title: Postnuclear disaster evacuation and chronic health in adults in Fukushima, Japan: a long-term retrospective analysis.
abstract: OBJECTIVE
  Japan's 2011 Fukushima Daiichi Nuclear Power Plant incident required the evacuation of over a million people, creating a large displaced population with potentially increased vulnerability in terms of chronic health conditions. We assessed the long-term impact of evacuation on diabetes, hyperlipidaemia and hypertension.
  
  
  METHODS
  We considered participants in annual public health check-ups from 2008 to 2014, administrated by Minamisoma City and Soma City, located about 10-50 km from the Fukushima nuclear plant.
  
  
  METHODS
  Disease risks, measured in terms of pre-incident and post-incident relative risks, were examined and compared between evacuees and non-evacuees/temporary-evacuees. We also constructed logistic regression models to assess the impact of evacuation on the disease risks adjusted for covariates.
  
  
  RESULTS
  Data from a total of 6406 individuals aged 40-74 years who participated in the check-ups both at baseline (2008-2010) and in one or more post-incident years were analysed. Regardless of evacuation, significant post-incident increases in risk were observed for diabetes and hyperlipidaemia (relative risk: 1.27-1.60 and 1.12-1.30, respectively, depending on evacuation status and post-incident year). After adjustment for covariates, the increase in hyperlipidaemia was significantly greater among evacuees than among non-evacuees/temporary-evacuees (OR 1.18, 95% CI 1.06 to 1.32, p<0.01).
  
  
  CONCLUSIONS
  The singularity of this study is that evacuation following the Fukushima disaster was found to be associated with a small increase in long-term hyperlipidaemia risk in adults. Our findings help identify discussion points on disaster planning, including preparedness, response and recovery measures, applicable to future disasters requiring mass evacuation.
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Shuhei
authors: S
authors: Nomura
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Marta
authors: M
authors: Blangiardo
authors: Division of Social Communication System for Advanced Clinical Research, The Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Masaharu
authors: M
authors: Tsubokura
authors: Department of Surgery, Minamisoma Municipal General Hospital, Fukushima, Japan.
authors: Akihiko
authors: A
authors: Ozaki
authors: Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan.
authors: Tomohiro
authors: T
authors: Morita
authors: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
authors: Susan
authors: S
authors: Hodgson
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004190:Disasters; D005260:Female; D062406:Fukushima Nuclear Accident; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: EPIDEMIOLOGY; PUBLIC HEALTH