#Radioactive Japan: One of the Most Contaminated Villages and Towns in #Fukushima Lures Children Back with $100 Book Coupons

Meanwhile in one of the most contaminated towns and villages in Fukushima after the nuclear accident more than two years ago, officials have just launched a new program to encourage children to receive annual health checkups.

If a child undergoes one annual health checkup, he/she will receive 10,000 yen (these days it's close to US$100) worth of book coupons (gift certificates for books).

If a child happens to have evacuated from the village and does not go to the village schools (temporarily re-located to Fukushima City and Kawamata-machi, both contaminated to lesser degrees than this particular village), oh well that's too bad, his/her coupon value will be only 5,000 yen.

The officials openly admit the scheme is to incentivize people with children to come back to the village.

What's the name of the village?

Iitate-mura, with extremely high levels of iodine-131 and several thousand becquerels/kg of neptunium right after the March 2011 accident, and which, thanks to the very politically savvy mayor, has managed to keep the businesses and factories inside the village operating despite the village having been designated as "planned evacuation zone".

From Fukushima Minpo reporting as if it's a good thing (4/18/2013; part):

スタンプで受診率向上へ　飯舘村　内部被ばく、甲状腺検査　中学生以下図書カードに交換

Collect the stamps: Iitate-mura to give book coupons to children in middle schools and younger to boost the participation rate for internal radiation exposure [WBC] tests and thyroid tests

東京電力福島第一原発事故で全村避難した飯舘村は１７日、村の幼稚園児から中学生までの子ども全員に毎年、内部被ばく検査と甲状腺検査を受けることを促す「全までいっ子内部被ばく・甲状腺検査事業」を開始した。受診するとスタンプがたまり、図書カードと交換できる。受診率の低下が背景にあり、園児や児童・生徒に受診を習慣化させたい考えだ。

Iitate-mura, whose residents have evacuated from the village because of the Fukushima I Nuclear Power Plant accident, started a new program on April 17 to urge children in the village from kindergarteners to middle schoolers to get tested for internal radiation exposure and thyroid every year. If children get tested, they will be given a stamp, which will be exchanged with book coupons. The project is in response to the lower participation rate, and [the village officials] want these children to make it a habit to be tested.

村が打ち出した内部被ばく・甲状腺検査事業は、福島市のあづま脳神経外科病院で年１回、両検査を受けるとスタンプが１個もらえる。スタンプは１個１万円分の図書カードに交換でき、卒園・卒業時にスタンプ数に応じた図書カードが交付される。幼稚園や学校が病院での検査を学校行事として計画する。

The program will give one stamp to a child if the child receives both internal radiation check and thyroid test once a year at Azuma Neurosurgical Hospital in Fukushima City. One stamp can be exchanged for book coupons worth 10,000 yen, and at graduation from kindergartens and schools children will be given the book coupons depending on the number of stamps they will have accumulated. [The village] kindergarten and schools will plan the tests at the hospital as school events.

避難のため村の幼稚園や学校から転校した子どもも対象だが、１スタンプで交換できるのは５千円分の図書カード。福島市飯野町にある村の幼稚園と中学校、川俣町にある村の小学校に戻ってもらう狙いもある。

The program also covers children who have transferred to other schools after they evacuated from the village. However, for them, one stamp is exchangeable for book coupons worth 5,000 yen. One of the program's aims is to have them come back to the village kindergarten and middle school in Iino-machi in Fukushima City, and the village elementary school in Kawamata-machi.

村は子どもの健康管理のため、年１回の内部被ばくと甲状腺の検査受診を求めているが、一度受診するとその後は受診しない子どもが増えている。受診者のほとんどが問題のない数値だったため、定期的な受診に結び付いていない、と村は分析している。

The village officials want children to undergo annual internal radiation testing and thyroid testing, but an increasing number of children have stopped taking these tests after the initial tests. The officials believe that since the initial test results for most children were not in the range that would cause alarm they haven't led to regular checkups.

Testing at a neurosurgical hospital? I checked the website of Azuma Neurosurgical Hospital. They do have pediatrics as one of their specialties but the doctor in charge of the pediatrics section is a surgeon specialized in cardiology. There is no thyroid specialist, or for that matter, radiation specialist.

