title: Impact of natural disaster combined with nuclear power plant accidents on local medical services: a case study of Minamisoma Municipal General Hospital after the Great East Japan Earthquake.
abstract: OBJECTIVE
  To elucidate the impacts of nuclear plant accidents on neighboring medical centers, we investigated the operations of our hospital within the first 10 days of the Great East Japan Earthquake followed by the Fukushima Daiichi nuclear power plant accident.
  
  
  METHODS
  Data were extracted from medical records and hospital administrative records covering 11 to 20 March 2011. Factual information on the disaster was obtained from public access media.
  
  
  RESULTS
  A total of 622 outpatients and 241 inpatients were treated. Outpatients included 43 injured, 6 with cardiopulmonary arrest, and 573 with chronic diseases. Among the 241 inpatients, 5 died, 137 were discharged, and the other 99 were transferred to other hospitals. No communication methods or medical or food supplies were available for 4 days after the earthquake. Hospital directors allowed employees to leave the hospital on day 4. All 39 temporary workers were evacuated immediately, and 71 of 239 full-time employees remained. These employees handled extra tasks besides patient care and patient transfer to other hospitals. Committed effective doses indicating the magnitude of health risks due to an intake of radioactive cesium into the human body were found to be minimal according to internal radiation exposure screening carried out from July to August 2011.
  
  
  CONCLUSIONS
  After the disaster, hospitals located within the evacuation zone of a 30-km radius of the nuclear power plant were isolated. Maintenance of the health care system in such an event becomes difficult.
authors.affiliation: Institute of Medical Science,The University of Tokyo,Tokyo,Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Neurological Surgery,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Oikawa
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Takano
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nagano
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Katsuko
authors.initials: K
authors.lastname: Onoda
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Nursing,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Takada
authors.affiliation: Department of Radiology,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hanai
authors.affiliation: Department of Clinical Laboratory,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Department of Radiology,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Department of Pharmacy,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nishiuchi
authors.affiliation: Department of Physical Therapy,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Syuichi
authors.initials: S
authors.lastname: Onoda
authors.affiliation: Department of Medical Professions Division,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Monma
authors.affiliation: Institute of Medical Science,The University of Tokyo,Tokyo,Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Tsubokura
authors.affiliation: Institute of Medical Science,The University of Tokyo,Tokyo,Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Matsumura
authors.affiliation: Institute of Medical Science,The University of Tokyo,Tokyo,Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.affiliation: Department of Internal Medicine,Minamisoma Municipal General Hospital,Fukushima,Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kanazawa
mesh_terms: D000553:Ambulatory Care; D003153:Community Health Services; D004189:Disaster Planning; D055866:Earthquakes; D062406:Fukushima Nuclear Accident; D006769:Hospitals, General; D006801:Humans; D007564:Japan / Q000453:epidemiology; D055848:Nuclear Power Plants; D019982:Organizational Case Studies; D010360:Patient Transfer / Q000706:statistics & numerical data; D010564:Personnel, Hospital; D011834:Radiation Monitoring
keywords: nuclear power plants