Thyroid Cancer Detection by Ultrasound Among Residents Ages 18 Years and Younger in Fukushima, Japan: 2011 to 2014

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Background: After the Great East Japan Earthquake and Tsunami in March 2011, radioactive elements were released from the Fukushima Daiichi Nuclear Power Plant. Based on prior knowledge, concern emerged about whether an increased incidence of thyroid cancer among exposed residents would occur as a result.

Methods: After the release, Fukushima Prefecture performed ultrasound thyroid screening on all residents ages ≤18 years. The first round of screening included 298,577 examinees, and a second round began in April 2014. We analyzed the prefecture results from the first and second round up to December 31, 2014, in comparison with the Japanese annual incidence and the incidence within a reference area in Fukushima Prefecture.

Results: The highest incidence rate ratio, using a latency period of 4 years, was observed in the central middle district of the prefecture compared with the Japanese annual incidence (incidence rate ratio = 50; 95% confidence interval [CI] = 25, 90). The prevalence of thyroid cancer was 605 per million examinees (95% CI = 302, 1,082) and the prevalence odds ratio compared with the reference district in Fukushima Prefecture was 2.6 (95% CI = 0.99, 7.0). In the second screening round, even under the assumption that the rest of examinees were disease free, an incidence rate ratio of 12 has already been observed (95% CI = 5.1, 23).

Conclusions: An excess of thyroid cancer has been detected by ultrasound among children and adolescents in Fukushima Prefecture within 4 years of the release, and is unlikely to be explained by a screening surge.

http://journals.lww.com/epidem/Citation/2016/05000/Thyroid_Cancer_Detection_by_Ultrasound_Among.3.aspx

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New Study Points to Measurable and Significant Increase in Incidents of Thyroid Cancer

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A new study documents rising incidents of thyroid cancer, calculated at about 3% per year, and describes a rising death rate from thryoid cancer at about 1% per year:
Hyeyeun Lim, Susan S. Devesa, Julie A. Sosa, David Check, Cari M. Kitahara, (April 4, 2017). Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013. JAMA. 2017;317(13):1338-1348. doi:10.1001/jama.2017.2719 
Question: What have been the trends in US thyroid cancer incidence and mortality, and have they differed by tumor characteristics at diagnosis?
 
Findings:  In this analysis of 77 276 thyroid cancer patients diagnosed during 1974-2013 and of 2371 thyroid cancer deaths during 1994-2013, average annual increases in incidence and mortality rates, respectively, were 3.6% and 1.1% overall and 2.4% and 2.9% for patients diagnosed with advanced-stage papillary thyroid cancer.
 
Meaning: Thyroid cancer incidence and mortality rates have increased for patients diagnosed with advanced-stage papillary thyroid cancer in the United States since 1974, suggesting a true increase in the occurrence of thyroid cancer.
 The study has been covered in the mainstream media:
Amanda Onion. (March 31, 2017). Thyroid Cancer Rates Triple, and Scientists Look for Cause. Live Science, http://www.livescience.com/58489-thyroid-cancer-rates-tripled.html
 
Thyroid cancer rates are rising faster than any other cancer in the United States, a new study found: Between 1975 and 2013, the number of thyroid cancer cases diagnosed yearly more than tripled…. in the new analysis, scientists argued that the alarming rise isn’t just due to improvements in detecting thyroid cancer.
The media is framing the cause of the rising incidents of thyroid cancer in relation to obesity, declining smoking ( crazy! ) and chemicals used as flame retardants:
Sumathi Reddy. (April 10, 2017). Thyroid Cancer Rates Raise New Concerns. The Wall Street Journal, https://www.wsj.com/articles/thyroid-cancer-rates-raise-new-concerns-1491855921
 
Two new studies show that the high incidence of thyroid cancer may be more dangerous than previously thought.
… The JAMA study showed that the incidence of thyroid cancer has more than tripled over the past four decades, and this includes larger tumors and patients with more deadly disease. The Duke University and National Cancer Institute researchers also found that mortality for thyroid cancer patients has been rising slightly for the past two decades…
 
…The NCI and Duke researchers tracked the number of thyroid cancer cases from 1974 to 2013 and found there was an increase of 3.6% cases a year on average with mortality increasing 1% a year since 1994, said Cari Kitahara, an investigator at the NCI, part of the federal National Institutes of Health, and a senior author on the JAMA study.
 
…In a separate study, whose results were presented at the Endocrine Society’s annual meeting in Orlando, Fla., earlier this month, Dr. Sosa and colleagues at the Nicholas School of Environmental Health at Duke University found that higher exposure to three types of flame retardants was associated with papillary thyroid cancer. The data are currently under review for publication….
 
The flame retardant account is being forwarded by Drs. Sosa and colleagues, who are among the authors of the JAMA study cited above.
 
Although I have little doubt that there are multiple environmental inputs that are responsible for rising thyroid cancer rates, I find it interesting that ionizing radiation is MISSING from mainstream accounts despite the alarming increase in thyroid cancer among Fukushima’s children.
 
In fact, in Japan there are efforts underway to “scale down” monitoring of thyroid cancer among Fukushima residents despite the rising incidents of cancerous thyroid tumors among children (see my discussion here: (http://majiasblog.blogspot.com/2017/04/efforts-to-scale-down-fuukshima-health.html).
 
Efforts to marginalize the role of ionizing radiation in producing thyroid cancer are inconsistent with formal acknowledgement by the International Atomic Energy Association that ionizing radiation causes thyroid cancer.
 