The hospital has Fastscan by Camberra.

From Camberra's website about Fastscan:

The Fastscan whole body counter is designed to quickly and accurately monitor people for internal contamination of radionuclides with energies between 300 keV to 1.8 MeV. The FASTSCAN system uses large area sodium iodide detectors and CANBERRA's Apex-InVivo™ and Genie™ software to achieve low minimum detectable activities with count times as fast as one minute. It is intended for use in power plants and other facilities where the possible contamination spectra are well known and uncomplicated.

That doesn't seem to fit the situation in Fukushima and Tohoku/Kanto regions affected by the nuclear accident.

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#Radioactive Japan: Thyroid Control Screening Reveals Much Higher Percentages of Cysts and Nodules in Children Far Away from Fukushima

The control screening tests for thyroid abnormalities in children is being carried out by the Ministry of the Environment in Hirosaki City in Aomori Prefecture (distance from Fukushima I Nuclear Power Plant about 420 kilometers), Kofu City in Yamanashi Prefecture (about 380 kilometers), and Nagasaki City in Nagasaki Prefecture (about 1,480 kilometers).

The preliminary results have been announced by the Ministry of the Environment, and they more or less match the unofficial small-scale screening test results announced by doctors in Kobe City back in November 2012: Children in these far-away areas have higher incidents of nodules and cysts than children in Fukushima Prefecture.

Aomori and Nagasaki hardly had fallout from the accident. Yamanashi had some fallout, but the numbers don't even compare to the prefectures in Kanto, or even to neighboring Shizuoka.

Fallout from the Fukushima I Nuclear Power Plant accident in these prefectures in March 2011 (Monthly fallout data from the Ministry of Education):

• Aomori: I-131 1 MBq/km2, Cs-134 0.12 MBq/km2, Cs-137 0.097 MBq/km2

• Yamanashi: I-131 480 MBq/km2, Cs-134 170 MBq/km2, Cs-137 170 MBq/km2

• Nagasaki: I-131 9.8 MBq/km2, Cs-134 0.32 MBq/km2, Cs-137 0.35 MBq/km2

Here are the numbers for the thyroid screening, as reported by Fukushima TV on March 8, 2013:

Number of subjects: 4,300 total
Age of subjects: 3 to 18 years
Tests scheduled to run from November 2012 to the end of March 2013
Locations: Hirosaki City, Aomori Prefecture; Kofu City, Yamanashi Prefecture; Nagasaki City, Nagasaki Prefecture
Results:

Percentage of children found with nodules and/or cysts

• Fukushima Prefecture: 41.2%

• Nagasaki, Aomori, Yamanashi: 56.6%

Percentage of children in B-category that requires further testing　[with nodules larger than 5mm, cysts larger than 20mm]

• Fukushima Prefecture: 0.6%

• Nagasaki, Aomori, Yamanashi: 1%

For more on thyroid abnormalities in children, see this togetter if you read Japanese. It seems these thyroid "abnormalities" are quite normally occurring anywhere in Japan.

That's not what many people in Japan and abroad want to hear. The conclusion for people in Japan who believe any bad news and rumors and disbelieves any non-bad news and rumors when it comes to radiation is either that the rest of Japan is so heavily contaminated by the Fukushima nuclear accident that children outside Fukushima have even higher incidents of thyroid abnormalities, or that the government is lying.

The former doesn't make any scientific sense if they want to attribute these abnormalities singularly to the Fukushima nuclear accident (which they do), and the latter doesn't advance any understanding or discussion. But it doesn't seem to matter anyway. Radiation contamination has become almost like a religion, and since the national and local governments and government scientists did such a poor job of informing citizens of the nuclear accident and radiation contamination in the early days of the accident, people heavily discount anything they say or do.

Knowledge hasn't advanced much, with the 2nd anniversary of the triple disaster of earthquake, tsunami and nuclear accident fast approaching.

For that matter, recovery hasn't happened much either, other than the fake dead tree in Rikuzen Takata (which now has fake branches and leaves).

