How Do Disaster Relief Nurses in Japan Perceive and Respond to Risks? A Cross-Sectional Study.

This study assessed the risk perceptions among disaster relief nurses (DRNs) in Japan by focusing on 15 risk factors associated with frequent natural disasters and the ongoing coronavirus disease 2019 (COVID-19) pandemic. We conducted a cross-sectional study that targeted DRNs across six prefectures in Japan and explored nurses' perceptions of risks including radiation exposure, volcanic eruptions, and mass infections. The findings indicated a heightened perception of radiation and nuclear-related risks. In the context of the COVID-19 pandemic, DRNs perceived "mass infection" as a significant risk. An age-based analysis revealed that younger nurses had more dread about "mass infection" and had heightened uncertainty about the "X-ray test" compared with their older peers. Understanding DRNs' risk perceptions is crucial for effective disaster response preparedness and training. The study highlights the need to address these perceptions to ensure that DRNs are well prepared and supported in their roles. This study was not pre-registered on a publicly accessible registry.

The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident:results from the Fukushima health management survey.

INTRODUCTION: We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children's experience of the nuclear disaster. METHODS: We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS);FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the "Strengths and Difficulties Questionnaire (SDQ)" scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster - "nuclear disaster (+)" and "nuclear disaster (-)" - were also compared. RESULTS: Our effective response was 93 (59.6%);the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between "elementary school" and "junior high school" or "nuclear disaster" (+) and (-). There was no significant difference between these items. CONCLUSIONS: We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster.

Survey of awareness of radiation disasters among firefighters in a Japanese prefecture without nuclear power plants.

Japanese firefighting organisations are essentially run as village, town, or city units. The Great Hanshin Earthquake of 1995 led to the establishment of emergency support teams to ensure rapid action in response to disasters beyond the capacities of local fire departments. The 2011 Great East Japan Earthquake involved both a tsunami and a radiation disaster caused by a nuclear reactor meltdown, underscoring the need for responses in complex disasters. This study aimed to assess Nagasaki Prefecture firefighters' preparedness for, awareness of, and anxiety regarding radiation disaster response with the aim of elucidating the factors affecting individuals' decisions to accept or reject assignment to a radiation disaster response team. A questionnaire survey was carried out with 1,122 firefighters in three firefighting departments in Nagasaki Prefecture, which does not have nuclear power plants. In total, 920 questionnaires were returned, and the 784 that were valid were analysed. Among the participants, 39% replied that they would have no difficulty accepting assignment to a radiation disaster response team; most of them were under 30 years old and unmarried. This group also included significantly higher percentages of participants who were confident about radiation disaster response or, if anxious, believed things would turn out fine, as well as those who replied that they were able to use the necessary equipment. Furthermore, this group had significantly higher percentages of participants who replied that they would definitely participate in seminars and those who replied that their level of preparedness for radiation disasters was sufficient. The willingness to be assigned to a radiation disaster response team was linked to confidence about radiation disaster response and about handling materials and/or equipment. Therefore, it is considered that measures to increase firefighters' confidence regarding response to radiation disasters will be linked to more proactive measures if and when such disasters occur.

Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey.

BACKGROUND: To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS. METHODS: We conducted the cross-sectional study within the framework of the FHMS. Exposure values were "anorexia," "subjective feelings about health," "feelings about sleep satisfaction," and "bereavement caused by the disaster," confounding variables were "age" and "sex," and outcome variables were "K6 points." We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012. RESULTS: A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among people with PCL-S score above the cut-off in Kawauchi was higher than in previous studies in other locations. CONCLUSIONS: These results suggest that there are severe mental health problems, such as depression and PTSD, among adults as a consequence of the accident at the FDNPS. Our study showed that residents who lived in the evacuation zone before the disaster are at high risk psychological distress. To facilitate local residents' recovery from Fukushima, there is a need to continue providing them with physical and mental support, as well as communication regarding the health risks of radiation.

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.

Factors associated with nurses' intention to leave their jobs after the Fukushima Daiichi Nuclear Power plant accident.

