Naomi Hayashida

Thyroid function is associated with carotid intima-media thickness in euthyroid subjects.

To investigate the relationship between thyroid function and carotid intima-media thickness (CIMT) in a relatively large general population with euthyroid status we initially enrolled 1772 Japanese adults (421 men and 1351 women) who participated in a medical screening program for the general population over 40 years old. To evaluate only euthyroid subjects without vascular diseases and/or its major risk factors, 1129 were excluded and 643 participants (175 men and 468 women) were included for further analysis. Simple and multivariate linear regression analyses were performed to evaluate free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels and other existing parameters, including carotid intima-media thickness. By multivariate linear regression analysis adjusted for age and sex, free thyroxine was significantly correlated with triglycerides (beta=0.07, p=0.015), carotid intima-media thickness (beta=-0.091, p=0.049), and thyroid-stimulating hormone (beta=-0.091, p=0.003). Thyroid-stimulating hormone was significantly correlated with high-density lipoprotein cholesterol (HDL-C) (beta=-0.001, p=0.015), HbA(1c) (beta=0.038, p=0.045), carotid intima-media thickness (beta=0.27, p=0.001), and free thyroxine (beta=-0.15, p=0.003). When adjusted for confounding factors, free thyroxine was significantly correlated only with carotid intima-media thickness (beta=-0.13, p=0.043) and thyroid-stimulating hormone was significantly correlated with HDL-C (beta=-0.001, p<0.001), HbA(1c) (beta=0.04, p=0.021), and carotid intima-media thickness (beta=0.29, p=0.001). We have demonstrated that carotid intima-media thickness is independently associated with thyroid function within the normal reference range, which suggests an increased cardiovascular risk in subjects with low normal thyroid function.

Thyroid ultrasound findings in children from three Japanese prefectures: Aomori, Yamanashi and Nagasaki.

Due to the likelihood of physical and mental health impacts following the unprecedented accident at the Fukushima Dai-ichi Nuclear Power Plant, the Fukushima prefectural government decided to conduct the Fukushima Health Management Survey to assist in the long-term health management of residents. This included thyroid ultrasound examination for all children in Fukushima. For appropriate evaluation of ultrasound screening of the thyroid, it is important to understand its reference data of thyroid findings in children in general. In order to analyze the frequencies of specific thyroid findings, we conducted ultrasound screening of the thyroid by the same procedures as used in Fukushima in 4,365 children, aged 3 to 18 years, from three Japanese prefectures. Overall, thyroid cysts were identified in 56.88% and thyroid nodules in 1.65% of the participants. Thyroid cysts and nodules with a maximum diameter of more than 5 mm were identified in 4.58% and 1.01%, respectively, and age-adjusted prevalences were 3.82% and 0.99%, respectively. Although the prevalence of cysts and nodules varied among the examination areas, no significant differences were observed among the three examination areas in the prevalence of cysts and nodules with a maximum diameter of more than 5 mm. Also, the prevalence of thyroid cysts and nodules, especially those with a maximum diameter of more than 5 mm, significantly increased with age, and showed a female predominance. We also identified ectopic thymus (1.95%), diffuse goiter (1.40%), ultimobranchial body (0.73%), lymph node swelling (0.21%) and thyroid agenesis (0.05%). This is the first ultrasound description of the age-adjusted prevalence of thyroid cysts and nodules, or of the prevalence of abnormalities other than cysts and nodules, such as ectopic thymus, in relation to age, in the general Japanese child population. We contend that this can provide relevant information for the Fukushima Health Management Survey and future population studies.

Determinants of the return to hometowns after the accident at Fukushima Dai-ichi nuclear power plant: a case study for the village of Kawauchi

The Great East Japan Earthquake in March 2011 destroyed the Fukushima Dai-ichi Nuclear Power Plant (FNPP) and almost all residents in a 20 km radius from the plant eventually evacuated. FNPP reactors were stabilised in December 2011; some evacuees decided to return to their hometowns, and the other evacuees remained. Efforts were made to identify the determinants that affect the decision to return home in order to promote recovery of the surrounding area of FNPP. Seventy-one residents who had not returned to hometown and 56 residents who had returned were selected. Logistic regression analysis adjusted for confounding factors showed that being female [odds ratio (OR): 2.43, p = 0.03], living in areas with relatively higher ambient doses (OR: 3.60, p=0.01) and expressing anxiety over radiation exposure (OR: 8.91, p < 0.01) were independently associated with decisions not to return. Results of this study suggest the importance of active participation by scientists and local authorities in communicating the risk to the general population involved in returning home.

