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OBJECTIVE: This study investigated post-traumatic stress symptoms in relation to the population affected by the Fukushima Nuclear Disaster, one year after the disaster. Additionally, we investigated social factors, such as forced displacement, which we hypothesize contributed to the high prevalence of post-traumatic stress. Finally, we report of written narratives that were collected from the impacted population. DESIGN AND SETTINGS: Using the Impact of Event Scale-Revised (IES-R), questionnaires were sent to 2,011 households of those displaced from Fukushima prefecture living temporarily in Saitama prefecture. Of the 490 replies; 350 met the criteria for inclusion in the study. Multiple logistic regression analysis was performed to examine several characteristics and variables of social factors as predictors of probable post-traumatic stress disorder, PTSD. RESULTS: The mean score of IES-R was 36.15±21.55, with 59.4% having scores of 30 or higher, thus indicating a probable PTSD. No significant differences in percentages of high-risk subjects were found among sex, age, evacuation area, housing damages, tsunami affected, family split-up, and acquaintance support. By the result of multiple logistic regression analysis, the significant predictors of probable PTSD were chronic physical diseases (OR = 1.97), chronic mental diseases (OR = 6.25), worries about livelihood (OR = 2.27), lost jobs (OR = 1.71), lost social ties (OR = 2.27), and concerns about compensation (OR = 3.74). CONCLUSION: Although there are limitations in assuming a diagnosis of PTSD based on self-report IES-R, our findings indicate that there was a high-risk of PTSD strongly related to the nuclear disaster and its consequent evacuation and displacement. Therefore, recovery efforts must focus not only on medical and psychological treatment alone, but also on social and economic issues related to the displacement, as well.

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US President Barack Obama's November 13-14, 2009 visit to Japan gave us an opportunity to enhanced routine syndrome surveillance upgrade countermeasure against bioterrorism attacks and other emergencies. We conducted analysis using suspected case surveillance based on the Infection Control Law, surveillance for ambulance transfer by the local Tokyo government, and prescription surveillance by the National Institute of Infectious Diseases. Thanks to regularly conducted prior surveillance, we enhanced the routine by closer monitoring and sharing information, conducting postvisit surveillance for two weeks until November 30. Information as of 07:00 from the Prescription Survey and a 17:00 ambulance transfer survey were submitted to and evaluated National Institute of Infectious Diseases and Tokyo Metropolitan Institute of Public Health. The fact that we conducted enhanced surveillance easily without prior preparation indicates that we may be able to cut the cost and time of syndrome surveillance negotiation and preparation. Such enhanced surveillance is highly feasible and we expect to do so similarly cooporating flexibly with local and central governments.

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Attenuation correction is necessary for the reconstruction of SPECT images. One report has mentioned that attenuation correction by X-ray computed tomography (CT) is effective for a non-uniform attenuation body. We examined the effect of attenuation correction on SPECT images by changing the scanning conditions of CT, and evaluated the possibility of attenuation correction by low-dose CT. The phantom was scanned under several X-ray tube conditions varying from 80 kV to 135 kV and from 7.5 mAs to 200 mAs. We obtained equations of attenuation correction based on the Hounsfield Unit (HU) units of each pixel and compared the effects of attenuation correction. The results showed that the equation for attenuation correction under each condition did not vary significantly, and the effects of attenuation correction by the equations did not vary significantly between CT of low dose and that of clinical dose. This result suggest that the attenuation correction obtained by low-dose CT was equal to that obtained by the clinical dose. In conclusion, it seemed that the equation and map of attenuation correction matched with each radionuclide yielded more adequate attenuation correction than conventional methods.

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To explore the possibility of which medical radioactive wastes could be disposed as general wastes after keeping them a certain period of time and confirming that their radioactivity reach a background level (BGL), we made a survey of these wastes in several nuclear medicine facilities. The radioactive wastes were collected for one week, packed in a box according to its half-life, and measured its radioactivity by scintillation survey meter with time. Some wastes could reach a BGL within 10 times of half-life, but 19% of the short half-life group (group 1) including 99mTc and 123I, and 8% of the middle half-life group (group 2) including 67Ga, (111)In, and 201Tl did not reach a BGL within 20 times of half-life. A reason for delaying the time of reaching a BGL might be partially attributed to high initial radiation dose rate or heavy package weight. However, mixing with the nuclides of longer half-life was estimated to be the biggest factor affecting this result. When disposing medical radioactive wastes as general wastes, it is necessary to avoid mixing with radionuclide of longer half-life and confirm that it reaches a BGL by actual measurement.

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Societies concerned with radioactive rays and nuclear medicine have recently highlighted the necessity of managing radioactive medical waste resulting from nuclear medicine examinations. We introduce a manual that we have created and explain its use in decision-making and management practices aimed at the reduction of radioactive medical waste at hospitals that have not yet solved this problem. We hope that our manual will help in reducing this medical waste.

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