Questioning the Very Status of the Ministry of the Environment

Expert Meeting Regarding

the Status of Disaster Victims' Health Management
It might have been a slip of a tongue, but Chairman Shigenobu Nagataki, an emeritus
professor at Nagasaki University, a former chairman of Radiation Effects Research
Foundation, and a mentor to infamous Shunichi amashita, appeared to be speaking
earnestly !hen he said, "Committee members, please do not hesitate to ask #uestions$ %iven
!hat !as &ust stated, it !ill be disastrous for this committee to have to conclude that there is
an actual increase in thyroid cancer 'due to the Fukushima accident($" )oshihide )suda, a
physician and an epidemiologist at *kayama University, has &ust emphatically stated that in
certain Fukushima municipalities there !as a clear evidence of a thyroid cancer epidemic in
those !ho !ere +, or younger at the time of the -arch ./++ accident$ Calling this an
0outbreak, occurring only 1$+ to 1$. years after the accident,2 )suda stressed that in the near
future, thyroid cancer !ould begin to appear in those !ith relatively longer latency periods,
!hich means a #uick action is needed to secure ade#uate medical resources in order to be
able to provide diagnosis and treatment in a timely manner$
)his conversation happened during the eighth session of the E3pert -eeting Regarding the
Status of 4ealth -anagement of Residents Follo!ing the )okyo Electric Fukushima 5aiichi
Nuclear 6o!er 6lan 7ccident, held by the -inistry of the Environment on 8uly +9, ./+:$ )he
E3pert -eeting !as originally established in order to discuss the health care and radiation
e3posure aspects of the Children and 5isaster ;ictims Support 7ct, !hich !as approved by
the 5iet in 8une ./+.$
7s a background, Fukushima 6refecture is already conducing health management survey for
the residents utili<ing a fund established by the national government$ 4o!ever, the national
government is in need of discussing the current status of health management and its
challenges in Fukushima 6refecture as !ell as the surrounding prefectures from a medical
vie!point$ In addition, the Children and 5isaster ;ictims Support 7ct re#uires the national
1
government to take any necessary measures regarding surveys on radiation health effects$
=ased on these needs, the E3pert -eeting !as established !ithin the -inistry of the
Environment to discuss, from an e3pert perspective, the status of measures for grasping and
assessing e3posure doses, health management, and medical care$
Fundamentals of the Children and 5isaster ;ictims Support 7ct are summari<ed as follo!s>
providing accurate information?
supporting the choice of residing, moving and returning based on the intention of
disaster victims?
making efforts for prompt alleviation of health concerns from radiation e3posure?
giving due consideration so that disaster victims do not face un!arranted
discrimination?
giving special consideration for children @including fetusesA and pregnant !omen?
and continuing a longBterm and reliable support for radiation effects as long as needed$
Issues discussed at the -*E E3pert -eeting !ere in particular related to the 7rticle +1 of the
Children and 5isaster ;ictims Support 7ct, in regards to the study on health effects of
radiation e3posure and the provision of medical care$ )he 7rticle +1 reads as follo!s>
+$ In order to clarify the situation of radiation e3posure caused by the )okyo Electric
nuclear accident, the national government shall take measures such as estimating
radiation e3posure doses and assessing e3posure doses using tests effective for dose
assessment, and any other necessary measures$
.$ )he national government shall take necessary measures in regards to implementing
regular medical checkups for the disaster victims and conducting other surveys of
health effects from radiation e3posure due to the )okyo Electric nuclear accident$ In
this case, necessary measures should be taken so that those !ho have resided in
areas !ith radiation levels measured above a certain threshold as children @including
those !ho !ere in utero !hen their mothers resided in such areasA, or those in
2
e#uivalent circumstances, shall have lifelong medical checkups$
1$ In relation to the medical e3penses to be borne by children or pregnant !omen !ho