At the third Chernobyl Forum Meeting held in Vienna by the IAEA, representatives from that organization, UNSCEAR, the WHO, and governmental representatives issued a three-volume report concluding that 9,000 persons died or developed radiation caused cancers and 4,000 children received operations for Chernobyl-induced thyroid cancer.
 
It is no secret that ionizing radiation causes thyroid cancer, as discussed here:
Yuri E. Nikiforov. Is ionizing radiation responsible for the increasing incidence of thyroid cancer? Cancer. 2010;116(7):1626-1628. doi:10.1002/cncr.24889.
Damage to developing children’s thyroid glands doesn’t simply cause cancer. Damage, whether by radioactive elements or complex chemicals, also causes cognitive and/or social developmental problems.
 
I have previously blogged about a sharp increase in the autism rate among California children who entered kindergarten last year. They would have been exposed to Fukushima fallout during their first year of life (see http://majiasblog.blogspot.com/2016/10/sharp-increase-in-autism-rate-among.html).
 
Did Fukushima fallout cause or contribute to these California kids’ autism? Although this question could be studied empirically, few researchers will risk their careers studying the potential relationship.
 
Instead researchers will point to other, less politicized environmental culprits.
 
Although I support efforts to identify endocrine disrupting industrial chemicals, we must not ignore the most potent cause of thyroid cancer, IONIZING RADIATION.
 

Doubt cast on prefecture after boy’s cancer diagnosis confirmed

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A group supporting child cancer sufferers in Fukushima on Friday confirmed the diagnosis of a boy who at the time of the 2011 disaster was just four years old, contradicting the local government’s position that no child of that age has been diagnosed with thyroid cancer.

The boy was diagnosed with cancer and underwent surgery after taking part in a Fukushima prefectural government survey to gauge the impact of the disaster. Local authorities, however, claim at the time of the survey he had not yet been officially confirmed as suffering thyroid cancer.

The survey found that of the 385,000 people aged 18 or younger at the time of the disaster, a total of 184 youths aged between 5 and 18 have been diagnosed with or are suspected to have thyroid cancer.

http://english.kyodonews.jp/news/2017/03/466482.html

Follow Up on Thyroid Cancer! Patient Group Voices Opposition to Scaling Down the Fukushima Prefectural Health Survey¹

By Aihara Hiroko, Translation by Miyamoto Yuki, Introduction by Eiichiro Ochiai

INTRODUCTION

More than five years have elapsed since the great earthquake and the accompanying huge tsunami (on 3.11 of 2011), and its subsequent disaster at the Fukushima Dai-ichi Nuclear Power Plant of the Tokyo Electric Power Co. Three nuclear reactors there underwent explosions and another, though without explosion, was highly damaged. A large amount of radioactive material has been and is still being released as a result of the accidents.

Aside from the very difficult issues of how to deal with the melted nuclear fuel rods and with the increasing amount of contaminated water, people all over Japan, particularly those in Fukushima prefecture, are concerned with the effects of radiation on human health from the released radioactive material.

One disease, childhood thyroid cancer, has been recognized even by the authorities including the International Atomic Energy Agency (IAEA) and International Commission of Radiation Protection (ICRP), as the result of radiation released by the 1986 Chernobyl disaster in today’s Ukraine. Hence Fukushima Prefecture initiated a health survey of Fukushima citizens, including evacuees, that included scanning for thyroid abnormalities of all children under age 18 at the time of the accidents. It turned out that a large number of children have contracted thyroid cancers over the last five years: 172 out of ca. 380,000 children by the end of 2015. The majority of them have undergone surgery, and many have been found to have metastasized. This number , and the annual rate per 1,000,000, ca 90, is unusually high, compared with the rate 1 to 3 per 1,000,000 under normal circumstances.

The Fukushima prefectural government and the organization charged with conducting the examination are trying to rationalize the results in many ways, without invoking the radiation impact of the reactor meltdowns. If this is indeed unrelated to the radiation from the damaged Fukushima Nuclear Power Plants, a similarly high rate of thyroid cancer should be found all over Japan. The survey should be expanded in order to see whether that is indeed the case. In fact, however, as Aihara Hiroko details, the authorities are interested in scaling down the survey in Fukushima itself. They argue, curiously, that the results are causing anxiety and therefore are an example of “reputational damage,” an interpretation that excludes the possibility of actual harm to health and agricultural produce and other commercial activity. Moreover, they throw out the distraction of the need to respect individual choice, that is, the right of families to refuse screening. It is difficult to understand their reasoning as anything other than an expression of their wish to leave ambiguous the cause of rising rates of thyroid cancer. Thyroid cancer seems to be increasing even among adults. Indeed, Aihara’s article introduces the case of an adult patient, a rare case in which an individual is willing to be identified by name, given the degree of social anxiety generated by the fear of discrimination in Japan.

Thyroid cancer is only one of many health problems observed in the atomic bomb victims and the people affected by the Chernobyl disaster. Indeed, there are indications that many diseases including leukemia and heart diseases are increasing after the Fukushima accident all over Japan (Ochiai, 2015). Radiation is basically incompatible with life, indeed, everything on this earth (Ochiai, 2013). This fact needs to be recognized by the human race. No activity that releases radioactive materials in large quantities, whether for military use or power generation, should be allowed.

