The July 22 Tokyo Shimbun article, "Running Backwards on Health Support After the Nuclear Accident: Ministry of Environment Expert Meeting"

On July 22, 2014, Tokyo Shimbun published an article titled, "Running Backwards on Health Support After the Nuclear Accident: Ministry of Environment Expert Meeting." The entire article is only available in the paper edition as in the image below, but it has been written out in this blog post.

Below is the complete English translation of this article.

Running Backwards on Health Support After the Nuclear Accident: Ministry of Environment Expert Meeting

The Ministry of the Environment (MOE) Expert Meeting Discussing Health Support After the Fukushima Nuclear Accident is taking an unthinkable twist. At the July 16th meeting, an outside researcher asked for the expansion of health checkups, but the committee chair looked the other way, stating “I don’t want to discuss the issue.” The expansion of health checkup is part of the Act Concerning Support for Children and Disaster Victims, but the committee chair himself voiced an opinion, “We now have different circumstances from when the Act was first approved.” There is no way disaster victims can accept such attitudes. (by T. Sakakibara)

◆ Hesitant on the Expansion of Health Checkups

“Radioactive materials [being disseminated due to the Fukushima nuclear accident] are not thought to remain within borders of Fukushima Prefecture. We need to urgently figure out if there are any cases in non-Fukushima residents. We should not be fixated only on dose assessments.”

It was the Ministry of the Environment Expert Meeting held on July 16th. An invited guest speaker Toshihide Tsuda, an epidemiologist and an Okayama University professor, challenged the current state of the meeting spending time on discussing what the exposure dose was for residents within and out of Fukushima Prefecture.

However, Shigenobu Nagataki, the committee chair and a former chairman of Radiation Effects Research Foundation, pushed aside what Professor Tsuda pointed out, stating, “You are extremely unique.”

Fukushima Prefecture began the Prefectural Resident Health Survey immediately after the accident, including thyroid examination for those who were under age 18 at the time of the accident. However, the central government currently pays for health examination only for Fukushima residents. Therefore, the Expert Meeting is presently discussing whether other areas might need health checkups.

Chairman Nagataki has set a policy to: 1) Assess the exposure dose for residents within and out of Fukushima Prefecture; 2) Analyze health effects based on the dose; and 3) Consider which health support might be necessary. At the last meeting (the seventh session) on June 26th, the rough outline of dose assessment was finally put together.

The outline, based on the dose estimates by an Independent Administrative Institution, National Institute of Radiological Sciences, as well as the behavior questionnaire of residents by Fukushima Prefecture, stated that the internal exposure dose from radioactive iodine that can cause thyroid cancer was “mostly under 50 mSv.” In regards to the external exposure dose, it noted that “The survey finding, ’99.8% was under 5 mSv in Fukushima Prefecture,’ could be reasonably applied to see the overall tendency.”

However, there are large uncertainties in this assessment result.

Only about 1,000 had direct measurements of exposure from radioactive iodine taken, which is 0.3% of residents eligible for thyroid examination by Fukushima Prefecture. Radioactive iodine has a short half-life of 8 days and cannot be measured now. Behavior questionnaires for external dose assessment had a low response rate of only 25.9%.

During the meeting, Professor Tsuda claimed, “When considering a causal relationship between an illness and a cause, data for the cause often tends to be scant. It is a principle of international epidemiological analysis to see it from the side of the illness. Considering the cause first is merely a laboratory method.”

In addition, he continued, “Fixating on dose assessments will delay countermeasures, worsening the damage.” He emphasized that health checkups should be immediately carried out within and out of Fukushima Prefecture, in order to identify cases of thyroid cancer and other illnesses and to analyze whether the number of cases increased after the accident or whether there are regional differences.

Despite inviting Professor Tsuda to the meeting, Chairman Nagataki practically ignored his opinion.

To this response [by Nagataki calling him unique], Professor Tsuda retorted, “My opinions are based on a textbook published by Oxford University Press. Chairman, you are the one that is unique.” However, Chairman Nagataki unilaterally cut off the conversation, stating, “I have no intention of arguing with you. We are going to carry on discussion based on exposure dose.”

◆ Not Meeting the Expectations by Residents

Passive assessments of radiation health effects by the Japanese government predate this meeting.

