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.”