We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants' demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR = 1.87, 95%CI: 1.02-3.44, p = 0.042), anxiety about life in Fukushima City after the accident (OR = 5.55, 95%CI: 1.18-26.13, p = 0.030), consideration of evacuation from Fukushima after the accident (OR = 2.42, 95%CI: 1.45-4.06, p = 0.001), consideration of the possible radiation health effects in children (OR = 1.90, 95%CI: 1.02-3.44, p = 0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR = 3.23, p = 0.001) were independently associated with the nurses' intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects.

Determinants of the return to hometowns after the accident at Fukushima Dai-ichi nuclear power plant: a case study for the village of Kawauchi.

The Great East Japan Earthquake in March 2011 destroyed the Fukushima Dai-ichi Nuclear Power Plant (FNPP) and almost all residents in a 20 km radius from the plant eventually evacuated. FNPP reactors were stabilised in December 2011; some evacuees decided to return to their hometowns, and the other evacuees remained. Efforts were made to identify the determinants that affect the decision to return home in order to promote recovery of the surrounding area of FNPP. Seventy-one residents who had not returned to hometown and 56 residents who had returned were selected. Logistic regression analysis adjusted for confounding factors showed that being female [odds ratio (OR): 2.43, p = 0.03], living in areas with relatively higher ambient doses (OR: 3.60, p=0.01) and expressing anxiety over radiation exposure (OR: 8.91, p < 0.01) were independently associated with decisions not to return. Results of this study suggest the importance of active participation by scientists and local authorities in communicating the risk to the general population involved in returning home.

[Vaccination against rubella, measles, chickenpox, and mumps in nursing students].

The past history of infection and vaccination, and serum antibodies against rubella, measles, chickenpox, and mumps were investigated, before vaccine was inoculated in the susceptible nursing students. The subjects were 221 nursing students (208 women, 13 men, the average age 18.4 +/- 1.8 years old) who entered Nagasaki University from 2001 to 2003. The positive rates of the past history of rubella, measles, chickenpox, and mumps were 49.8%, 28.1%, 86.4%, 50.7%, and that of previous vaccination were 31.7%, 69.2%, 10.9%, 5.3%, respectively. The serum antibody was measured with HI assay for rubella, or with EIA assay for measles, chickenpox, and mumps. The positive rates for the antibodies against rubella, measles, chickenpox, and mumps were 92.8%, 90.0%, 82.3%, and 85.0%, respectively. The rates for vaccine inoculation to the students without antibody were 92.8% in rubella, 100.0% in measles, 66.7% in chickenpox, 85.0% in mumps, and that to the low titer antibody (2.0 < or = EIA-IgG < 4.0) students were 70.6% in measles, 48.0% in chickenpox, 93.8% in mumps, respectively. Susceptible nursing students, as well as the medical stuff, should be vaccinated in order to prevent hospital infection of rubella, measles, chickenpox, and mumps.

[Analysis of tuberculin skin test in employees of Nagasaki University Hospital].

The tuberculin skin test (TST) was conducted in 1,087 employees of Nagasaki University Hospital. The size of erythema (T1) was 27.3 +/- 17.0 mm, and 8.6% of all participants showed < = 9 mm, 49.9% showed 10-29 mm, 41.5% showed > = 30 mm. Laboratory technologists showed significantly larger reactions than other groups. Doctors and nurses working on the tuberculosis ward showed larger reactions than those working on the non-tuberculosis wards. Reactions tended to be larger with aging, and the younger employees in their 20s showed significantly smaller reactions than those in their 40s. The second TST was carried out in 253 employees whose T1 was below 30 mm. The size of erythema enlarged from 16.1 +/- 6.6 mm (T1) to 26.4 +/- 15.4 mm (T2), with the difference (booster phenomenon) of 10.2 +/- 14.4 mm. T2 and T2-T1 were larger in nurses working on the tuberculosis ward than those on the non-tuberculosis wards. It was suggested that laboratory technologists, nurses and doctors especially working on the tuberculosis ward are at risk of tuberculosis infection, and the two-step TST was an essential means to know the baseline reactivity, and to determine recent tuberculosis infection.