and radiation exposures to the residents is warranted.

Medical preparedness in radiation accidents: a matter of logistics and communication not treatment!

The currently reactor wreckage in Fukushima raised the following important questions: Is our knowledge of the possible dangers of ionizing radiation sufficient to warrant special action? What is the role of the medical community in technical radiation accidents from Windscale to Fukushima? What is the role of the medical community in terrorist radiation attacks? Are we prepared for those challenges? How can medical services communicate information in the media framework? What have we learned recently? And, what should be improved? In this review of the current literature on ionizing radiation, we try to answer these questions. Our conclusion is that medical services have to improve their communication skills and convince the public that the dangers of ionizing radiation can be quantitated within certain limits to support a qualified discussion about its risks and benefits

Reliability of a Questionnaire in an Epidemiological Study for Nuclear Power Plants Workers in Korea / 대한산업의학회지

OBJECTIVE: This study was conducted to evaluate the reliability of a questionnaire from an epidemiological study for nuclear power plants workers in Korea. METHODS: Among a total of 8,832 nuclear power plants workers who participated in the questionnaire survey, we selected 646 workers who repeatedly submitted the self-reported questionnaire. The reliability of the questionnaire for the categorical items was measured using kappa statistics and percentages of exact agreement, false disagreement and positive disagreement. Significance was evaluated for the continuous items by paired t-tests and intra-class correlation coefficients (ICCs). RESULTS: The questionnaire was observed to be highly reliable for the smoking history (kappa=0.85), which is known as an important confounding factor in assessing the cancer risk among radiation workers. Education level as a surrogate for the socio-economic status also appeared to be highly reliable with a kappa=0.89 and 95.09% of exact agreement. The history of alcohol drinking, medical exams and diseases showed more than moderately good agreement between the first and second responses (kappa>0.4). The self-reported values for physical measurements, the smoking period and smoking amount, and the period of alcohol drinking were highly correlated between the two responses (ICC>0.7). CONCLUSIONS: The questionnaire from an epidemiological study for nuclear power plants workers in Korea was found to be reliable for most items. To estimate the cancer or noncancer risk for nuclear power plants workers, we need to use the national database for incidence of diseases or death from diseases and the exposure history, and the medical records as well as the data collected from this study.

Reliability of Covariates in Baseline Survey of a Cohort Study: Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea / 예방의학회지

OBJECTIVES: We evaluated the reliability of the possible covariates of the baseline survey data collected for the Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea. METHODS: Follow-up surveys were conducted for 477 participants of the cohort at less than 1 year after the initial survey. The mean interval between the initial and follow-up surveys was 282.5 days. Possible covariates were identified by analyzing the correlations with the exposure variable and associations with the outcome variables for all the variables. Logistic regression analysis with stepwise selection was further conducted among the possible covariates to select variables that have covariance with other variables. We considered that these variables can be representing other variables. Seven variables for the males and 3 variables for the females, which had covariance with other possible covariates, were selected as representative variables. The Kappa index of each variable was calculated. RESULTS: For the males, the Kappa indexes were as follow; family history of cancer was 0.64, family history of liver diseases in parents and siblings was 0.56, family history of hypertension in parents and siblings was 0.51, family history of liver diseases was 0.50, family history of hypertension was 0.44, a history of chronic liver diseases was 0.53 and history of pulmonary tuberculosis was 0.36. For females, the Kappa indexes were as follow; family history of cancer was 0.58, family history of hypertension in parents and siblings was 0.56 and family history of hypertension was 0.47. CONCLUSIONS: Most of the possible covariates showed good to moderate agreement.

Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis / 예방의학회지

OBJECTIVES: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

Ionizing Radiation-induced Diseases in Korea

Radiation risk has become well known through epidemiological studies of clinically or occupationally exposed populations, animal experiments, and in vitro studies; however, the study of radiation related or induced disease has been limited in Korea. This study is to find the level of occupational radiation exposure for various kinds of accidents, compensated occupational diseases, related studies, and estimations on future occupational disease risks. Research data of related institutions were additionally investigated. About 67% of 62,553 radiation workers had no exposure or less than 1.2 mSv per year. The 5 reported cases on radiation accident patients in Korea occurred during nondestructive testing. According to the recent rapid increase in the number of workers exposed to radiation, a higher social recognition of cancer, and an increasing cancer mortality rate, it is expected that occupational disease compensation will rapidly increase as well. Therefore, it is important to develop scientific and objective decision methods, such as probability of causation and screening dose in the establishment of an exposure and health surveillance system.