Ochiai, 2013: “Hiroshima to Fukushima: Biohazards of Radiation” (Springer Verlag Heidelberg, 2013)

Ochiai, 2015: “The Human Consequences of the Fukushima Daiichi Nuclear Power Plant Accident

 

Follow Up on Thyroid Cancer! Patient Group Voices Opposition to Scaling Down the Fukushima Prefectural Health Survey2

The total cost of the damage caused by the Fukushima Daiichi nuclear power plant accident is estimated at thirteen trillion yen. Yet, health damage is hard to see, and even when problems become evident, many of them are neglected. One of the most worrisome of these is thyroid cancer. Five years have passed since the accident of 2011, the threshold year when thyroid cancer began to increase after Chernobyl, according to experts such as Yamashita Shun’ichi, known as the “authority on the health risks of radiation exposure.” Here we try to grasp what is happening on the ground.

Although getting a checkup was a financial strain and time consuming, I am trying to view the experience positively as my cancer was detected at an early stage. If treatment had been delayed, the probability of the cancer spreading was quite high.”

So says Watanabe Norio, a high school teacher in Fukushima Prefecture who had thyroid cancer surgery in 2015. It was in the summer of 2013, when he and his family had their thyroids checked at a private clinic, that a tumor was discovered. The initial diagnosis was that the tumor was benign but called for observation. After a year, the tumor had grown bigger. Watanabe went to a larger hospital where his tumor was diagnosed, this time, as cancerous, and one side of his thyroid gland was removed.

Once Watanabe was discharged from the hospital, several of his current and former students, who happened to learn about his surgery, came to ask him personally about group thyroid screening: what to expect, the nature of the examination and treatment, and his hospitalization experience. All of them suffered from thyroid problems after the Fukushima nuclear accident.

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Self-portrait of Mr. Watanabe in the hospital. Photo by Watanabe Norio

Among them, one had been diagnosed with a primary thyroid cancer with an uncomplicated convalescence and favorable prognosis; another was diagnosed with papillary thyroid cancer. One had thyroid cancer surgery; another stopped going to school, unable to talk to anyone about the surgery. One was shocked by the scar on the neck left by the surgery, while another could not speak of the surgery even to extended family. People react to their illnesses differently: on the one hand, we know people who are leading “normal” lives after the surgery; on the other, there are those who, fearful of discrimination and prejudice, have no one to talk to.

Watanabe recalls that during his hospitalization, a nurse told him that there were a considerable number of people hospitalized for thyroid cancer surgery. Even as an adult, he found the hospital stay and cancer treatment difficult to deal with financially, physically and emotionally. It was an experience that inevitably affected his whole family. Every time Watanabe hears doctors talk optimistically about the “favorable prognosis of thyroid cancer relative to other cancers” in the context of the Prefectural Health Survey conducted by Fukushima Prefecture, he feels put off, as if they were making light of his illness.

What to Expect after the Dissolution of the Reconstruction Agency?

As part of the Prefectural Health Survey, Fukushima Prefecture has conducted checkups on the thyroid glands of children who were under eighteen years old at the time of the accident. Among the 370,000 examined, 172 minors have been diagnosed with thyroid cancer or suspected thyroid cancer. 131 have already had their thyroids removed.

The Fukushima Prefectural Oversight Committee of the Prefectural Health Survey (hereafter “Oversight Committee”) holds that it is “unlikely” that these cases are related to radiation exposure from the accident in 2011, but the residents’ anxiety continues to mount over the abnormally high rate of cancer in children. Doctor Yamashita Shun’ichi,3 the “authority on radiation exposure risk,” estimates the dormant period of thyroid cancer to be four to five years, based upon the Chernobyl nuclear accident (though some argue that an increase in thyroid cancer was observed two to three years after the accident), which suggests that there may be a precipitous rise in rates in the near future.

It is precisely at this moment that plans to reevaluate the thyroid examination program, including the possibility of scaling back, surfaced.4 The rationale is that the screening is “disadvantageous for the children of Fukushima.”

After the nuclear accident, Fukushima Prefecture embarked on the Prefectural Health Management Survey of May 2011 to study the impact of radiation on health and managing resident health. The task was consigned to Fukushima Medical University. It entails a “basic survey” in which all citizens of the prefecture (including mandatory and voluntary evacuees) are queried about their daily activities following the accident in order to estimate their level of external exposure; “thyroid examinations” targeting 370,000 children who were eighteen or younger at the time of the accident; an “internal exposure examination using whole body counters,” which measure the internal exposure dose; a “medical examination” providing a general checkup, including measuring leukocyte counts5 and a “survey on mental health and daily habits” of the residents of evacuation zones; and a “questionnaire for expectant and nursing mothers” who have maternity passbooks.6

Since the establishment of the Survey, however, problems have emerged one after another. For example, in the fall of 2012, it turned out that the Oversight Committee held a “secret meeting,” inviting the members to conform to an interpretation of the Survey results that concludes that a newly discovered thyroid cancer case has no causal relation with the Fukushima nuclear accident. When this secret meeting was made public, Murata Fumio, then vice governor, apologized for it before the prefectural assembly.7 The Committee also received complaints about the term “management” in the title of the Survey, as it suggested that the Survey could lead to the “management/control” of citizens. The Oversight Committee subsequently removed “management” from the Survey name [in 2014, the Survey was renamed the Prefectural Health Survey].