Environmental contamination and external radiation dose rates from radionuclides released from the Fukushima nuclear power plant

To evaluate the environmental contamination and contributory external exposure after the accident at the Fukushima Nuclear Power Plant (FNPP), the concentrations of artificial radionuclides in soil samples from each area were analysed by gamma spectrometry. Six artificial radionuclides ((131)I, (134)Cs, (137)Cs, (129m)Te, (95)Nb and (136)Cs) were detected in soil samples around FNPP. Calculated external effective doses from artificial radionuclide contamination in soil samples around FNPP were 1.9-2.9 μSv h(-1) (8.7-17.8 mSv y(-1)) in Fukushima city on 22 March 2011. After several months, these calculated external effective doses were 0.25-0.88 μSv h(-1) (2.2-7.6 mSv y(-1)) in Fukushima city on 29 June 2011. The present study revealed that the detected artificial radionuclides around FNPP mainly shifted to long-lived radionuclides such as radioactive caesium ((134)Cs and (137)Cs) even though current levels are decreasing gradually due to the decay of short-lived radionuclides such as (131)I, (129m)Te, (95)Nb and (136)Cs. Thus, radiation exposure potency still exists even though the national efforts are ongoing for reducing the annual exposure dose closer to 1 mSv, the public dose limit. Long-term environmental monitoring around FNPP contributes to radiation safety, with a reduction in unnecessary exposure to the residents.

Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant.

The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP.

Evaluation of environmental contamination and estimated exposure doses after residents return home in Kawauchi Village, Fukushima Prefecture.

The external and internal exposure doses due to artificial radionuclides after the return of residents to their homes in Kawauchi Village, Fukushima Prefecture, including the restricted area within a 20-km radius from the Fukushima Dai-ichi Nuclear Power Plant (FNPP), were evaluated by gamma spectrometry of the soils and local agricultural products. The prevalent dose-forming artificial radionuclides from all samples were determined to be (134)Cs and (137)Cs (radiocesium). The estimated external effective doses from soils sampled on December 24 and 25, 2012 were 0.0017-9.2 mSv/y in the areas within a 20- to 30-km radius from the FNPP and 0.39-1.3 mSv/y in the areas within a 20-km radius from the FNPP. These levels appeared to be decreasing, despite the distance from the FNPP (median: 0.21 (0.012-0.56) mSv/y), compared to the levels just before the return of the residents to their homes on December 19 and 20, 2011 (median: 0.85 (0.40-1.4) mSv/y). The committed effective doses from the local agricultural samples in Kawauchi Village from May 1, 2012 to March 31, 2013 were sufficiently low, in the range of 18-44 μSv/y for males and 20-48 μSv/y for females (the range was 18-48 μSv/y for children and 25-43 μSv/y for adults), compared to the public dose limit (1 mSv/y, ICRP, 1991), although the potential for radiation exposure still exists. Residents who have not yet returned may be able to return to their homes with a long-term follow-up of environmental monitoring and countermeasures to reduce unnecessary radiation exposure.

Evaluation of environmental contamination and estimated radiation doses for the return to residents' homes in Kawauchi Village, Fukushima prefecture.

To evaluate the environmental contamination and radiation exposure dose rates due to artificial radionuclides in Kawauchi Village, Fukushima Prefecture, the restricted area within a 30-km radius from the Fukushima Dai-ichi Nuclear Power Plant (FNPP), the concentrations of artificial radionuclides in soil samples, tree needles, and mushrooms were analyzed by gamma spectrometry. Nine months have passed since samples were collected on December 19 and 20, 2011, 9 months after the FNPP accident, and the prevalent dose-forming artificial radionuclides from all samples were 134Cs and 137Cs. The estimated external effective doses from soil samples were 0.42–7.2 µSv/h (3.7–63.0 mSv/y) within the 20-km radius from FNPP and 0.0011–0.38 µSv/h (0.010–3.3 mSv/y) within the 20–30 km radius from FNPP. The present study revealed that current levels are sufficiently decreasing in Kawauchi Village, especially in areas within the 20- to 30-km radius from FNPP. Thus, residents may return their homes with long-term follow-up of the environmental monitoring and countermeasures such as decontamination and restrictions of the intake of foods for reducing unnecessary exposure. The case of Kawauchi Village will be the first model for the return to residents’ homes after the FNPP accident.

