Academic journal article Bulletin of the World Health Organization

Psychological Distress and the Perception of Radiation Risks: The Fukushima Health Management survey/Detresse Psychologique et Perception Des Risques Lies Aux Rayonnements: L'enquete De Surveillance Sanitaire Fukushima Health Management Survey/La Angustia Psicologica Y la Percepcion De Los Riesgos De Radiacion: La Encuesta Sobre la Gestion Sanitaria En Fukushima (Fukushima Health Management Survey)

Academic journal article Bulletin of the World Health Organization

Psychological Distress and the Perception of Radiation Risks: The Fukushima Health Management survey/Detresse Psychologique et Perception Des Risques Lies Aux Rayonnements: L'enquete De Surveillance Sanitaire Fukushima Health Management Survey/La Angustia Psicologica Y la Percepcion De Los Riesgos De Radiacion: La Encuesta Sobre la Gestion Sanitaria En Fukushima (Fukushima Health Management Survey)

Article excerpt

Introduction

The Tohoku earthquake in Japan on 11 March 2011 was a triple disaster --earthquake, tsunami and nuclear incident--that had major health effects. The Chernobyl nuclear disaster in the former Soviet Union led to increased mental health problems among residents, which persisted and consequently became a public health problem. (1-2) Likewise, a high proportion of the evacuees in Fukushima have experienced psychological distress and traumatic reactions. (3)

The complex nature of the events at Fukushima, comprising both natural and technological disasters, created an additional burden on residents' mental health. (4) Previous research has identified factors affecting mental health following a disaster, including female gender, low-socioeconomic status, experience of severe disaster damage, poor social support, physical injuries, history of mental illness or traumatic experience and proximity to the disaster site." (5-8) Risk perception is an additional factor affecting mental health following a nuclear disaster. (9) Risk perception concerns the subjective judgment that people make about the characteristics and severity of risks.

Similar factors can reasonably be expected to have affected Fukushima residents; indeed, research on health workers dispatched after the earthquake revealed that their concerns over radiation exposure adversely affected their mental health status. (10) Moreover, Japanese people were concerned about the risk of radiation even before the Fukushima disaster, as a result of the atomic bombing of Hiroshima and Nagasaki. (11)

After the Fukushima disaster, the local government launched an extensive health survey to reach evacuees at risk of health problems and to monitor their health status. (12) Here, we assess whether psychological distress is associated with perceived risks of radiation exposure and disaster-related stressors in people who were evacuated from their homes because of the disaster.

Methods

Study design

The Fukushima health management survey was implemented to monitor the long-term health and lifestyle changes of the evacuees following the Fukushima disaster. The present study was conducted as a part of a longitudinal study to monitor the mental health status of evacuees of the Fukushima disaster. (12)

The data reported here are from a baseline cross-sectional survey conducted in 2012, within a year of the disaster. The target population were all residents registered within the government-designated evacuation zone, which included the following municipalities: Hirono-machi, Naraha-machi, Tomioka-machi, Kawauchi-mura, Okuma-machi, Futaba-machi, Namie-machi, Katsurao-mura, Iitate-mura, Minamisoma City, Tamura City and part of Date City in Fukushima prefecture. On January 18, 2012, questionnaires were posted out to evacuees who were at least 15 years old on March 11, 2011 (n = 180 604). The questionnaire on mental health and lifestyle was self-administered. Reminders were sent, but no incentives were offered to the residents. The study was approved by the Ethics Committee of Fukushima Medical University and the National Center of Neurology and Psychiatry, Japan.

Data sources

The outcome variable was non-specific psychological distress as measured by the K6 scale. (13) This scale, which ranges from zero to 24, asks respondents whether they have experienced six mental health symptoms during the past 30 days. Each question is rated on a five-point Likert scale, with higher scores signifying higher psychological distress. The Japanese version of the K6 score has been validated. (14) We defined psychological distress as a K6 score [greater than or equal to] 13. (13)

We measured participants' beliefs about the potential health effects of radiation exposure (15) based on their responses to the following questions: (i) What do you think is the likelihood of having immediate health damage (e. …

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