The Prefectural Health Survey (hereafter “Survey”) is administered independently by Fukushima Prefecture. It is to be distinguished from the medical examinations and special health checkups mandated at businesses and schools. Under the supervision of the central government’s Reconstruction Agency, the Act on Special Measures for Fukushima Reconstruction and Revitalization8 stipulates the content of the Survey and provides budgetary assistance. An enormous sum of public funds and funds related to reconstruction poured into the reserves of the Prefectural Health Management Fund for these activities. As of the beginning of fiscal year 2015, the amount in this Fund was approximately 135 billion yen. However, 55.7 billion of that 135 billion has already been spent, and the current balance is estimated to be 76 billion. Although Fukushima Prefecture claims that the national government has pledged to continue to fund the Survey, the Reconstruction Agency itself is scheduled to be dissolved in 2020, and the Fund to be discontinued in 2040. While the prefecture promises “life-long examinations,” with funding and other issues unresolved, continuationof the practice is up in the air.

A New Form of “Reputational Damage” (Fūhyō higai)?

The discussion about “reevaluation/scaling down” began on July 3, 2016 when the Fukushima Pediatric Association (hereafter “Pediatric Association”) adopted a statement at its general assembly, which it submitted to Fukushima Prefecture in the form of a petition on August 25. The statement reads, “[regarding the result of the Prefectural Health Survey] at this stage, it is difficult to make a scientific and objective assessment of the multiple cases reported [of thyroid cancer]. Yet we observe health concerns and anxieties spreading among not only the youth targeted for this examination and their parents but among prefectural residents in general.” Here, the Survey reports are identified as the cause of resident anxiety.

From the standpoint of alleviating such anxiety,” reads the statement, “current practice regarding thyroid examination as well as subsequent medical treatment and care should be reconsidered in part.” Additionally, the statement announces the launching of a new and independent review committee by the Pediatric Association.

On July 4, Fukushima Min’yū, a local newspaper, first reported the Pediatric Association’s statement under the following headline: “Calling for reconsideration of ‘thyroid examinations,’ Fukushima Pediatric Association to establish independent committee.” About a month later, on August 8, Min’yū ran another article, entitled “Discussion to reconsider thyroid examination; Oversight Committee may reduce scope,” introducing the views of Hoshi Hokuto, chair of the Oversight Committee, and Ōga Kazuhiro, president of the Pediatric Association.

In the article, both Hoshi and Ōga endorse the idea of restructuring the thyroid examinations, despite the fact that the risk of exposure following the nuclear accident remains high in Fukushima. Moreover, neither refers to the importance of early detection and prevention of cancer among children.

There is little merit to early detection of a cancer that progresses slowly and has a favorable prognosis,” Ōga declares. “Conducting the screening is itself provoking anxiety.” He continues, “Reports of multiple cancer cases can lead to reputational damage, which might disadvantage not only the children but all residents of Fukushima.” It is his personal opinion that “The choice not to take the examination should be respected, and the current practice, in which examinations are conducted in semi-compulsory fashion at schools and kindergartens needs to be corrected. Instead, we should establish a system restricted to those who wish to be screened.”

Showing his respect for Ōga’s opinion, Hoshi states that, “At the very least, we cannot willfully charge ahead with the current form of examination.”

No Expansion in Scope or Substance

Let us now turn to the prefectural take on this issue—the very agent of the examinations.

Ide Takatoshi, director of the health and welfare division, received the petition from the Fukushima Pediatric Association, represented by Ōga, on August 25. In response to my query, Ide stated, “We would like to await the discussions that will take place at an Oversight Committee meeting and an international conference to be held in September in Fukushima.” The 24th Oversight Committee meeting was scheduled to take place on September 14, and Ide did not deny the possibility that the meeting might spark a discussion for scaling down the thyroid screenings (As for the result, please see note 3).

In fact, however, even before the Pediatric Association petition, the Prefecture had already taken steps to prepare for the possibility of decreasing the pool of examinees.

One of these can be seen in the change in the consent form distributed at the second round of full-scale examinations that began in fiscal year 2015. Whereas earlier forms simply had a “consent” box to be checked off, the new form had a new “do not consent” box.

This addition may suggest the desire of the prefecture to respect the will of individuals who do not wish to take the examination. Given, however, the clearly noninvasive technology of ultrasound examination of the thyroid, and the importance from the standpoint of preventive medicine of protecting children’s health through early detection and treatment, does this shift—which proactively identifies children who will not be examined and removes them from the process—not strike at the heart of the principle of “fairness and uniformity” underlying this taxpayer-supported project? This change gives rise to another question, as to whether the prefecture has fully explained the possible consequences of delayed cancer detection. Adding the choice to opt out, I worry, is a means for gathering concrete numbers of those who are not interested, which in turn, might be used to provide “a rationale for scaling down the examinations.”

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On August 25: representatives of the Fukushima Pediatric Association submitting a petition to Fukushima Prefecture, asking for reevaluation/scaling-down of thyroid examinations.

With these questions in mind, I had an opportunity to ask Ōga and Hoshi about the motivation behind their statements. Both Ōga and Hoshi said “the newspapers exaggerated,” and denied a part of their statements as cited in the media. Ōga claims, “There was too much personal opinion in my interview article, which wasn’t great. What the Pediatric Association is asking for is not to cut back on the examination, but to revise a part of its procedure. The current thyroid screening practice turns up more and more latent cancer cases, which almost all medical doctors ‘believe have no association with radiation exposure.’” In response to my question on revision of the procedure, Ōga replied, “We will discuss the best procedure to be implemented in our review committee.” But he also made clear that “neither expansion of the examination nor enhancement of its content” would be on the table.