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Latest Numbers on Thyroid Testing in Fukushima (November 1, 2012)

From the September 2012 report (that details the result of the fiscal 2011 testing) and November 2012 report from the Fukushima prefectural government on the thyroid testing for children in Fukushima, using ultrasound:

Number of children tested so far (2011, 2012): 114,471
Number of children whose test results have been confirmed, as of September 28: 95,954
(to base the ratios of children with nodules and cysts)

Number of children with nodules larger than 5mm: 491 (0.51%)
Number of children with nodules 5mm or less: 432 (0.45%)

Number of children with cysts larger than 20mm: 5 (0.005%)
Number of children with cysts 20mm or less: 37,758 (39.35%)
(Of the above, children with cysts 3mm or less: 21,031)

In regular medical practice, thyroid cysts of 3mm or less are considered as "no cysts", according to the Fukushima Prefecture.

Summary page of the November 2012 report by the Fukushima prefectural government (English labels are mine):

And the page that has the breakdown of the cyst by size, for children tested in the fiscal 2012 up to September 28, 2012 (English labels are mine):

People in Japan continue to freak out after listening to Dr. Caldicott, particularly over her remark that 40 percent of 80,000 children tested in Fukushima "have thyroid abnormalities, which is incredibly rare in pediatrics". (Around 11:30 into the video.)

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#Fukushima Health Management Survey Protocol, in Researchers' Own Words

Not much, unfortunately, due to the nature of the paper whose focus is on the protocol, not data analysis.

The Japan Epidemiological Association's official magazine "Journal of Epidemiology" has the paper titled "Study Protocol for the Fukushima Health Management Survey", by Seiji Yasumura et al (including Dr. Shunichi Yamashita).

It is about the health survey on Fukushima residents including children, from which some fantastic stories have been woven and disseminated, including "CONFIRMED: 36 Percent Of Fukushima Kids Have Abnormal Thyroid Growths".

Thyroid examination of children in Fukushima is discussed in some detail in the paper, as, the authors admit, the basic survey response rate is too low to form and present a credible opinion on the health issues. However, the paper does not have the children's thyroid test data, as the paper is clearly about test protocol and methodology.

From the paper's abstract:

Background: The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey.

Methods: This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation.

Conclusions: The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long-term large-scale epidemiologic study is expected to provide valuable data in the investigation of the health effects of low-dose radiation and disaster-related stress.

The entire paper is free to download (in PDF) from the Journal of Epidemiology site:

Full Text PDF [3173K]

I may finally finish writing about the "36% of Fukushima children with thyroid abnormalities". For now, I'll just say that the owner of the blog who started the story openly admitted that he/she had chosen not to mention certain facts about the past survey of children in the areas affected by the Chernobyl accident by Dr. Shunichi Yamashita. That deliberate omission ended up casting Dr. Yamashita in even worse light (if that's still possible), but that is of concern to hardly anyone at this point.

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89 Millisieverts Equivalent Dose at Thyroid from a Resident in Namie-machi, Fukushima, Says Hirosaki University Researchers

Professor Shinji Tokonami, Department of Radiation Physics, Institute of Radiation Emergency Medicine, Hirosaki University and his researchers say people who escaped from the coastal areas of Fukushima Prefecture after the accident and people who continued to live in Namie-machi after the March 11, 2011 nuclear accident were found with high levels of radiation exposure on the thyroid.

They tested 65 residents in April 2011, and it is in the news on March 9, 2012. Another case of nearly one-year delay in disclosing the information that would have made the difference if known earlier. Like 11 months ago.

From Asahi Shinbun (3/9/2012):

東京電力福島第一原発事故で、放射性ヨウ素によって甲状腺に９０ミリシーベルト近い被曝（ひばく）をしていた人がいることが分かった。弘前大学被ばく医療総合研究所の床次眞司（とこなみ・しんじ）教授らが、事故の約１カ月後に行った住民６５人の測定結果を分析した。被曝した人の約半数が１０ミリシーベルト以下だったが、５人が５０ミリシーベルトを超えていた。

It has been disclosed that someone was exposed to nearly 90 millisievert radiation [equivalent dose] on the thyroid from radioactive iodine during the Fukushima I Nuclear Power Plant accident. Professor Shinji Tokonami, Department of Radiation Physics, Institute of Radiation Emergency Medicine, Hirosaki University and his researchers analyzed the test result of 65 Fukushima residents. The test was conducted 1 month after the accident. Of people who were exposed to radiation, about half had equivalent dose of 10 millisieverts or less, but 5 people had equivalent dose exceeding 50 millisieverts.

