One of the biggest health risks after Fukushima
Health risks from any radiation fall-out mostly focus on an increased risk of cancer. Experts, however, believe that the social and psychological effects of a nuclear disaster may be more damaging and long-term than the risk associated with radiation itself.
Whether it is studies from Fukushima crisis or from previous nuclear disasters such as Hiroshima and Nagasaki, Chernobyl or Three Mile Island, the data indicates that such incidents have a devastating effects on families and communities. In fact, nuclear accidents present unique risks that are different than what is faced during natural disasters, mostly due to stigma associated with radiation.
What’s more, immediate evacuation following a nuclear tragedy brings changes in people’s diet and exercise and also cause disruptions in their health services. This gives rise to secondary health issues such as worsening of diabetes, poor bone health and increased risk of chronic diseases.
The social-and psychological effects: The most over-looked health risks
People often consider direct risks – such as increased risk of thyroid cancer or leukaemia and genetic effects – as the biggest threats to health after a nuclear accident.
However, a number of factors are known to have a devastating social and psychological impact on individuals and communities. These include:
- Mass evacuation
- Relocation to unknown settings without any clear expectations
- Exaggerated risk perception
- Ambiguous and inadequate risk communication
- Stigma leading to social prejudices and discrimination
- Workplace discrimination
- Bullying at school
These factors can cause:
- Post-traumatic stress disorder (PTSD)
- Anxiety and depression
- Low self-esteem
- Social withdrawal
- Alcohol and drug abuse
- Suicidal thoughts and tendencies
A 2018 review paper cites a number of studies that highlight how the Fukushima nuclear accident impacted mental health of the residents. 
It reported that evacuees suffered from severe PTSD symptoms and “PTSD symptoms were also associated with chronic physical and mental diseases, anxiety about livelihoods, lost jobs and social ties, and concerns about monetary compensation”.
The paper also stated that, “PTSD and other complicated situations lead to chronic psychiatric issues such as depression, suicide, and alcohol abuse,” and that “High psychological distress was associated with discrimination and slurs.” Most importantly, increased risk perception towards radiation effects was majorly responsible for depressive symptoms and psychological distress in both the general people and in rescue workers.
Young women, in particular, tend to feel stigmatised, mostly because of the concerns that radiation exposure can impact future pregnancy and cause genetic abnormalities. This kind of concern is typically associated with nuclear accidents but not with other natural disasters, and arises due to physical risks of radiation exposure, self-stigma and “radiation stigma” among people.
Young mothers suffered from intense anxieties about the well-being of their children. And this leads to behavioral problems among their children with symptoms such as hyperactivity, irritability, and withdrawal behavior. In addition to these apprehensions, there were restrictions on children’s outdoor activities. This could have increased the obesity risk in children in the affected areas.
Impact of disaster on the health professionals
It is not only the evacuees and rescue workers that go through emotional distress. Medical professionals, including nurses, are also mentally affected by disasters of such scale.
Following the Fukushima Daiichi Nuclear Power Plant disaster, healthcare professionals were saddled with additional workload and stress caused by the disaster itself.
A 2018 review looked at the psychological effects of the disaster on hospital nurses. It highlighted that health care workers have their own fears about the health risks to self and their families, which leads to anxiety. In addition, they are also affected by the same factors as other residents such as death of their loved ones, loss of property and fear of evacuation.
The 2018 study reported that nurses with more awareness on radiation and its risks tend to have better mental health, concluding that, “it is essential that nurses are provided with education about radiation exposure and its associated health risks, and also that there is a comprehensive approach to mental health care for nurses during the chronic phase of a disaster.” 
The review also spotlights another concern: “Fuhyohigai” – loosely translated as ‘frustration damage’. Unfounded and unsubstantiated rumours circulated by the media result in a multi-dimensional damage on every front; be it social, economic and psychosocial.
This can lead to reduced sales of products that are locally grown or produced. It can impact trade and tourism in the region. The term Fuhyohigai also applies to damage caused at social and psychological level, due to increased perception of risk, discrimination against people from affected areas and self-stigmatization.
Forced to return despite nagging fears?
The nuclear plant meltdown and the resulting radiation led to the evacuation of more than 200,000 people from high-risk areas.
After almost eight years, the Japanese government has lifted evacuation orders in many towns near the plant, despite the fact that in some places radiation still measures at least 5 millisieverts (mSv) annually, which is five times more than what was recommended for the general public before the Fukushima nuclear disaster happened.
According to this article by Scientific American, “In certain spots radioactivity is as high as 20 mSv, the maximum exposure recommended by international safety experts for nuclear power workers.”
A 2018 report by Greenpeace concluded that, “Seven years after the start of the Fukushima Daiichi nuclear disaster, the radiation levels in areas of Namie and Iitate where evacuation orders were lifted in March 2017 remain too high for the safe return of thousands of evacuees.” 
When evacuation orders are lifted, subsidies and housing support also come to an end. This has left some people with no choice but to return. And there is a considerable sense of fear among the returning evacuees.
They worry that their hometown and surrounding places are not safe and ongoing radioactivity could have detrimental effects on their health. The former residents are also worried about the delayed and uncertain decontamination processes. Worse yet, ongoing radiation could be even more damaging to children, increasing their risk of leukaemia and other cancers. Children are small in size and have developing bodies. This makes them more vulnerable to the radiation damage.