In contrast, Hoshi remained ambiguous: “The Pediatric Association’s petition is one of many opinions. We will continue to discuss the matter, including maintaining the current practice as an option.”

The Disadvantages of Screening?

Excessive screening? Preposterous. I am quite concerned about the discussion of possible scaling down. I asked the prefectural staff what disadvantages could be expected, with respect to protecting residents and patients. They only said, ‘That’s what the experts say,’ and failed to provide any concrete explanations. They ought to be seriously thinking about what disadvantages there are to be eliminated, and what advantages are to be protected.”

Such is the strong protest expressed by lawyer Kawai Hiroyuki, founding member and co-organizer of the “3/11 Thyroid Cancer Family Association” (hereafter “Family Association”), at a press conference held at the prefectural hall press club after submitting a petition on behalf of the Family Association to Fukushima Prefecture on August 23.9

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On August 23: lawyer Kawai Hiroyuki and co-organizers of the “3/11 Thyroid Cancer Family Association” holding a press conference pleading for expansion of the scope and substance of thyroid examinations.

Dentist Takemoto Yasushi, vice-representative of the Family Association, followed up with this appeal: “Some may think that it is the growing frequency of diagnosis that is causing anxiety, but discontinuing the examination would cause anxiety. True relief would come from enhancing the examination and follow-up treatment.”

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Shadow of Mr. Watanabe.

Medical doctor and another Family Association facilitator, Ushiyama Motomi, added, “It was just at the five-year point after Chernobyl that cancer cases started increasing. There is so much that we don’t know yet. Given the fact that so many cancer patients were found after the second-round full-scale examination, scaling down the screenings will not benefit residents. Without providing sufficient and appropriate information to patients, it is problematic to leave individuals to decide on their own whether to take part in the examination.”

On September 1,124 groups—domestic and international—jointly submitted a petition to the prefecture. They demand that the prefecture maintain the current practice and further broaden the pool in order to gain an accurate grasp of the situation; to elucidate the causal relationship between cancer and radiation exposure; and to reexamine the appropriateness of the surgeries performed upon 131 patients.10

Watanabe, the high school teacher introduced at the beginning of this article who had his thyroid removed, reflects, “We Fukushima residents have fears about health problems cropping up in the future. Especially for the young generation, continued screening and examination are indispensable. Even adults should have regular checkups.”

For the second-round full-scale examination, there is no compensation for parents who miss work to accompany their children, and transportation is also out of pocket. The Family Association receives complaints about a system that fails to provide for accessible examination and treatment.

Continued vigilance is necessary to ensure that the prefecture not scale back the screening and examination program in response to pressures from one set of doctors and organizations while ignoring the voices of all residents as well as patients.

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This article originally appeared in Shukan Kinyobi, no. 1103, Sept. 9, 2016.

It was Norma Field who suggested a contribution from Eiichiro Ochiai as a preface to this article. Without her generous help, recommendations and suggestions, this article would not be made available in English, and in fact, it would be more appropriate to name her as a co-translator. Having said that, however, should any mistakes and factual errors be found in this article, it would fall under the responsibility of myself.

Related Articles

Eiichiro Ochiai, The Human Consequences of the Fukushima Dai-ichi Nuclear Power Plant Accidents

Eiichiro Ochiai, The Manga “Oishinbo” Controversy: Radiation and Nose Bleeding in the Wake of 3.11

Nakasatomi Hiroshi, After Nuclear Disaster: The decision-making of Fukushima University authorities, the threat to democratic governance and countermovement actions 

Kyle Cleveland, Mobilizing Nuclear Bias: The Fukushima Nuclear Crisis and the Politics of Uncertainty

David McNeill, Japanese Government Squelching Efforts to Measure Fukushima Meltdown

Yasuhito Abe, Safecast or the Production of Collective Intelligence on Radiation Risks after 3.11

Adam Broinowski, Fukushima: Life and the Transnationality of Radioactive Contamination

Paul Jobin, The Roadmap for Fukushima Daiichi and the Sacrifice of Japan’s Clean-up Workers

Anders Pape Møller and Timothy A. Mousseau, Uncomfortable Questions in the Wake of Nuclear Accidents at Fukushima and Chernobyl

 

Notes

1

The website of the Fukushima prefectural government translates Fukushima kenmin kenkō chōsa as the “Residents’ Health Survey,” but in this article, I will employ the term “Prefectural Health Survey”. See here. [All footnotes are by the translator].

2

The website of the Fukushima prefectural government translates Fukushima kenmin kenkō chōsa as the “Residents’ Health Survey,” but in this article, I will employ the term “Prefectural Health Survey”. See here.

3

Yamashita was a Nagasaki-born second-generation hibakusha. After working at the Nagasaki University School of Medicine, he visited Chernobyl in 1991 in order to conduct research on children suffering from thyroid cancer. Since then, he has visited Chernobyl over a hundred times. In light of his experience in Chernobyl, shortly following the meltdown of nuclear reactors in Fukushima in 2011, Yamashita was invited to serve as a radiation risk management adviser to Fukushima Prefecture. He is known for his claims, regarding radiation risk in Fukushima, that exposure to 100 mSv of radiation per year is safe and that radiation does not affect people who are “happy and laughing” but rather affects those who are “weak-spirited” and who “brood and fret.” See “Japan Admits 3 Nuclear Meltdowns, More Radiation Leaked into Sea; U.S. Nuclear Waste Poses Deadly Risks” Democracy Now! June 10, 2011. Transcript is available here.

