Radiation Emergency Medical Preparedness in Japan: A Survey of Nuclear Emergency Core Hospitals

Abstract

Objective: Based on experiences following the Great East Japan Earthquake and nuclear power plant accident in 2011, Nuclear Emergency Core Hospitals (NECHs) were designated as centers for radiation disaster management in Japan. This study aimed to investigate their current status and identify areas for improvement. Methods: This cross-sectional study was conducted in October 2018. Demographic data were collected by a questionnaire with free text responses about attitudes toward NECHs. Considerations regarding risk communications during a radiation disaster were analyzed using qualitative text mining analysis. Results: A total of 36 hospitals participated in this study. Only 31% of NECHs anticipated a radiation disaster. The importance of business continuity plans and risk communications was shown. Text analysis identified 7 important categories for health care workers during a radiation disaster, including media response, communications to hospital staff, risk communications, radiation effects on children, planning for a radiation disaster in the region, rumors, and the role in the region. Conclusion: The radiation disaster medical system and NECHs in Japan were surveyed. The importance of risk communications, planning for a radiation disaster in each region, and the role in the region are identified as issues that need to be addressed.

Factors Affecting the Intervention of Health-Care Professionals in Radiological Events: A Systematic Review

“…18,20 It was also seen that their hospitals did not accept the injured because of the high contamination levels. 18,20,21 Based on these reasons, it is understood that the medical intervention of ambulances and hospitals in high contamination casualties was insufficient. In addition, in another study, it was emphasized that the number of specialist personnel to respond to the injured was insufficient when such events occurred.…”

“…A quantitative study called Nuclear Emergency Core Hospitals mentioned that it was difficult to organize medical intervention in radiological events. 21 In 2 qualitative studies describing the radiological events experienced in the past, it was stated that the ambulance staff had problems with the hospital supervisor and that the occupational groups responsible for such incidents in the hospital could not reach a common decision on accepting contaminated patients. Therefore, it is seen that patients could not access treatment for a long time.…”

“…19 In addition, it was mentioned that health-care professionals did not want to receive training due to the rare occurrence of radiological disasters or the low probability of encountering them, that they could not receive training, and that additional training/technical support was not provided. 10,15,16,18,21,24 For this reason, it was stated that health-care professionals did not know where the personal protective equipment was, that they were afraid of risking their own health, and that they could not provide the medical treatment that the victim affected by the radiological release needed. 17,[23][24][25][26] In 1 study, it was expressed that health-care professionals did not have sufficient experience due to the rare occurrence of a radiological event.…”

“…28 In addition, in 2 qualitative studies, it was mentioned that these fears and concerns of health-care professionals affected their treatment decisions and that they had difficulty in continuing their operations. 21,27 In a survey conducted after the Fukushima earthquake in 2011, it was determined that health professionals had concerns about exposure to radiation. 29 It was mentioned that this concern caused stress and psychological problems among health-care professionals.…”

“…30 In another study, although it was stated that risk communication was important among health-care professionals, it was mentioned that such an infrastructure did not exist. 21 Finally, it was observed that health professionals had difficulty in communicating with each other due to having to wear protective clothing, and that they could not communicate quickly and effectively due to the problems experienced in the communication networks at the scene. 22 7.…”