　甲状腺被曝はがんのリスクがあるが、ヨウ素は半減期が短く、事故直後の混乱などで、きちんとした計測はされておらず、詳しい実態は分かっていなかった。

The radiation exposure on the thyroid increases the risk of cancer. However, radioactive iodine has a short half life, and the exposure was not measured properly in the confusion right after the accident and the details were not known.

　床次さんらは昨年４月１１～１６日、原発のある福島県浜通り地区から福島市に避難してきた４８人と、原発から３０キロ圏周辺の浪江町津島地区に残っていた住民１７人を対象に、甲状腺内の放射性ヨウ素の濃度を調べた。この結果、８割近い５０人からヨウ素が検出された。

From April 11 to 16 last year, Professor Tokonami's group measured the density of radioactive iodine in the thyroid of 48 people who evacuated from Hamadori (coastal 1/3 of Fukushima) to Fukushima City and 17 people who remained in Tsushima District of Namie-machi, right outside the 30 kilometer radius from the nuclear power plant. Radioactive iodine was found in 50 people, nearly 80% of people tested.

　この実測値から、甲状腺の内部被曝線量を計算した。事故直後の３月１２日にヨウ素を吸い込み、被曝したという条件で計算すると、３４人は２０ミリシーベルト以下で、５人が、健康影響の予防策をとる国際的な目安の５０ミリシーベルトを超えていた。

From the actual measurement, the researchers calculated the equivalent dose at the thyroid. Assuming they had inhaled radioactive iodine immediately after the accident on March 12 and were exposed to radiation, the calculation showed that 34 people had equivalent dose of 20 millisieverts and less, and 5 people exceeded 50 millisieverts, which is an international standard for intervention to prevent negative effect on health.

　最高は８７ミリシーベルトで、事故後、浪江町に残っていた成人だった。２番目に高かったのは７７ミリシーベルトの成人で、福島市への避難前に同町津島地区に２週間以上滞在していた。子どもの最高は４７ミリシーベルト。詳しい行動は不明だ。

The maximum equivalent dose was 87 millisieverts, from an adult who remained in Namie-machi after the accident. The second highest was 77 millisieverts from an adult who had spent more than 2 weeks in Tsushima District of Namie-machi on his/her way to evacuate to Fukushima City. The highest dose in children was 47 millisieverts. There is no information of whereabouts of the child during the weeks in March and April.

　国が昨年３月下旬、いわき市、川俣町、飯舘村の子ども１０８０人に行った測定では、３５ミリシーベルトが最高値と公表されていた。

In the test done by the national government late last March on 1,080 children in Iwaki City, Kawamata-machi, and Iitate-mura, 35 millisievert equivalent dose was announced as the maximum.

From Asahi's extremely convoluted tabulation, here's what I've figured out (I think, maybe):

• 48 people from Hamadori (coastal 1/3), 17 people who remained in Tsushima District of Namie-machi, total 65 people

• Radioactive iodine detected in 50 people

• 25 people below 10 millisieverts equivalent dose
  

• 9 people between 10 and 20

• 11 people between 20 and 50

• 5 people above 50

Why can't Asahi say it straight? (Rhetorical question in case you're wondering.)

NHK, reporting on the same news, says the researchers are yet to tell the residents about the test result:

調査チームでは、今後、検査を行った住民に対し結果を報告することにしています。

The researchers plans to tell the residents about the test result in the near future.

How nice of them.

Hirosaki University is one of the 86 national universities in Japan.

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1143 Children (Over 30%) of 3765 Tested for Thyroid Abnormalities in Fukushima Had Lumps or Cysts (Updated)

(UPDATE: The document issued by the Fukushima Prefecture's expert committee is here (PDF, in Japanese).