4

The Fukushima prefectural assembly, in response to a petition opposing cutbacks in health screenings, agreed to maintain the program at its regular meeting on October 13, 2016. See “Fukushima Daiichi genpatsu jiko kōjōsen kensa kibo iji o Kenmin kenkō chōsa, kengikai ga seigan saitaku” (Fukushima Daiichi nuclear accident, thyroid examinations will remain at the same scale; Prefectural assembly adopts petition)

5

Leukocytosis occurs when white cells (the leukocyte count) are above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, but may also occur following certain parasitic infections or bone tumors. See here.

6

The “maternity passbook” is issued to a woman when she reports her pregnancy to the municipal government of her residence. The book provides health advice, and documents the prenatal development of a baby as well as post-delivery health of mother and child. It also allows the holder to receive free public health services. See the website of Fukushima Prefecture: “Health of prefectural residents”

7

See “Fukushima kenkō chōsa: ‘himitsukai’ de kenkai suriawase” (Prefectural Health Survey: Producing an agreement by a secret meeting) here and here. The original article in Mainichi Shimbun on October 3, 2012 has been taken down from their website.

8

Article 26 of the act states: “Based on the Basic Guidelines for Reconstruction and Revitalization of Fukushima, Fukushima Prefecture may conduct Health Management Surveys (meaning surveys to estimate radiation exposure, conduct health checkups on thyroid cancer in children, and otherwise manage residents’ health care effectively; the same applies hereinafter), covering persons who had addresses in Fukushima as of March 11, 2011 and others equivalent thereto.” The document is available here.

9

The 3.11 Fund for Children with Thyroid Cancer was established on September 8, 2016, with the purpose of supporting thyroid cancer patients and their families. Donations are accepted at the organization website. The first round of applications for the fund began on December 1, 2016. See more information here.

10

Since this article was published, the number of thyroid cancer patients among those 18 years old and younger at the time of the accident has increased from 131 to 145. “18sai ika no kōjōsengan, kei 145nin ni Fukushima ken kensa” (The examinations show a rise of thyroid cancer patients among children to 145), December 27, 2016. 

Source : http://apjjf.org/2017/02/Aihara.html

 

Tepco worker’s thyroid cancer is recognized as a work-related

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Tepco worker’s thyroid cancer is recognized as a work-related

Japanese labor authorities have recognized the thyroid cancer of a man who worked at Tepco’s stricken Fukushima No. 1 nuclear plant as a work-related, it was learned Friday.

It is the first time that thyroid cancer has been recognized as a work-related illness caused by radiation from the plant after it was damaged in the March 2011 earthquake and tsunami.

This is the third case labor authorities have linked to radiation exposure for workers at the Fukushima plant. The two previous cases involved leukemia.

At a meeting Friday, a Health, Labor and Welfare Ministry panel of experts presented for the first time criteria for recognizing thyroid cancer as a work-related disease from radiation, including doses of 100 millisieverts or more and a period of five years or more between exposure to radiation and the development of cancer.

Based on the criteria, a labor standards office in Fukushima Prefecture concluded that the cancer of the employee, who is in his 40s, was caused by radiation from the plant.

The man joined Tokyo Electric Power Company Holdings Inc. in 1992 and worked at several nuclear power plants for over 20 years.

After checking reactor instruments and carrying out other duties at the Fukushima No. 1 plant from March 2011 to April 2012, he was diagnosed with thyroid cancer in April 2014. His cumulative radiation dose after the accident stood at 139.12 millisieverts.

According to the International Commission on Radiological Protection, lifetime cancer mortality rises by about 0.5 percent for those exposed to a dose of 100 millisieverts.

http://www.japantimes.co.jp/news/2016/12/17/national/tepco-workers-thyroid-cancer-recognized-work-related/#.WFUH-lzia-c

Thyroid cancer compensation for Fukushima plant worker

A man who developed thyroid gland cancer after working at the stricken Fukushima No. 1 nuclear plant has for the first time won the right to work-related compensation.

While the case ranks as the third time a worker at the Fukushima plant has been recognized as eligible for work-related compensation because of cancer caused by radiation exposure, it is the first instance involving thyroid gland cancer.

The Ministry of Health, Labor and Welfare announced its decision Dec. 16.

The man in his 40s, an employee of plant operator Tokyo Electric Power Co., worked at the Fukushima plant after the triple meltdown triggered by the 2011 Great East Japan Earthquake and tsunami. He was diagnosed with thyroid gland cancer in April 2014.

The man worked at various nuclear plants, including the Fukushima facility, between 1992 and 2012. He was mainly involved in operating and overseeing reactor operations.

After the March 2011 nuclear accident, the man was in the plant complex when hydrogen explosions rocked the No. 1 and No. 3 reactor buildings. His duties included confirming water and pressure meter levels as well as providing fuel to water pumps.

The amount of his accumulated whole body radiation exposure was 150 millisieverts, with about 140 millisieverts resulting from the period after the nuclear accident. Of that amount, about 40 millisieverts was through internal exposure caused by inhaling or other ways of absorbing radioactive materials.

Along with recognizing the first work-related compensation involving thyroid gland cancer, the labor ministry also released for the first time its overall position on dealing with compensation issues for workers who were at the Fukushima plant after the accident.