Adequação estratégica de projetos: o caso da Eletronuclear / Strategic fit of project management: the Eletronuclear case

Na literatura menciona-se perda significativa de recursos devido à implementação de projetos que não contribuem para os objetivos principais da empresa, por, geralmente, não terem uma conexão clara com sua estratégia. A falta de adequação dos projetos à estratégia acaba tendo assim um impacto negativo no desempenho e competitividade da empresa. Este artigo compartilha os resultados de um estudo sobre o gerenciamento de projetos (GP), na empresa estatal chamada Eletronuclear, que foi criada em 1997 para construir e operar as usinas termonucleares do país. O estudo teve como objetivo avaliar a adequação estratégica do GP na empresa e identificar fatores que contribuíam e os que dificultavam a desejada adequação. Observe que por adequação estratégica entende-se alinhamento, orientação e aderência à estratégia. Utilizou-se como principal método de pesquisa o estudo de caso, coletando dados de várias fontes e por diferentes meios - investigação documental, questionário estruturado e entrevistas - para assegurar sua consistência. Os resultados apontaram fraquezas em GP na empresa, no sentido de inconsistências com sua estratégia, que evidenciaram uma falta de adequação estratégica do GP. Destacaram-se os recursos - notadamente alocação e qualidade inapropriadas - e a dificuldade de mudar para uma cultura de GP, com visão estratégica, como os maiores problemas. Ao mesmo tempo, revelaram-se iniciativas recentes, pertinentes à adoção de processos de mediação no nível estratégico de projetos e de um planejamento de portfólio de projetos, que se forem traduzidas em ações concretas, poderiam contribuir para uma melhor adequação estratégica de GP. O estudo forneceu assim subsídios para outras empresas que procuram aprimorar seu gerenciamento de projetos.

Distribution of a pelagic tunicate, Salpa fusiformis in warm surface current of the eastern Korean waters and its impingement on cooling water intakes of Uljin nuclear power plant.

Impingement of a large amount of gelatinous plankton, Salpa fusiformis on the seawater intake system-screens in a nuclear power plant at Uljin was firstly recorded on 18th June 2003. Whole amount of the clogged animals was estimated were presumptively at 295 tons and the shortage of cooling seawater supply by the animal clogging caused 38% of decrease in generation capability of the power plant. Zooplankton collection with a multiple towing net during the day and at night from 5 to 6 June 2003 included various gelatinous zooplanktons known to be warm water species such as salps and siphonophores. Comparatively larger species, Salpa fusiformis occupied 25.4% in individual density among the gelatinous plankton and showed surface distribution in the depth shallower than thermocline, performing little diel vertical migration. Temperature, salinity and satellite data also showed warm surface current predominated over the southern coastal region near the power plant in June. The results suggested that warm surface current occasionally extended into the neritic region may transfer S. fusiformis, to the waters off the power plant. The environmental factors and their relation to ecobiology of the large quantity of salpa population that are being sucked into the intake channel of the power plant are discussed.

Seasonal variations of marine algal community in the vicinity of Uljin nuclear power plant, Korea.

Three marine algal sites were examined seasonally in an area of thermal discharge from the Uljin nuclear power plant in Korea to assess possible impacts from thermal stress. Quadrat samples were taken at three sites: cooling water intake, outfall and Chukbyon. The degree of wave exposure increased from intake, outfallto Chukbyon. Percent cover and biomass were response variables. All sites were, by numbers red algae, followed by brown and green algae. Over the year the maximum species diversity was also found at the Chukbyon (2.39), but the minimal one (1.67) was observed at the outfall. Seasonally generally among algal form-functional groups, filamentous and coarsely branched algae were most abundant throughout the year at the three sites. The numberof species in the jointed calcareous groups increased remarkably at the outfall. Based on these results, species richness appears tobe strongly affected by wave exposure and thermal stress. The higher proportion of calcareous form groups at the outfall sites indicates that these species are better adapted morphologically to thermal stress such as high temperatures.