title: Reduction of high levels of internal radio-contamination by dietary intervention in residents of areas affected by the Fukushima Daiichi nuclear plant disaster: a case series.
abstract: Maintaining low levels of chronic internal contamination among residents in radiation-contaminated areas after a nuclear disaster is a great public health concern. However, the efficacy of reduction measures for individual internal contamination remains unknown. To reduce high levels of internal radiation exposure in a group of individuals exposed through environmental sources, we performed careful dietary intervention with identification of suspected contaminated foods, as part of mass voluntary radiation contamination screenings and counseling program in Minamisoma Municipal General Hospital and Hirata Central Hospital. From a total of 30,622 study participants, only 9 residents displayed internal cesium-137 (Cs-137) levels of more than 50 Bq/kg. The median level of internal Cs-137 contamination in these residents at the initial screening was 4,830 Bq/body (range: 2,130-15,918 Bq/body) and 69.6 Bq/kg (range: 50.7-216.3 Bq/kg). All these residents with high levels of internal contamination consumed homegrown produce without radiation inspection, and often collected mushrooms in the wild or cultivated them on bed-logs in their homes. They were advised to consume distributed food mainly and to refrain from consuming potentially contaminated foods without radiation inspection and local produces under shipment restrictions such as mushrooms, mountain vegetables, and meat of wild life. A few months after the intervention, re-examination of Cs levels revealed remarkable reduction of internal contamination in all residents. Although the levels of internal radiation exposure appear to be minimal amongst most residents in Fukushima, a subset of the population, who unknowingly consumed highly contaminated foodstuffs, experienced high levels of internal contamination. There seem to be similarities in dietary preferences amongst residents with high internal contamination levels, and intervention based on pre- and post-test counseling and dietary advice from medical care providers about risky food intake appears to be a feasible option for changing residents' dietary practices, subsequently resulting in a reduction in Cs internal contamination levels.
authors.affiliation: Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Minato-ku, Tokyo, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Tsubokura
authors.affiliation: Department of Radiation Protection, Soma Central Hospital, Soma, Fukushima, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, United Kingdom.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Stuart
authors.initials: S
authors.lastname: Gilmour
authors.affiliation: Hirata Radioactivity Inspection Center, Hirata Central Hospital, Hirata, Fukushima, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nihei
authors.affiliation: Hirata Radioactivity Inspection Center, Hirata Central Hospital, Hirata, Fukushima, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Oikawa
authors.affiliation: Department of Radiation Protection, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kanazawa
authors.affiliation: Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Minato-ku, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.affiliation: Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Ryugo
authors.initials: R
authors.lastname: Hayano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002588:Cesium Radioisotopes / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D004435:Eating; D004781:Environmental Exposure / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D062406:Fukushima Nuclear Accident; D006801:Humans; D008297:Male; D008875:Middle Aged; D055848:Nuclear Power Plants; D011379:Prognosis; D011834:Radiation Monitoring; D011835:Radiation Protection; D014915:Whole-Body Counting; D055815:Young Adult
chemical_list: D002588:Cesium Radioisotopes