are disaster victims @e3cluding medical care relating to in&uries or illnesses not caused
by radiation e3posure due to the )okyo Electric nuclear accidentA, the national
government shall take necessary measures to reduce the financial burden or any other
measures relating to the provision of medical care to the disaster victims$
7 point of contention at the -*E E3pert -eeting, headed by Nagataki, has been the dose
assessment, especially the direct measurements of thyroid glands of +,/,/ children @age / to
+CA, conducted in late -arch ./++$ Nagataki seemed determined to utili<e the direct
measurement data, !hich concluded that nobody e3ceeded C/ mSv, despite critical issues
such as a small sample si<e and high background radiation levels$ 4e has been trying to build
an 0e3pert consensus2 regarding the validity of the direct measurement data$ 4o!ever, guest
presentations by e3perts at the E3pert -eeting have revealed that the contamination level of
clothing, not the background air dose rate, !as used as the background radiation level, !hich
!as subtracted from the actual count to obtain the e3posure dose$ )his could have potentially
resulted in underestimation$
In addition, Nagataki emphasi<ed ho! the high kombu @a type of sea!eed !ith especially
high iodine contentA consumption rate amongst the 8apanese offered protective effects
against radioactive iodine, given the fact the ma&ority of children never received stable iodine
tablets for thyroid blocking before e3posure to the radioactive plume$ 4o!ever, the actual
consumption amount of kombu in last :/ years has gone do!n, for reasons such as the
introduction of !estern food in the +DE/s$ 7ccording to NagatakiFs presentation at the .//E
7merican )hyroid 7ssociation meeting, the average dietary iodine intake from sea!eeds !as
+$. mgGday in 8apan
+
$ 4o!ever, kombu consumption appears to be decreasing each year,
especially in younger families !ith children !hich consumed oneBthird of average amount of
sea!eed consumption, due to decreased consumption of traditional foods$ ChildrenFs dietary
intake from sea!eeds might be a #uarter to oneBthird of NagatakiFs outdated claim$
7s each session of the E3pert -eeting progressed, Nagataki !orked to!ards building a
3
consensus to 0scientifically2 validate the +,/,/ screening data for dose assessment and thus
the basis for estimating health risks, despite its shortcomings$ )he e3posure dose estimate
from the +,/,/ screening data, !ell belo! +// mSv, !hich is !idely regarded by regulators
and radiation protection specialists as the level cancers might increase, !ould allo! the
government to claim that health risks is too lo! to necessitate e3pansion of medical checkups
to !ider areas and age groups$ 7t the seventh session held on 8une .C, ./+:, Nagataki
pointed out
.
that 0)imes are different bet!een no! and !hen the Children and 5isaster
;ictims Support 7ct !as approved$ He no! have more dose assessment data !hich allo! us
to talk about the health risks scientifically$ )his is a huge difference,2 !hen 4iromi Ishika!a,
the e3ecutive director of 8apan -edical 7ssociation, pressed for consideration of introduction
of medical checkups in hotspots outside Fukushima 6refecture, such as -atsudo and
Iamagaya in Chiba 6refecture, based on the principle of the Children and 5isaster ;ictims
Support 7ct$
7s a matter of fact, in his attempt to build an e3pert consensus, Nagataki appeared not to
take into consideration opinions of outside e3perts if they differed from his$ Even more, he
appeared to be trying to disregard the very mission of the E3pert -eeting> discussing
radiation health effects and health management on the basis of the Children and 5isaster
;ictims Support 7ct$
)his became the most apparent at the 8uly +9
th
session, as depicted in the 8uly .. )okyo
Shimbun article, translated into English here$
)suda, one of the five e3pert !itnesses invited, claims that the current 0outbreak2 of thyroid
cancers in Fukushima children cannot be e3plained by the 0screening effect,2 !hen the data
is analy<ed and compared !ith the national cancer statistics as !ell as !ithin Fukushima
6refecture against municipalities !ith the lo!est e3posure dose$
4
Table 1 Comparison of thyroid cancer detection probabilities within Fukushima Prefecture
(Prevalence Odds Ratio determined against Aizu and Soma areas as the control).
