title: Quantitative assessment of preventive behaviors in France during the Fukushima nuclear crisis.
abstract: BACKGROUND
  The Fukushima nuclear disaster has generated worldwide concern on the risk of exposure to nuclear radiations. In Europe, health authorities had to issue statements about the lack of usefulness of iodine based preventive treatments within their borders. However a lack of confidence in official messages has developed in various European countries due to recent perceived failures in managing public health crises. The lay population preventive behaviors in this context are largely unknown. Consequently, to examine the effects of public health crisis on lay behaviors leading to pharmaceuticals purchases, we studied the sales of iodine-based products in France before, during and after the crisis.
  
  
  METHODS
  We focused our study on 58 iodine-based drugs available with and without a physician prescription. Our data came from a stratified sample of 3004 pharmacies in metropolitan France. Our study period was from January 2010 to April 2012, with a focus on March-April 2011. We differentiated sales of drugs prescribed by physicians from sales of drugs obtained without a prescription. We used a CUSUM method to detect abnormal increases in sales activity and cross-correlations to assess shifts in sales timing.
  
  
  RESULTS
  Sales of iodine-based nutritional complements, and later sales of iodine-based homeopathic remedies, substantially increased (up to 3-fold) during a period of 20 days. Their temporal patterns were correlated to specific events during the crisis. Prescriptions for iodine-based homeopathy increased (up to 35% of all sales). Iodine pills, strictly regulated by health authorities, have also been sold but on a very small scale.
  
  
  CONCLUSIONS
  These results indicate uncontrolled preventive behaviors resulting in the potentially unjustifiable consumption of available drugs. They have implications in public policy, and demonstrate the usefulness of drug sales surveillance for instantaneous evaluation of population behavior during a global crisis.
authors.affiliation: EHESP Rennes, Sorbonne Paris Cité, Paris, France. Pascal.Crepey@ehesp.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Crépey
authors.forename: Mathilde
authors.initials: M
authors.lastname: Pivette
authors.forename: Avner
authors.initials: A
authors.lastname: Bar-Hen
mesh_terms: D005602:France; D062406:Fukushima Nuclear Accident; D015438:Health Behavior; D006801:Humans; D010594:Pharmacies / Q000191:economics; D055553:Prescription Drugs / Q000191:economics; D011837:Radiation-Protective Agents / Q000191:economics; D013997:Time Factors
chemical_list: D055553:Prescription Drugs; D011837:Radiation-Protective Agents