Impacts of the 2011 Fukushima nuclear accident on emergency medical service times in Soma District, Japan: a retrospective observational study.
OBJECTIVE
To assess the influence of the 3.11 triple disaster (earthquake, tsunami and nuclear accident) on the emergency medical service (EMS) system in Fukushima.


METHODS
Total EMS time (from EMS call to arrival at a hospital) was assessed in the EMS system of Soma district, located 10-40 km north of the nuclear plant, from 11 March to 31 December 2011. We defined the affected period as when total EMS time was significantly extended after the disasters compared with the historical control data from 1 January 2009 to 10 March 2011. To identify risk factors associated with the extension of total EMS time after the disasters, we investigated trends in 3 time segments of total EMS time; response time, defined as time from an EMS call to arrival at the location, on-scene time, defined as time from arrival at the location to departure, and transport time, defined as time from departure from the location to arrival at a hospital.


RESULTS
For the affected period from week 0 to week 11, the median total EMS time was 36 (IQR 27-52) minutes, while that in the predisaster control period was 31 (IQR 24-40) min. The percentage of transports exceeding 60 min in total EMS time increased from 8.2% (584/7087) in the control period to 22.2% (151/679) in the affected period. Among the 3 time segments, there was the most change in transport time (standardised mean difference: 0.41 vs 0.13-0.17).


CONCLUSIONS
EMS transport was significantly delayed for ∼3 months, from week 1 to 11 after the 3.11 triple disaster. This delay may be attributed to malfunctioning emergency hospitals after the triple disaster.
Department of Internal Medicine, Soma Central Hospital, Soma City, Fukushima, Japan Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan.
Tomohiro
T
Morita
Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan.
Masaharu
http://orcid.org/0000-0001-8027-202X
M
Tsubokura
Faculty of Policy Management, Keio University, Fujisawa, Kanagawa, Japan.
Tomoyuki
T
Furutani
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Shuhei
S
Nomura
Department of Internal Medicine, Soma Central Hospital, Soma City, Fukushima, Japan.
Sae
http://orcid.org/0000-0003-4133-3170
S
Ochi
Department of Research, Minamisoma Municipal General Hospital, Minamisoma City, Fukushima, Japan.
Claire
C
Leppold
Fire Suppression Division, the Soma Regional Fire Department, Minamisoma City, Fukushima, Japan.
Kazuhiro
K
Takahara
Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma City, Fukushima, Japan.
Yuki
Y
Shimada
Department of Gastroenterology, Minamisoma Municipal General Hospital, Minamisoma City, Fukushima, Japan.
Sho
S
Fujioka
Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan.
Masahiro
M
Kami
Department of Radiation Protection, Soma Central Hospital, Soma City, Fukushima, Japan.
Shigeaki
S
Kato
Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma City, Fukushima, Japan.
Tomoyoshi
T
Oikawa
ACCIDENT & EMERGENCY MEDICINE; Disaster Medicine; Emergency Medical Services; Fukushima Nuclear Accident; PUBLIC HEALTH
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