# of
cancer
cases
# of
participants for
primary
examination
POR
Prevalence
Odds Ratio
(95% C.I.) Detection
probability
H23 Most exposed areas 14 41,981 6.11 (1.08, 130.53) 1/ 2,998.6
H24 North (Fukushima City, etc.) 12 50,773 4.33 (0.75, 93.48) 1/ 4,231.1
H24 Middle (Nihonmatsu City, etc.) 11 17,969 11.22 (1.92, 243.83) 1/ 1,633.5
H24 Koriyama City 23 54,951 7.67 (1.43, 179.76) 1/ 2,389.2
H24 South (Shirakawa City, etc.) 8 16,912 8.67 (1.39, 194.01) 1/ 2,114.0
H25 Iwaki City 14 47,519 5.40 (0.96, 115.31) 1/ 3,394.2
H25 SE area excluding Iwaki City 6 25,876 4.25 (0.63, 98.45) 1/ 4,312.7
H25 Rest excluding Aizuwakamatsu 1 18,327 1 1/18,327
Critical of the commonly accepted notion that health effects do not occur belo! +// mSv,
)suda presented numerous published studies that proved other!ise$ In fact, he by far
e3ceeded +/ minutes allotted for each of the five e3pert !itnesses that day, and Nagataki had
to nudge him to !rap up more than t!ice$ )suda defiantly replied, 0)his E3pert -eeting has
not brought up these studies 'as it should have(, so I must do it 'for you(,2 and !ent on until he
!as done$
)suda e3plained that in outbreak epidemiology, !hich !as developed as an investigative tool
in studying disease outbreaks !here the cause isnFt al!ays apparent, the effect @diseaseA is
!hat is studied and dealt !ith$ 4e called the E3pert -eetingFs fi3ation on dose assessment
0back!ards2 and 0a mere laboratory method$2 )suda said to Nagataki, 0He must remember
that this is an issue of humans$2
)suda also said that the E3pert -eeting should consider the fact that all age groups including
pregnant !omen !ere still being e3posed to radiation in Fukushima 6refecture$ )his dre! an
applause from the audience of general public, !hich made Nagataki displeased$ 4e said,
0Um, this applause$$$havenFt the audience been asked not to applause ahead of timeJ2 )his
statement also appeared to startle Nagataki and other members, such as *tsura Ni!a, a
5
retired Iyoto University 6rofessor !ho holds a position of Special 6rofessor at Fukushima
-edical University$ =oth Nagataki and Ni!a, in disbelief, had to confirm !ith )suda !hat he
meant$ )suda said, 0He are all being e3posed to radiation in 8apan, e3cept the air dose rate
is higher in Fukushima$2
5uring the debate follo!ing the presentations by the !itnesses, there !ere some #uestions
regarding )sudaFs presentation as described in this post$ )suda insisted that the Horld 4ealth
*rgani<ation @H4*A report clearly stated thyroid cancer, leukemia, breast cancer and other
solid cancers !ould increase$ In response, Ni!a talked
1
about the dilemma he faced as a
member of the H4* 4ealth Risk 7ssessment E3pert %roup, !hich compiled Health risk
assessment from the nuclear accident after the 2011 Great East apan earth!uake and
tsunami" based on a preliminary dose estimation
:
in February ./+1$
Ni!a felt that doses !ere overestimated due to various issues !ith assumptions utili<ed in
dose estimation$ 4e repeatedly asked the E3pert %roup to employ more realistic methods to
estimate doses, but the E3pert %roup chose to stick to higher estimate doses, taking a
conservative and cautious approach based on a radiation protection concept$ Ni!a says he
disagreed !ith the E3pert %roupFs decision and argued that the conservative approach
certainly !ould be reasonable and indeed very important in a prospective estimation, but that
it !ould not be appropriate to retrospectively estimate unnecessarily high doses in those !ho
!ere already e3posed$ Ni!a disclosed during the discussion that he suggested reducing the
estimated doses by oneBtenth, but that the E3pert %roup never incorporated his suggestion$
@7fter the meeting !as over, )suda and Ni!a carried out further, informal discussion on
