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A Comparative Survival Analysis Between Evacuees and Nonevacuees Among Dialysis Patients in Fukushima Prefecture After Japan’s 2011 Fukushima Nuclear Incident

Published online by Cambridge University Press:  27 May 2019

Shuhei Nomura*
Affiliation:
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Jyoban Hospital, Tokiwakai Group, Fukushima, Japan Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
Yukie Matsuzaki
Affiliation:
Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
Yuko Sato
Affiliation:
Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
Jyunko Takasaki
Affiliation:
Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
Yuki Sonoda
Affiliation:
Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
Hiroaki Shimmura
Affiliation:
Jyoban Hospital, Tokiwakai Group, Fukushima, Japan
Yuko Kodama
Affiliation:
Graduate School of Education, Seisa University, Kanagawa, Japan
*
Correspondence and reprint requests to Shuhei Nomura, Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (e-mail: [email protected]).

Abstract

Objective:

There has been little research on the health consequences of evacuation in the disaster context. A comparative analysis of survival between evacuated and nonevacuated hospital dialysis patients was conducted following Japan’s Fukushima Dai-ichi nuclear power plant incident, which occurred on March 11, 2011.

Methods:

The study included 554 patients (mean age: 70.9) receiving dialysis therapy at one of the Tokiwakai Group hospitals—all of which are located in and around Iwaki City, approximately 50 km from the Fukushima nuclear plant—as of the incident date. The patients’ survival after the incident was tracked until March 3, 2017. Significant differences in mortality rates between postincident evacuees and nonevacuees were tested using the Bayesian survival analysis with Weibull multivariate regression.

Results:

Out of 554 dialysis patients, 418 (75.5%) were evacuated after the incident. The postincident mortality rate (adjusted for covariates) of evacuees was not statistically significantly different from that of nonevacuees. The hazard ratio was 1.17 (95% credible intervals: 0.77-1.74).

Conclusions:

If performed in a well-planned manner with satisfactory arrangements for appropriate selection of evacuees and their transportation, evacuation could be a reasonable option, which might save more lives of vulnerable people.

Type
Original Research
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

Jia, Z, Tian, W, Liu, W, et al. Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake. BMC Public Health. 2010;10:172.CrossRefGoogle ScholarPubMed
Rafiey, H, Momtaz, YA, Alipour, F, et al. Are older people more vulnerable to long-term impacts of disasters? Clin Interv Aging. 2016;11:17911795.CrossRefGoogle ScholarPubMed
Willoughby, M, Kipsaina, C, Ferrah, N, et al. Mortality in nursing homes following emergency evacuation: a systematic review. J Am Med Dir Assoc. 2017;18(8):664670.CrossRefGoogle ScholarPubMed
Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: emergency planning for patients and dialysis facilities. Clin J Am Soc Nephrol. 2007;2(4):825838.CrossRefGoogle ScholarPubMed
Kleinpeter, MA. Disaster preparedness of dialysis patients for Hurricanes Gustav and Ike 2008. Adv Perit Dial. 2009;25:6267.Google ScholarPubMed
Bailey, JH, Deshazo, RD. Providing healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning. Am J Med Sci. 2008;336(2):124127.CrossRefGoogle ScholarPubMed
Zoraster, R, Vanholder, R, Sever, MS. Disaster management of chronic dialysis patients. Am J Disaster Med. 2007;2(2):96106.CrossRefGoogle ScholarPubMed
Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814824.CrossRefGoogle ScholarPubMed
Dosa, DM, Grossman, N, Wetle, T, et al. To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007;8(3):142149.CrossRefGoogle ScholarPubMed
Dosa, D, Hyer, K, Thomas, K, et al. To evacuate or shelter in place: implications of universal hurricane evacuation policies on nursing home residents. J Am Med Dir Assoc. 2012;13(2):190e1190e17.CrossRefGoogle ScholarPubMed
Pierce, JR, Morley, SK, West, TA, et al. Improving long-term care facility disaster preparedness and response: a literature review. Disaster Med Public Health Prep. 2017;11(1):140149.CrossRefGoogle ScholarPubMed
Ochi, S, Tsubokura, M, Kato, S, et al. Hospital staff shortage after the 2011 triple disaster in Fukushima, Japan—an earthquake, tsunamis, and nuclear power plant accident: a case of the Soso District. PLoS One. 2016;11(10):e0164952.CrossRefGoogle ScholarPubMed
Coleman, L. Frequency of man-made disasters in the 20th century. J Contingencies Crisis Manage. 2006;14(1):311.CrossRefGoogle Scholar
Congdon, P. Bayesian Statistical Modelling. New Jersey: Wiley; 2007.Google Scholar
Zhang, Z. Parametric regression model for survival data: Weibull regression model as an example. Ann Transl Med. 2016;4(24):484.CrossRefGoogle ScholarPubMed
Nomura, S, Blangiardo, M, Tsubokura, M, et al. Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: a comparative analysis between evacuees and non-evacuees. Prev Med. 2016;82:7782.CrossRefGoogle ScholarPubMed
Nomura, S, Gilmour, S, Tsubokura, M, et al. Mortality risk amongst nursing home residents evacuated after the Fukushima nuclear accident: a retrospective cohort study. PLoS One. 2013;8(3):e60192.CrossRefGoogle ScholarPubMed
Nomura, S, Parsons, AJQ, Hirabayashi, M, et al. Social determinants of mid- to long-term disaster impacts on health: a systematic review. Int J Disaster Risk Reduct. 2016;16:5367.CrossRefGoogle Scholar
Brown, LM, Dosa, DM, Thomas, K, et al. The effects of evacuation on nursing home residents with dementia. Am J Alzheimers Dis Other Demen. 2012;27(6):406412.CrossRefGoogle ScholarPubMed
Blanchard, G, Dosa, D. A comparison of the nursing home evacuation experience between hurricanes katrina (2005) and gustav (2008). J Am Med Dir Assoc. 2009;10(9):639643.CrossRefGoogle Scholar
Archibald, E, McNeil, S. Learning from traffic data collected before, during and after a hurricane. IATSS Res. 2012;36(1):110.CrossRefGoogle Scholar
Castle, NG. Nursing home evacuation plans. Am J Public Health. 2008;98(7):12351240.CrossRefGoogle ScholarPubMed
McCurry, J. Anxiety over radiation exposure remains high in Japan. Lancet. 2011;378(9796):10611062.CrossRefGoogle Scholar
Murakami, M, Ono, K, Tsubokura, M, et al. Was the risk from nursing-home evacuation after the Fukushima accident higher than the radiation risk? PLoS One. 2015;10(9):e0137906.CrossRefGoogle Scholar
Nomura, S, Shimada, Y, Ozaki, A, et al. Balancing the risk of the evacuation and sheltering-in-place options: a survival study following Japan’s 2011 Fukushima nuclear incident. BMJ Open. 2018;8(7):e021482.Google ScholarPubMed