OBJECTIVES: After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village. METHODS: Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: "Diabetes (DM)" (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5% or hospital visit for DM or usage of diabetic medication), "Borderline DM" (126 mg/dL > FBG ≥ 110 mg/dL or 6.5% > HbA1c ≥ 6.0%, and without hospital visit, and without diabetic medication), and "Normoglycemic" (FBG < 110 mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9 years in Kawauchi village and 3.6 years in Ono town. RESULTS: Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village. CONCLUSIONS The current results confirmed that diabetes incidence was increased 6 years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority.
Aged ; Cohort Studies ; Diabetes Mellitus ; epidemiology ; etiology ; Female ; Fukushima Nuclear Accident ; Health Surveys ; Humans ; Incidence ; Japan ; epidemiology ; Life Style ; Male ; Middle Aged ; Retrospective Studies

Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation.
DNA Damage/drug effects ; Environmental Exposure ; Humans ; Leukemia/epidemiology/etiology ; Neoplasms, Radiation-Induced/epidemiology ; *Radiation Dosage ; Radiation Tolerance ; *Radiation, Ionizing ; Radioactive Hazard Release ; Risk

PURPOSE: The aim of this study was to evaluate the characteristics of Emergency Medical Service (EMS) provider responded chemical, biological, radiological, and nuclear (CBRN) incidents in Korea. METHODS: Nationwide EMS rescue records from Jan 2012 to Dec 2014 were analyzed. All EMS rescue records were integrated according to the unique accident ID. Cases related to animal rescue, hive removal, and suicide-related were excluded. CBRN-associated keywords were extracted by literature review and pilot survey. In-depth review of cases containing CBRN-associated keywords in the activity summary were conducted by trained emergency medical technicians, and predefined information was abstracted. Descriptive analyses were performed to characterize the EMS provider responded CBRN incidents. RESULTS: A total of 1,571,293 cases were included, and 1,335,205 cases had a unique accident ID; 515,417 cases were excluded because of their association with animal rescue, hive removal, and suicide attempts; 19,663 cases contained CBRN-associated keywords in the activity summary, and in-depth review identified 1,862 cases as CBRN incidents. Among them 1,856 cases were chemical incidents, and 6 cases were radiological incidents; 144 cases were resulted to victims. In chemical incidents, ammonia, hydrogen chloride, sulfuric acid, hydrogen fluoride, and nitric acid were the top 5 toxic substances. In chemical incidents with victims, the proportion of explosion/implosion, and suffocation in sealed space was more prevalent than chemical incidents without victims. Median scene time of all CBRN incidents was 41 minutes (interquartile range 18.0-57.0). CONCLUSION: We evaluated the characteristics of CBRN incidents responded by EMS in Korea.
Ammonia ; Animals ; Asphyxia ; Biohazard Release ; Chemical Hazard Release ; Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians ; Humans ; Hydrochloric Acid ; Hydrofluoric Acid ; Korea ; Nitric Acid ; Radioactive Hazard Release ; Suicide ; Sulfur

Disasters, or mass casualty incidents, occurring in modern history differ from those occurring in even the recent past. In previous times, disasters were mostly the result of natural causes such as earthquakes or floods. Currently, multiple casualty incidents are often the result of human actions such as vehicular accidents involving many vehicles with multiple operators, passengers and collateral victims, terror attacks and acts of war, radiation accidents, toxic chemical releases, and pandemic infectious agent exposures. Especially, events involving accidental and intentional exposures of chemical, biological, radiological/nuclear materials, often abbreviated as CBR or CBRN events present unique challenges to the healthcare system in caring for the victims. In these mass casualty incidents, a fully comprehensive, coordinated team response involving many different components of the community healthcare system need to be mobilized to effectively meet the modern challenge of CBRN events. Necessary components of a modern emergency response include training for prompt triage, decontamination, detoxification, emergency medical treatment, as well as providing appropriate transport to the proper medical treatment facility. Meeting these challenges requires maintaining ongoing communications between agencies charged with meeting the disaster to allow acquisition of information and location for the patients, transfer the information to both the Central Medical Emergency Response Center and the designated hospital. While sharing this information was problematic in the past, modern wireless communications and information technologies provide convenient means for the rapid sharing of important patient data and current situational details. Finally, improving modern disaster response requires the development of a disaster response plan, ongoing training in implementing the plan including disaster scenario simulation, and budgeting to acquire the necessary equipment involved for the emergency response personnel to meet the presenting crisis.
Budgets ; Community Health Services ; Decontamination ; Delivery of Health Care ; Disasters* ; Earthquakes ; Emergencies* ; Emergency Medical Service Communication Systems ; Emergency Medical Services* ; Floods ; History, Modern 1601- ; Humans ; Mass Casualty Incidents ; Pandemics ; Radioactive Hazard Release ; Transportation of Patients ; Triage

Humans ; Radiation Injuries ; drug therapy ; prevention & control ; Radiation, Nonionizing ; Radiation-Protective Agents ; therapeutic use ; Radioactive Hazard Release ; prevention & control