Is this fear of low dose radiation valid? Emerging studies show that low-dose, chronic radiation pose health risks, and can be especially threatening to your cardiovascular health. This is interesting on two levels. First, exposure to low-dose radiation is not considered as a potential health risk by some. And secondly, non-cancerous diseases are not given much importance when it comes to recognizing physical health risks caused by radiation.
The fact is radiation dosage as small as 0.5 Gy can damage your heart health. This small dose is equivalent to what you would receive after repeated CT scans. And this risk lasts up to decades after exposure. This 2017 study found that low-dose radiation contact can trigger changes in the endothelial cells – causing increased oxidative damage, reduced NO levels that are needed for blood vessels dilation, and inability of endothelial cells in removing damaged, oxidized proteins. These factors increase the risk of cardiovascular disease.
The researchers concluded that, “even a moderate radiation dose of 0.5 Gy has a significant adverse impact on the endothelial proteome. Molecular alterations seen here support the data from population studies suggesting an increased risk for cardiovascular disease after exposure to 0.5 Gy.”
Emerging risks of secondary health issues like diabetes
Following a nuclear disaster, immediate evacuation is the most effective way to limit radiation exposure among residents. However, this also brings changes in people’s life in the way they eat, exercise and live in a community. There is a lot involved – loss of jobs, separation from loved ones, settling in unfamiliar surroundings with uncertain future, stress from radiation risks and disruption in their healthcare services.
This can have a major impact on their health, leading to secondary health issues down the line such as increased risk of chronic and lifestyle diseases like diabetes, poor bone health and impaired motor functions.
Studies show that: [5,6]
- The risk of developing diabetes increases for many years after a nuclear accident, a risk that was not only observed in evacuees but also in people living outside the evacuation area.
- Health of people, diagnosed as diabetics before, worsened after the disaster, and this worsening of diabetes is seen among both evacuees and residents outside the evacuation area.
- Fukushima nuclear disaster lowered life expectancy among residents in their 40s and 70s and this loss of life expectancy was more due to a significant increase in the rates of diabetes caused by the disaster than the rates of cancer caused by radiation.
- The children experienced problems such as obesity; induced by stress and lifestyle modifications (inability to play and be physically active)
- The negative changes in lifestyle also affects bone health and motor functions, especially in the elderly
These findings point out that changes in the social environment can trigger greater risks to heath than just radiation and cancer risks alone – leading to secondary health issues such as increased risk of developing diabetes, worsening of diabetes, poor bone health, obesity in children, and not to mention the mental stress that comes with stigma, social isolation and discrimination.
This 2016 reports mentions that psychiatric and mental health issues are only one side of the coin. Complex nuclear accidents like Fukushima also lead to conditions that are associated with lifestyle, such as increase in the number of overweight people, and increased risk of high blood pressure, diabetes mellitus and high cholesterol levels. All these factors may increase the risk of cardiovascular disease. 
In 2018, Tokyo Electric Power Co. (TEPCO) admitted that water stored in over 1000 tanks at the plant is still radioactive, loaded with dangerously high levels of radioactive isotopes including tritium and Strontium-90. TEPCO acknowledged that water processing efforts, including its ALPS system, were not enough to reduce radioactivity levels below the permissible limit.
This was a shocking revelation considering that the Japanese government is planning to release the treated water into the Pacific Ocean, which would contaminate the ocean further.
Strontium 90 mimics potassium and has a special affinity for bones. It can accumulate in the bones and damage bone marrow – resulting in anemia, reduced immunity and blood clotting issues. Chronic exposure to Strontium 90 is known to cause bone cancer and cancers of bone marrow.
Now, a new 2019 report by Greenpeace Germany concluded that the water crisis at the Fukushima Daiichi plant shows no sign of ending anytime soon. 
In Japanese culture, there already exists a strong stigma against psychiatric illnesses such as depression and anxiety. This makes the situation even worse. Keeping all this in mind, the concerned authorities should take additional, robust measures to address a broad spectrum of health risks that are uniquely posed by nuclear disasters.
- Maeda et al. Psychosocial effects of the Fukushima disaster and current tasks: Differences between natural and nuclear disasters. 2018.
- Nukui et al. Mental health of nurses after the Fukushima complex disaster: a narrative review. J Radiat Res. 2018
- Shaun Burnie and Kazue Suzuki. Reflections in Fukushima: The Fukushima Daiichi Accident Seven Years On. Greenpeace. 2018.
- Azimzadeh et al. Proteome analysis of irradiated endothelial cells reveals persistent alteration in protein degradation and the RhoGDI and NO signalling pathways. Internation Journal of Radiation Biology. 2017
- Masaharu Tsubokura. Secondary health issues associated with the Fukushima Daiichi nuclear accident, based on the experiences of Soma and Minamisoma Cities. J. Natl. Inst. Public Health. 2018
- Murakami et al. Additional risk of diabetes exceeds the increased risk of cancer caused by radiation exposure after the Fukushima disaster. PLoS One. 2017
- Hasegawa et al. Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation. Clinical Oncology. 2016
- Shaun Burnie. Tepco Water Crisis. Greenpeace, 2019.