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      Environmental radiation level, radiation anxiety, and psychological distress of non-evacuee residents in Fukushima five years after the Great East Japan Earthquake: Multilevel analyses ☆

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          Abstract

          The present study aimed to clarify the associations among radiation exposure or psychological exposure to the Fukushima nuclear power plant accident (i.e., fear/anxiety immediately after the accident), current radiation anxiety, and psychological distress among non-evacuee community residents in Fukushima five years after the Great East Japan Earthquake, which occurred in March 2011. A questionnaire survey was administered to a random sample of non-evacuee community residents from 49 municipalities of Fukushima prefecture from February to April 2016, and data from 1684 respondents (34.4%) were analyzed. Environmental radiation levels at the time of the accident were ascertained from survey meter data, while environmental radiation levels at the time of the survey were ascertained from monitoring post data. In the questionnaire, immediate fear/anxiety after the accident, current radiation anxiety, and psychological distress were measured using a single-item question, a 7-item scale, and K6, respectively. Multilevel linear or logistic regression models were applied to analyze the determinants of radiation anxiety and psychological distress. The findings showed that environmental radiation levels at the time of the survey were more strongly associated with radiation anxiety than radiation levels immediately after the accident. Disaster-related experiences, such as direct damage, disaster-related family stress, and fear/anxiety after the accident, and demographic characteristics (e.g., younger age, being married, low socioeconomic status) were significantly associated with radiation anxiety. Environmental radiation levels at the time of the accident or survey were not significantly associated with psychological distress. Radiation anxiety largely mediated the association between fear/anxiety after the accident and psychological distress. In addition to environmental radiation levels, respondents’ radiation anxiety was affected by multiple factors, such as disaster-related experiences and demographic characteristics. Radiation levels were not associated with psychological distress in non-evacuee community residents. Rather, fear/anxiety after the nuclear power plant accident may be a determinant of psychological distress, mediated by radiation anxiety.

          Highlights

          • •

            Environmental radiation levels affected radiation anxiety.

          • •

            Environmental radiation levels did not affect psychological distress.

          • •

            Fear/anxiety at time of nuclear power plant accident affected radiation anxiety.

          • •

            Fear/anxiety at time of accident affected psychological distress.

          • •

            Radiation anxiety mediated the effect of fear/anxiety on psychological distress.

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          Most cited references21

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          A 25 year retrospective review of the psychological consequences of the Chernobyl accident.

          E.J. Bromet, J.M. Havenaar, L.T. Guey (2011)
          The Chernobyl Forum Report from the 20th anniversary of the Chernobyl nuclear power plant disaster concluded that mental health effects were the most significant public health consequence of the accident. This paper provides an updated review of research on the psychological impact of the accident during the 25 year period since the catastrophe began. First responders and clean-up workers had the greatest exposure to radiation. Recent studies show that their rates of depression and post-traumatic stress disorder remain elevated two decades later. Very young children and those in utero who lived near the plant when it exploded or in severely contaminated areas have been the subject of considerable research, but the findings are inconsistent. Recent studies of prenatally exposed children conducted in Kiev, Norway and Finland point to specific neuropsychological and psychological impairments associated with radiation exposure, whereas other studies found no significant cognitive or mental health effects in exposed children grown up. General population studies report increased rates of poor self-rated health as well as clinical and subclinical depression, anxiety, and post-traumatic stress disorder. Mothers of young children exposed to the disaster remain a high-risk group for these conditions, primarily due to lingering worries about the adverse health effects on their families. Thus, long-term mental health consequences continue to be a concern. The unmet need for mental health care in affected regions remains an important public health challenge 25 years later. Future research is needed that combines physical and mental health outcome measures to complete the clinical picture. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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            Social capital, income inequality and self-rated health in Chita peninsula, Japan: a multilevel analysis of older people in 25 communities.