The ministry said it would recognize compensation for workers whose accumulated whole body dose exceeded 100 millisieverts and for whom at least five years have passed since the start of work involving radiation exposure and the diagnosis of cancer.

Ministry officials said the dose level was not a strict standard but one yardstick for recognizing compensation.

According to a study by TEPCO and a U.N. scientific committee looking into the effects of radiation, 174 people who worked at the plant had accumulated whole body doses exceeding 100 millisieverts as of this past March.

There is also an estimate that more than 2,000 workers have radiation doses exceeding 100 millisieverts just in their thyroid gland.

http://www.asahi.com/ajw/articles/AJ201612170027.html

First thyroid cancer case in Japan recognized as Fukushima-related & compensated by govt

A man who worked at the Fukushima nuclear power plant in Japan during the disastrous 2011 meltdown has had his thyroid cancer recognized as work-related. The case prompted the government to finally determine its position on post-disaster compensation.

The unnamed man, said to be in his 40s, worked at several nuclear power plants between 1992 and 2012 as an employee of Tokyo Electric Power Company Holdings Inc. He was present at the Fukushima Daiichi nuclear power plant during the March 11, 2011 meltdown. Three years after the disaster, he was diagnosed with thyroid gland cancer, which the Japanese Ministry of Health, Labor and Welfare confirmed on Friday as stemming from exposure to radiation.

The man’s body radiation exposure was totaled at 150 millisieverts, almost 140 of which were a result of the accident. Although this is not the first time that health authorities have linked cancer to radiation exposure for workers at the Fukushima plant, it is the first time a patient with thyroid cancer has won the right to work-related compensation.

There have been two cases previously, both of them involving leukemia.

The recent case prompted Japan’s health and labor ministry to release for the first time its overall position on dealing with compensation issues for workers who were at the Fukushima plant at the time and after the accident. Workers who had been exposed to over 100 millisieverts and developed cancer five years or more after exposure were entitled to compensation, the ministry ruled this week. The dose level was not a strict standard but rather a yardstick, the officials added.

As of March, 174 people who worked at the plant had been exposed to over 100 millisieverts worth of radiation, according to a joint study by the UN and the Tokyo Electric Power Company. There is also an estimate that more than 2,000 workers have radiation doses exceeding 100 millisieverts just in their thyroid gland, Japanese newspaper the Asahi Shimbun reported.

The 2011 accident at the Fukushima nuclear power plant was the worst of its kind since the infamous 1986 catastrophe in Chernobyl, Ukraine. After the Tohoku earthquake in eastern Japan and the subsequent tsunami, the cooling system of one of the reactors stopped working, causing a meltdown. Nearly half a million people were evacuated and a 20-kilometer exclusion zone was set up.

https://www.rt.com/news/370650-thyroid-cancer-fukushima-plant-radiation/#.WFZfzwMDsFM.facebook

Fukushima woman speaks out about her thyroid cancer

thyroid cancer woman videos june 2016

 

KORIYAMA, Fukushima Prefecture–She’s 21, has thyroid cancer, and wants people in her prefecture in northeastern Japan to get screened for it. That statement might not seem provocative, but her prefecture is Fukushima, and of the 173 young people with confirmed or suspected cases since the 2011 nuclear meltdowns there, she is the first to speak out.

That near-silence highlights the fear Fukushima thyroid-cancer patients have about being the “nail that sticks out,” and thus gets hammered.

The thyroid-cancer rate in the northern Japanese prefecture is many times higher than what is generally found, particularly among children, but the Japanese government says more cases are popping up because of rigorous screening, not the radiation that spewed from Fukushima No. 1 power plant.

To be seen as challenging that view carries consequences in this rigidly harmony-oriented society. Even just having cancer that might be related to radiation carries a stigma in the only country to be hit with atomic bombs.

“There aren’t many people like me who will openly speak out,” said the young woman, who requested anonymity because of fears about harassment. “That’s why I’m speaking out so others can feel the same. I can speak out because I’m the kind of person who believes things will be OK.”

She has a quick disarming smile and silky black hair. She wears flip-flops. She speaks passionately about her new job as a nursery school teacher. But she also has deep fears: Will she be able to get married? Will her children be healthy?

She suffers from the only disease that the medical community, including the United Nations Scientific Committee on the Effects of Atomic Radiation, has acknowledged is clearly related to the radioactive iodine that spewed into the surrounding areas after the only nuclear disaster worse than Fukushima’s, the 1986 explosion and fire at Chernobyl, Ukraine.

Though international reviews of Fukushima have predicted that cancer rates will not rise as a result of the meltdowns there, some researchers believe the prefecture’s high thyroid-cancer rate is related to the accident.

The government has ordered medical testing of the 380,000 people who were 18 years or under and in Fukushima prefecture at the time of the March 2011 tsunami and quake that sank three reactors into meltdowns. About 38 percent have yet to be screened, and the number is a whopping 75 percent for those who are now between the ages of 18 and 21.

The young woman said she came forward because she wants to help other patients, especially children, who may be afraid and confused. She doesn’t know whether her sickness was caused by the nuclear accident, but plans to get checked for other possible sicknesses, such as uterine cancer, just to be safe.

“I want everyone, all the children, to go to the hospital and get screened. They think it’s too much trouble, and there are no risks, and they don’t go,” the woman said in a recent interview in Fukushima. “My cancer was detected early, and I learned that was important.”

Thyroid cancer is among the most curable cancers, though some patients need medication for the rest of their lives, and all need regular checkups.