Thyroid ultrasound findings in a follow-up survey of children from three Japanese prefectures: Aomori, Yamanashi, and Nagasaki

We conducted ultrasound thyroid screening in cohort of 4,365 children aged between 3 to 18 years in three Japanese prefectures (Aomori, Yamanashi, and Nagasaki) using the same procedures as used in the Fukushima Health Survey. Forty-four children had nodules ≥ 5.1 mm in diameter or cysts ≥ 20.1 mm in diameter detected at the first screening, and 31 of these children underwent the second follow-up survey. We collected information from thyroid ultrasound examinations and final clinical diagnoses and re-categorized the thyroid findings after the second examination. Twenty children had nodules ≥ 5.1 mm in diameter or cysts ≥ 20.1 mm in diameter at the second examination; of these, one child was diagnosed with a thyroid papillary carcinoma and the remaining 19 children were diagnosed with possibly benign nodules such as adenomas, adenomatous nodules, and adenomatous goiters. A further 11 children were re-categorized as “no further examinations were required.” Our results suggest that ultrasound thyroid findings in children may change with a relatively short-term passing period, and that thyroid cancer may exist at a very low but certain frequency in the general childhood population.

Radiocesium concentrations in wild mushrooms collected in Kawauchi Village after the accident at the Fukushima Daiichi Nuclear Power Plant

It is well known from the experience after the 1986 accident at the Chernobyl Nuclear Power Plant that radiocesium tends to concentrate in wild mushrooms. In this study, we collected wild mushrooms from the Kawauchi Village of Fukushima Prefecture, located within 30 km of the Fukushima Daiichi Nuclear Power Plant, and evaluated their radiocesium concentrations to estimate the risk of internal radiation exposure in local residents. We found that radioactive cesium exceeding 100 Bq/kg was detected in 125 of 154 mushrooms (81.2%). We calculated committed effective doses based on 6,278 g per year (age > 20 years, 17.2 g/day), the average intake of Japanese citizens, ranging from doses of 0.11–1.60 mSv, respectively. Although committed effective doses are limited even if residents eat contaminated foods several times, we believe that comprehensive risk-communication based on the results of the radiocesium measurements of food, water, and soil is necessary for the recovery of Fukushima after this nuclear disaster.

Measurement of individual doses of radiation by personal dosimeter is important for the return of residents from evacuation order areas after nuclear disaster.

To confirm the availability of individual dose evaluation for the return of residents after the accident at the Fukushima Dai-ichi Nuclear Power Plant (FNPP), we evaluated individual doses of radiation as measured by personal dosimeters in residents who temporarily stayed in Evacuation Order Areas in Kawauchi village, which is partially located within a 20 km radius of the FNPP. We also compared individual doses with the external radiation doses estimated from the ambient dose rates and with doses estimated from the concentrations of radionuclides in the soil around each individual’s house. Individual doses were significantly correlated with the ambient doses in front of the entrances to the houses (r = 0.90, p<0.01), in the backyards (r = 0.41, p<0.01) and in the nearby fields (r = 0.80, p<0.01). The maximum cumulative ambient doses in the backyards and fields around the houses were 6.38 and 9.27 mSv/y, respectively. The maximum cumulative individual dose was 3.28 mSv/y, and the median and minimum doses were 1.35 and 0.71 mSv/y. The estimated external effective doses from concentrations of artificial radionuclides in soil samples ranged from 0.03 to 23.42 mSv/y. The individual doses were moderately correlated with external effective doses in the backyards (r = 0.38, p<0.01) and in the fields (r = 0.36, p<0.01); however, the individual doses were not significantly correlated with the external effective doses in front of the entrances (r = 0.01, p = 0.92). Our study confirmed that individual doses are low levels even in the evacuation order area in Kawauchi village, and external effective dose levels are certainly decreasing due to the decay of artificial radionuclides and the decontamination of contaminated soil. Long-term follow-up of individual doses as well as internal-exposure doses, environmental monitoring and reconstruction of infrastructure are needed so that residents may return to their hometowns after a nuclear disaster.