title: Decontamination Work and the Long-term Increase in Hospital Visits for Hymenoptera Stings Following the Fukushima Nuclear Disaster.
abstract: Animals, including arthropods, are one health threat that can be affected by disasters. This institution-based study aimed to assess trends in Hymenoptera stings following the 2011 Fukushima nuclear disaster.
  
  
  
  We reviewed the medical records of patients with hymenopteran stings who visited Minamisoma Municipal General Hospital, located 23 km from Fukushima Daiichi Nuclear Power Plant, from March 2005 to March 2016. Patient and sting characteristics of post-disaster patients were examined, and the annual incidence of hospital visits for hymenopteran stings was compared with the pre-disaster baseline, calculating an incidence rate ratio (IRR) for each year.
  
  
  
  We identified 152 pre-disaster patients (2005-2011) and 222 post-disaster patients (2011-2016). In the post-disaster period, 160 males (72.1%) were identified, with a median age of 59 years (range: 2-89 years). A total of 45 patients (20.3%) were decontamination workers. Post-disaster increases were found in the IRR for hymenopteran stings, peaking first in 2011 (IRR: 2.8; 95% confidence interval [CI]: 1.9-4.2) and later in 2014 (IRR: 3.2; 95% CI: 2.4-4.3) and 2015 (IRR 3.3; 95% CI: 2.5-4.4).
  
  
  
  Long-term increases were found in the IRR of hospital visits for hymenopteran stings in an institution affected by the Fukushima nuclear disaster. Decontamination workers appear to have been particularly affected by this phenomenon. Better disaster field worker monitoring and education about potential environmental health hazards may help to identify and prevent worker exposure to insect stings and other vectors in these settings. (Disaster Med Public Health Preparedness. 2017;11:545-551).
authors.affiliation: 1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ozaki
authors.affiliation: 1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Takeru
authors.initials: T
authors.lastname: Yokota
authors.affiliation: 6Department of Epidemiology and Biostatistics,School of Public Health,Imperial College London,London,United Kingdom.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nomura
authors.affiliation: 2Department of SurgeryRadiation Protection,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Tsubokura
authors.affiliation: 3Department of Surgery Research,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Claire
authors.initials: C
authors.lastname: Leppold
authors.affiliation: 7Department of Internal Medicine,Jyoban Hospital of Tokiwa Foundation,Iwaki,Fukushima,Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanimoto
authors.affiliation: 8Graduate School of Environmental Science,Hokkaido University,Sapporo,Hokkaido,Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Miura
authors.affiliation: Department of Surgery Obstetrics and Gynecology,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: 1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Sawano
authors.affiliation: 1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Tsukada
authors.affiliation: 9Medical Governance Research Institute,Minato-ku,Tokyo,Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.affiliation: 5Department of Surgery Gastroenterology,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kanazawa
authors.affiliation: 1Department of Surgery,Minamisoma Municipal General Hospital,Minamisoma,Fukushima,Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003666:Decontamination / Q000379:methods / Q000706:statistics & numerical data*; D055866:Earthquakes / Q000706:statistics & numerical data; D005260:Female; D062406:Fukushima Nuclear Accident; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D006927:Hymenoptera; D015994:Incidence; D007299:Insect Bites and Stings / Q000145:classification / Q000453:epidemiology / Q000628:therapy*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: environment; human migration; nuclear power plants; public health; wilderness medicine