The Cabinet Office expert meeting, “Working Group (WG) on Risk Management of Low-dose Radiation Exposure,” put together a report in December 2011, concluding, “…increased risk of cancer from low-dose radiation exposures at 100 mSv or less is so small as to be concealed by carcinogenic effects from other factors, making verification of any clear cancer risk from radiation exceedingly challenging.”　

The Cabinet Office WG was also headed by Nagataki. It also included other members of the MOE expert meeting, such as Ostura Niwa, a special professor at Fukushima Medical University, and Keigo Endo, president of Kyoto College of Medical Science.

The expert meeting, at this point of time, is leaning in the direction of “Radiation health effects cannot be proven,” and “As the effects cannot be proven, even health checkups within Fukushima Prefecture are unnecessary,” since the exposure dose within and out of Fukushima Prefecture is expected to be significantly lower than 100 mSv.

In fact, the expert meeting already has some opinions hesitant on expanding health checkups.

The Act Concerning Support for Children and Disaster Victims [English translation here], approved in June 2012, asks for expansion of health checkups as well as reduction of medical expenses, but Chairman Nagataki cast doubt on the need for it at the seventh session, stating “Circumstances are quite different now compared to the time when the act was approved,” and, “As the dose assessment has progressed, we can now make scientific statements in regards to the risk.”

Likewise, during the same session, a member of the expert meeting and a professor at Osaka University, Tomotaka Sobue, explained disadvantages of health checkups using the term, “overdiagnosis.”

This means that since a slow-growing cancer, such as thyroid cancer, has a possibility of never becoming symptomatic in lifetime and causing damages to the body, discovery of cancer during health checkups could cause excessive anxiety and a psychological and physical burden due to surgery.

Another member and the clinic director at International University of Health and Welfare, Gen Suzuki, claimed “An adequate debate needs to be carried out as to whether the best answer is to conduct health checkups as a response to anxiety by residents regarding their health.”

However, requests for expansion of health checkups are swelling from the side of the parties involved, the residents.

On July 13th, there was an event in Metropolitan Tokyo for mothers from within and out of Fukushima Prefecture to talk about life after the nuclear accident.

One of the participants, Kaoru Inagaki (age 42), a member of citizen’s group, Kanto Children Health Survey Support Fund, which conducts thyroid examination in four prefectures including Tochigi, Ibaraki, Chiba and Saitama, said, “When we announce openings for the examination, they are immediately taken up.”

Another participant, Kumi Kanome (age 46), a mother who evacuated with a second-grade daughter to Kanagawa Prefecture from Otama Village, Fukushima Prefecture, appealed, “The nuclear accident increased our worries about children’s illnesses. It is natural for us to want to have them checked out. Regardless of whether living in or outside Fukushima Prefecture, any mother would feel that way.”

Emiko Ito (age 51), director of the event organizer, non-profit organization “National Parents Network to Protect Children from Radiation,” said, “The expert meeting is ignoring the Act Concerning Support for Children and Disaster Victims. That won’t be conducive to resolving residents’ anxiety. It only leads to mistrust.”

Some of the members of the expert meeting have different views. One of them, Hiromi Ishikawa, Executive Director of Japan Medical Association, criticizes, “The present expert meeting does not reflect opinions of the residents. I don’t know why anybody would just one-sidedly tell worried people, ‘It’s okay.’”

From a stand point of “nobody knows the effect of low-dose radiation exposure,” he says, “We need to quickly consider whether there are any illnesses due to radiation and how to deal with them if there are any. Worries can be only resolved when we are prepared that way.”

“Advantages and disadvantages of health checkups are not something that can be uniformly decided by those who are called experts. We need to establish the system for health checkups and let the residents, who are the parties involved, decide.”

Memo from the editing desk:

Mr. Nagataki is running the expert meeting. This fact alone makes it clear how the government has summed up the Fukushima nuclear accident. The predecessor of Radiation Effects Research Foundation was the United States Atomic Bomb Casualty Commission (ABCC), which “investigated the effects of atomic bombs without treatment.” A network originating there was involved in developing the “Myth of Infallible Safety.” Now they are working hard to spread the “Myth of Reassurance.”