!hether the thyroid cancer cases in Fukushima !ere due to the screening effect or not$
)suda asked Ni!a if he has ever read a single published study regarding a screening effect$
Ni!a replied, 0No, not myself$2 )suda, speaking !ith a freelance &ournalist, *shidori -ako,
e3pressed his disappointment and frustration !ith the E3pert -eeting, as the soBcalled
e3perts !ere not even familiar !ith studies published on health effects of radiation belo! +//
mSv$ )suda felt that it !as impossible to carry out sufficient arguments as the grasp of the
basic kno!ledge differed so muchA$
6
5uring the concluding statement, Nagataki ackno!ledged that the consensus of the E3pert
-eeting to accept United Nations Scientific Committee on the Effects of 7tomic RadiationFs
@UNSCE7RFsA approach to assessing health risks, based on dose estimation, appeared to
differ vastly from the opinions of the !itnesses$ 4e stated that the E3pert -eeting !as taking
a serious care to consider 'the !ellBbeing of( the disaster victims and earnestly discussing the
best !ay to carry out health management for them$ )his statement contradicts the statement
he made at the 8une .C session, dismissing the Children and 5isaster ;ictims Support 7ct$
-ost of all, if the E3pert -eeting !ere seriously considerate of the disaster victims !hose true
e3posure doses are unkno!able, due to the lack of sufficient early e3posure data, !hy !ould
it be disastrous for this E3pert -eeting to have a conclusion that cases of thyroid cancers
might be increasingJ )he E3pert -eeting !ould be truly serving the disaster victims if it fully
embraces its mission to e3pertly discuss radiation health effects and health management,
adhering to the principles of the 7rticle +1 of the Children and 5isaster ;ictim Support 7ct,
from the vie!point of precautionary principle, rather than having pre&udged conclusions$
*ther important issues to be raised about this E3pert -eeting have to do !ith the potential
conflict of interest$ For instance, Ni!a, also a member of International Committee on
Radiation 6rotection @ICR6A , is kno!n to have received financial support from the Federation
of Electric 6o!er Companies of 8apan for his travel e3penses to the ICR6 meetings
C
$
7lthough the H4* E3pert %roup cleared his conflict of interests in this matter, citing his
e3pertise in molecular biology and radiation biology, he certainly appears to have a conflict of
interest for the -*E E3pert -eeting$
Ni!a is not the only one !ith the potential conflict of interest$ Chairman Nagataki is currently a
chairman of the board of Radiation Effects Foundation
9
, !hich arranged financial assistance
from the Federation of Electric 6o!er Companies of 8apan to Ni!a$ Some of the members,
Nobuhiko =an and )oshimitsu 4onma, !ere involved !ith the making of UNSCE7R
Fukushima report$ asuhito Sasaki is a former committee chairmann of UNSCE7R$
Hith the deviation from its original mission and the apparently predetermined conclusion to
underestimate health risks, along !ith the potential conflicts of interest in multiple members, is
7
it not time to #uestion the very status of the E3pert -eeting Regarding the Status of 4ealth
-anagement of Residents Follo!ing the )okyo Electric Fukushima 5aiichi Nuclear 6o!er
6lant 7ccidentJ
8
1

http://online.liebertpub.com/doi/abs/10.1089/thy.2007.0379
2
http://www.ourplanett!.or"/#$%node/1800 '(apanese)
3
https://www.youtube.com/watch#!%*s+,--.0/u012eature%youtu.be1t%2h32m8s '(apanese)
4
http://apps.who.int/iris/bitstream/10665/78218/1/97892415051303en".pd2#ua%1
5
http://bi"story.ap.or"/article/ape4clusi!e5apanscientiststoo6utilitymoney
6
http://www.rea.or.5p/honbu/"aiyou/ya6uinmeibo.pd2 '(apanese)