Although ionizing radiation is known to induce cellular senescence in vitro and in vivo, its long-term in vivo effects are not well defined. In this study, we examined the prolonged expression of senescence markers in mice irradiated with single or fractionated doses. C57BL/6 female mice were exposed to 5 Gy of gamma-rays in single or 5, 10, 25 fractions. At 2, 4, and 6 months after irradiation, senescence markers including mitochondrial DNA (mtDNA) common deletion, p21, and senescence-associated beta-galactosidase (SA beta-gal) were monitored in the lung, liver, and kidney. Increases of mtDNA deletion were detected in the lung, liver, and kidney of irradiated groups. p21 expression and SA beta-gal staining were also increased in the irradiated groups compared to the non-irradiated control group. Increases of senescence markers persisted up to 6 months after irradiation. Additionally, the extent of mtDNA deletion and the numbers of SA beta-gal positive cells were greater as the number of radiation fractions increased. In conclusion, our results showed that ionizing radiation, especially that delivered in fractions, can cause the persistent upregulation of senescence marker expression in vivo. This should be considered when dealing with chronic normal tissue injuries caused by radiation therapy or radiation accidents.
Aging ; Animals ; Cell Aging ; DNA, Mitochondrial ; Female ; Humans ; Kidney ; Liver ; Lung ; Mice ; Radiation, Ionizing ; Radioactive Hazard Release ; Up-Regulation ; beta-Galactosidase

Chernobyl Nuclear Accident ; Humans ; Japan ; epidemiology ; Neoplasms, Radiation-Induced ; etiology ; mortality ; Nuclear Warfare ; Radiation Dosage ; Radiation Injuries ; etiology ; mortality ; Radioactive Hazard Release ; Risk ; Ukraine ; epidemiology

Radiation risk has become well known through epidemiological studies of clinically or occupationally exposed populations, animal experiments, and in vitro studies; however, the study of radiation related or induced disease has been limited in Korea. This study is to find the level of occupational radiation exposure for various kinds of accidents, compensated occupational diseases, related studies, and estimations on future occupational disease risks. Research data of related institutions were additionally investigated. About 67% of 62,553 radiation workers had no exposure or less than 1.2 mSv per year. The 5 reported cases on radiation accident patients in Korea occurred during nondestructive testing. According to the recent rapid increase in the number of workers exposed to radiation, a higher social recognition of cancer, and an increasing cancer mortality rate, it is expected that occupational disease compensation will rapidly increase as well. Therefore, it is important to develop scientific and objective decision methods, such as probability of causation and screening dose in the establishment of an exposure and health surveillance system.
Female ; Humans ; Male ; Neoplasms, Radiation-Induced/*epidemiology ; Nuclear Power Plants ; Occupational Diseases/*epidemiology/etiology ; Occupational Exposure ; Radiation Injuries/*epidemiology ; *Radiation, Ionizing ; Radioactive Hazard Release/*statistics & numerical data ; Republic of Korea/epidemiology

Korea has advanced nuclear and radioisotope industry, and it is urgent to establish a national system to countermeasure the radiation accidents and preparedness for radiation emergency medical management. The Government opened the National Radiation Emergency Medical Center (NREMC) in the Korea Institute of Radiological and Medical Sciences (KIRAMS) in 2002, and the NREMC is setting up a radiation emergency medical preparedness and assistance network in nationwide. On April 30, 2003 the special law was proposed for the physical protection of nuclear facilities and emergency response against radiological accidents, which includes medical preparedness and management. Detailed guidelines for this law is being prepared by the Ministry of Science and Technology (MOST), and will be take effect in February 2004. Per this guideline, regional emergency medical centers will be appointed by the MOST, and the NREMC will operate this national system including education of the medical personnel.
Education ; Emergencies* ; Jurisprudence ; Korea ; Medical Assistance* ; Radioactive Hazard Release

Radiation disasters have a potential to cause a widespread feeling of destruction of safety in life and severe and complicated psychiatric problems to individuals and community. When a radiation accident occurs, it is essential to recognize the importance of psychosocial issues and to focus on the mental health aspect of victims. A radiation accident can produce profound psychological impacts at all levels of society, affecting individuals, families, communities, and the nation as a whole. These psychological effects may create longer-term problems, and the social stigma can be powerful and pervasive. The "post-traumatic stress reaction" has a broad range of disturbances from hyperarousal to psychiatric disorders, and can produce a marked deterioration in the quality of life. The strategy of the continuing care has been modest, based on promoting the victims' self-esteem and ability to cope with the disaster, while providing both social and life support. Rapid and appropriate intervention containing 'information management' is essential to prevent the progression of psychiatric disorders. Consideration of psychosocial factors needs to be an integral part of domestic preparedness efforts including multidimensional approach (planning, education, training, forum, and response operations). Therefore mental health care should be incorporated into the global strategy for victims' care, and this has to be done at a very early stage after the accident.
Disasters ; Education ; Humans ; Information Management ; Mental Health ; Psychology ; Quality of Life ; Radioactive Hazard Release* ; Social Stigma