The young woman had one cancerous thyroid removed, and does not need medication except for painkillers. But she has become prone to hormonal imbalance and gets tired more easily. She used to be a star athlete, and snowboarding remains a hobby.

A barely discernible tiny scar is on her neck, like a pale kiss mark or scratch. She was hospitalized for nearly two weeks, but she was itching to get out. It really hurt then, but there is no pain now, she said with a smile.

“My ability to bounce right back is my trademark,” she said. “I’m always able to keep going.”

She was mainly worried about her parents, especially her mother, who cried when she found out her daughter had cancer. Her two older siblings also were screened but were fine.

Many Japanese have deep fears about genetic abnormalities caused by radiation. Many, especially older people, assume all cancers are fatal, and even the young woman did herself until her doctors explained her sickness to her.

The young woman said her former boyfriend’s family had expressed reservations about their relationship because of her sickness. She has a new boyfriend now, a member of Japan’s military, and he understands about her sickness, she said happily.

A support group for thyroid cancer patients was set up earlier this year. The group, which includes lawyers and medical doctors, has refused all media requests for interviews with the handful of families that have joined, saying that kind of attention may be dangerous.

When the group held a news conference in Tokyo in March, it connected by live video feed with two fathers with children with thyroid cancer, but their faces were not shown, to disguise their identities. They criticized the treatment their children received and said they’re not certain the government is right in saying the cancer and the nuclear meltdowns are unrelated.

Hiroyuki Kawai, a lawyer who also advises the group, believes patients should file Japan’s equivalent of a class-action lawsuit, demanding compensation, but he acknowledged more time will be needed for any legal action.

“The patients are divided. They need to unite, and they need to talk with each other,” he said in a recent interview.

The committee of doctors and other experts carrying out the screening of youngsters in Fukushima for thyroid cancer periodically update the numbers of cases found, and they have been steadily climbing.

In a news conference this week, they stuck to the view the cases weren’t related to radiation. Most disturbing was a cancer found in a child who was just 5 years old in 2011, the youngest case found so far. But the experts brushed it off, saying one wasn’t a significant number.

“It is hard to think there is any relationship,” with radiation, said Hokuto Hoshi, a medical doctor who heads the committee.

Shinsyuu Hida, a photographer from Fukushima and an adviser to the patients’ group, said fears are great not only about speaking out but also about cancer and radiation.

He said that when a little girl who lives in Fukushima once asked him if she would ever be able to get married, because of the stigma attached to radiation, he was lost for an answer and wept afterward.

“They feel alone. They can’t even tell their relatives,” Hida said of the patients. “They feel they can’t tell anyone. They felt they were not allowed to ask questions.”

The woman who spoke to AP also expressed her views on video for a film in the works by independent American filmmaker Ian Thomas Ash.

She counts herself lucky. About 18,000 people were killed in the tsunami, and many more lost their homes to the natural disaster and the subsequent nuclear accident, but her family’s home was unscathed.

When asked how she feels about nuclear power, she replied quietly that Japan doesn’t need nuclear plants. Without them, she added, maybe she would not have gotten sick.

Ash’s video interview: https://www.youtube.com/playlist?list=PLpmdZYCRIZfvTtTE1sbY3ynaGsfDYmNWn

333 of 522 children diagnosed worse than A2 in Kashiwa city Chiba

For those of you not familiar with Japan’s geography, these children were diagnosed in Kashiwa city, Chiba Prefecture.

Chiba Prefecture is far from Fukushima Prefecture. From Fukushima Daiichi in Fukushima Prefecture to Kashiwa city, Chiba prefecture, at the door of Tokyo, there is 221.05 km, 137.35 miles.

Just one more proof that Tokyo and its surroundings has been also well plumed.

This is the test result from 7/1/2015 to 2/29/2016. 306 children were categorized as A2 (cyst (smaller than 5.1 mm) or nodule (smaller than 20.1 mm) was found), 11 were categorized as B (cyst (larger than 5.1 mm) or nodule (larger than 20.1 mm) was found), and 16 were categorized as C (Follow-up test is required).

 

april 11, 2016 333 thyroid cases.jpg

 

2-333-of-522-children-diagnosed-worse-than-A2-in-Kashiwa-city-Chiba-800x500_c

 

On 3/23/2016, Kashiwa city government of Chiba announced 333 of 522 children were diagnosed as A2 ~ C in their thyroid test.

This is the test result from 7/1/2015 to 2/29/2016. 306 children were categorized as A2 (cyst (smaller than 5.1 mm) or nodule (smaller than 20.1 mm) was found), 11 were categorized as B (cyst (larger than 5.1 mm) or nodule (larger than 20.1 mm) was found), and 16 were categorized as C (Follow-up test is required).

The local government states and testees are required to admit the test is not to evaluate the radiation effect on health after 311. Also, children who already have medical care for their thyroid problem were eliminated.

 

333-of-522-children-diagnosed-worse-than-A2-in-Kashiwa-city-Chiba.png

http://www.city.kashiwa.lg.jp/houshasenkanren/3327/3330/p0150603_d/fil/kashiwakojosen.pdf

http://www.city.kashiwa.lg.jp/houshasenkanren/3327/3330/p0150603.html

http://www.city.kashiwa.lg.jp/houshasenkanren/3327/3330/p034081.html

http://fukushima-diary.com/2016/04/333-of-522-children-diagnosed-worse-than-a2-in-kashiwa-city-chiba/