Trends in Lifestyle-related Diseases and Their Risk Factors After the Fukushima Daiichi Nuclear Power Plant Accident: Results of the Comprehensive Health Check in the Fukushima Health Management Survey

Abstract

Residents were forced to evacuate owing to the radiation released after the Fukushima Nuclear Power Plant (NPP) accident following the Great East Japan Earthquake on 11/03/2021; thus, their lifestyles drastically changed. The Comprehensive Health Check (CHC) of the Fukushima Health Management Survey (FHMS) was performed to evaluate health statuses and prevent lifestyle-related diseases in evacuation area residents. The first part of the CHC survey is a retrospective analysis of pre- and post-disaster data on health check-ups of evacuation area residents. The second part is a cross-sectional, prospective analysis of post-disaster (fiscal year (FY) 2011–2017) data on health check-ups. Subjects were men and women living in 13 municipalities in areas surrounding the NPP in Fukushima Prefecture. Post-disaster (FY 2011–2012) overweight, hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome, liver dysfunction, hyperuricemia, polycythemia and atrial fibrillation cases increased from the pre-disaster (FY 2008–2010) levels. This tendency was strongest among residents who were forced to evacuate. Proportion of overweight people remained unchanged, the prevalence of liver dysfunction decreased and the proportion of people with treated hypertension and dyslipidemia increased during FY 2011–2017. Meanwhile, the prevalence of diabetes mellitus and mean levels of HbA1c increased. Furthermore, Evacuees showed higher risks of diabetes mellitus, dyslipidemia, chronic kidney diseases and liver dysfunction than non-evacuees. Therefore, residents in the evacuation area, especially evacuees, are at high risk of developing lifestyle-related diseases, especially cardiovascular diseases; therefore, it is necessary to observe health statuses and implement measures to prevent lifestyle-related diseases.

Achievements and Current Status of the Fukushima Health Management Survey

“… 21 , 34 Furthermore, residents aged 16 years and older experienced an increase in the prevalence of obesity, dyslipidemia, hyperuricemia, liver dysfunction, hypertension, diabetes mellitus, metabolic syndrome, and kidney disease after the accident, and these increases were influenced by the evacuation. 9 , 35 Between 2011 and 2017, the prevalence of people who were overweight remained the same, the prevalence of liver dysfunction decreased, and the proportion of people with controlled hypertension and dyslipidemia increased. 9 Conversely, radiation exposure does not appear to have had any marked effect on residents’ white blood cell counts, including their neutrophil and lymphocyte counts, and lifestyle-related factors.…”

“…Protocols in the FHMS have been reported elsewhere. 1 , 6 In brief, the FHMS consists of the Basic Survey 7 and four detailed surveys: the Thyroid Ultrasound Examination, 8 Comprehensive Health Check, 9 Mental Health and Lifestyle Survey, 10 and Pregnancy and Birth Survey (Figure 1 ). 11 , 12 The eligible population of the Basic Survey was mainly individuals registered as residents in Fukushima Prefecture between March 11 and July 1, 2011 (including evacuees) and residents of other prefectures who commute to Fukushima Prefecture, totaling approximately 2.05 million people.…”

“… 1 The subjects were comprised of almost 210,000 individuals who were registered as residents in the evacuation area in Fukushima Prefecture between March 11, 2011 and April 1, 2012. 1 , 9 This area included the 13 municipalities of Tamura City, Minamisoma City, Kawamata Town, Hirono Town, Naraha Town, Tomioka Town, Kawauchi Village, Okuma Town, Futaba Town, Namie Town, Katsurao Village, Iitate Village, and Date City. Annual health check-ups have been conducted among residents of all ages in these municipalities since 2011.…”

“…The items to be measured depended on the age of the participants, but for those aged 16 and older, the measurements included white blood cell fractions, uric acid, creatinine, and estimated glomerular filtration rate (eGFR), in addition to the usual specified health checkup measurements. 1 , 9 , 20 , 21 …”

Effects of External Radiation Exposure Resulting From the Fukushima Daiichi Nuclear Power Plant Accident on the Health of Residents in the Evacuation Zones: the Fukushima Health Management Survey

“…Detailed methods of the CHC have been reported elsewhere. 1 – 3 , 21 The number of medical examinees in fiscal year (FY) 2011 was 72,869 (31,982 men; 40,887 women), and the participation rate for the initial census population was 30.9% for people ≥16 years old. We excluded 18,782 examinees who were <16 or ≥85 years of age as of March 11, 2011 from the study.…”