title: Study protocol for the Fukushima Health Management Survey.
abstract: BACKGROUND
  The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey.
  
  
  METHODS
  This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation.
  
  
  CONCLUSIONS
  The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long-term large-scale epidemiologic study is expected to provide valuable data in the investigation of the health effects of low-dose radiation and disaster-related stress.
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan. yasumura@fmu.ac.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
authors.forename: Kenji
authors.initials: K
authors.lastname: Kamiya
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
authors.forename: Makoto
authors.initials: M
authors.lastname: Akashi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kodama
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ozasa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004190:Disasters; D004307:Dose-Response Relationship, Radiation; D055866:Earthquakes; D005260:Female; D005500:Follow-Up Studies; D062406:Fukushima Nuclear Accident; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D007223:Infant; D007564:Japan; D008603:Mental Health; D011247:Pregnancy; D011834:Radiation Monitoring; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000528:radiation effects; D014463:Ultrasonography