            Yukinobu Ichida, Katsunori Kondo, Hiroshi Hirai … (2009)
            The effect of social capital on one's health has drawn researchers' attention. In East-Asian countries, however, such an effect has been less studied than in Western countries. Mindful of this background, this study aimed to investigate the linkage between social capital and health at the level of a small area in Japan, and also to examine whether social capital mediates the relation between income inequality and health. The main survey targeted 34,374 people aged 65 years and older from 25 communities who were without the need of nursing care. We collected 17,269 questionnaires (response rate 50.2%), from which we used 15,225 (response rate 44.3%) which had complete information on self-rated health, age, and sex. The main outcome measure was self-rated health status (1=fair/poor; 0=very good/good). The individual-level variables of age, sex, equivalised income, marital status, educational attainment, and type of housing were included to control for compositional effects. Average income, social capital and the Gini coefficient were used as community-level variables. The variable of social capital was calculated as the percentage of individuals in the community samples who reported "yes" or "it depends" to the question "Generally speaking, would you say that most people can be trusted?" When the individual-level variables and the average equivalised income at the community level were controlled for, we found that high social capital and a decreased Gini coefficient were significantly associated with good self-rated health using a multilevel model. The association between social capital and self-rated health was insignificant after adjustment for the Gini coefficient. However, in other series of models, we also detected a statistically significant linkage between the increased Gini coefficient and negative responses to the question of individual-level trust using multilevel models. This suggests that people who live in conditions of high-income inequality tend to exhibit low trust levels, and that social capital mediates the relation between income inequality and health. This study is, to our knowledge, the first investigation of the linkage between social capital and health in Japan using multilevel analysis, and reports the first supported result of the relative income hypothesis in Japan. Additionally, the statistically significant linkage between the increased Gini coefficient and low trust observed in this study provides additional evidence to support the social cohesion and collective social pathway between income inequality and health.
            Article 0 comments Cited 51 times – based on 0 reviews     Review now
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              Long-term mental health effects of the Chernobyl disaster: an epidemiologic survey in two former Soviet regions.

              N Poelijoe, G Rumyantzeva, M W J Koeter … (1997)
              This study assessed the long-term mental health effects of the nuclear accident at Chernobyl. Two population samples (N = 3,044), one from the Gomel region, close to the accident site, and one from Tver, 500 miles away, were studied 6 1/2 years after the event with the use of a variety of self-report questionnaires and a standardized psychiatric interview. The prevalence of psychological distress and DSM-III-R psychiatric disorders was exceptionally high in both regions. Scores on the self-report scales were consistently higher in the exposed region; however, a higher risk of DSM-III-R psychiatric disorders could be demonstrated only among women with children under 18 years of age in the exposed region. A substantial long-term mental health effect of the Chernobyl incident was demonstrated, mainly at a subclinical level.
              Article 0 comments Cited 39 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Norito Kawakami
                Journal
                Journal ID (nlm-ta): SSM Popul Health
                Journal ID (iso-abbrev): SSM Popul Health
                Title: SSM - Population Health
                Publisher: Elsevier
                ISSN (Electronic): 2352-8273
                Publication date PMC-release: 19 September 2017
                Publication date Collection: December 2017
                Publication date (Electronic): 19 September 2017
                Volume: 3
                Pages: 740-748
                Affiliations
                [a ]Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-0033, Japan
                [b ]Department of Neuropsychiatry and Department of Psychosomatic Medicine, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan
                [c ]Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima City 960-1295, Japan
                [d ]Department of Public Health, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City 960-1295, Japan
                [e ]Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima City 960-1295, Japan
                [f ]Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
                Author notes
                [* ]Corresponding author. nkawakami@ 123456m.u-tokyo.ac.jp
                [1]

                Present address: Graduate School of Nursing Science, St Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan

                Article
                Publisher ID: S2352-8273(17)30163-5
                DOI: 10.1016/j.ssmph.2017.09.002
                PMC ID: 5769096
                PubMed ID: 29349260
                SO-VID: 061cc716-e312-4787-95aa-3a698c03f80f
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 19 July 2017
                Date revision received : 23 August 2017
                Date accepted : 16 September 2017
                Categories
                Subject: Article

                Keywords: fukushima,mental health,radiation anxiety,nuclear power plant accident,environmental radiation level,great east japan earthquake
                Data availability:
                Keywords: fukushima, mental health, radiation anxiety, nuclear power plant accident, environmental radiation level, great east japan earthquake

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