Total number of children tested: 3765
No. of children found with lumps [nodules] 5.1 millimeter or larger: 26
No. of children found with lumps [nodules] less than 5.1 millimeter: 56
No. of children found with cysts 20.1 millimeter or larger: 0
No. of children found with cyst less than 20.1 millimeter: 1086
No. of children with no lumps [nodules], cysts: 2622

There are children who have both lump [nodule] and cyst.

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Waaaiiit a minute...

I was looking for more information on the post I wrote about the lumps on the thyroid 5.1 millimeters or bigger in diameter found in 0.7% or 26 children out of 3765 children tested in Fukushima Prefecture. I was specifically looking for information on the number of children who had any lump at all.

I've just found it in an unlikely place: Fukushima Minpo, local Fukushima newspaper. I thought they would obfuscate, but they have the details. The article looks like it is a part of a longer article; it is possible it is abbreviated from the article in the print version of the newspaper.

It turns out,

Total number of children tested: 3765
No. of children found with lumps 5.1 millimeters and larger: 26 (0.7% of total)
No. of children found with lumps smaller than 5.1 millimeters: 1117 (29.7% of total)

1143 children, or 30.4% of children tested, were found with lumps of varying sizes.

From Fukushima Minpo (1/25/2012):

検討委員会では、浪江、飯舘両町村、川俣町山木屋地区の１８歳以下を対象にした甲状腺検査の結果が報告された。３７６５人のうち、「直ちに二次検査を要する」と判断された県民はいなかった。

At the expert commission, the result of the thyroid test was reported. The test was done on the children below the age of 18 in Namie-machi, Iitate-mura, and Yamakiya District of Kawamata-machi [all planned evacuation zone]. Of 3765 children, there was no one who was deemed necessary to immediately go through further testing.

直径５・１ミリ以上のしこりなどが確認され、二次検査の対象となったのは２６人（０・７％）だったが、検討委座長の山下俊一福島医大副学長は「原発事故に伴う悪性の変化はみられない」と説明している。二次検査が不要の３７３９人（９９・３％）のうち、１１１７人（２９・７％）は５・０ミリ以下のしこりなどが確認されたが、県は「良性」と判断している。

26 children (0.7%) have been found with lumps with 5.1 millimeters or larger in diameter, and will go through further testing [at some time]. However, Shunichi Yamashita, the head of the commission and the vice president of Fukushima Medical University explains, "There is no malignant change due to the nuclear plant accident". Of 3739 children who will not need further testing (99.3% of children tested), 1117 children (29.7%) have been found with lumps 5.0 millimeters or less in diameter. But the prefectural government has decided they are "benign".

甲状腺検査は県民健康管理調査の一環で、浪江、飯舘両町村、川俣町山木屋地区で先行して行われた。他の地域では順次、実施している。

The thyroid testing is part of the Fukushima residents health management survey, and was carried out in Namie, Iitate-mura, and Yamakiya District of Kawamata-machi first. For the other areas, it has been on-going.

It decidedly does not look totally OK to me, and the explanation by the Fukushima officials sounds suspect.

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Thyroid Abnomalities in 0.7% of Fukushima Children, According to Prefectural Government

(UPDATE: See my latest post. Total 1143 children out of 3765 tested had lumps on the thyroid.)

============================

(Let's repeat the refrain: "It has nothing to do with radiation".)

From Jiji Tsushin (1/25/2012):

１８歳以下０．７％、５ミリ超のしこり＝放射線の影響「考えにくい」－福島県

0.7% of children under the age of 18 have developed lumps [on the thyroid] more than 5 millimeters in diamater: "Hard to believe" there is any effect of radiation, says Fukushima prefectural government

　福島県は２５日、東京電力福島第１原発事故の発生時に１８歳以下だった県内の子ども全員を対象とした甲状腺検査の先行調査の結果を初めて公表した。超音波検査を受けた３７６５人のうち、０．７％に当たる２６人から５．１ミリ以上のしこりが見つかった。

On January 25, the Fukushima prefectural government announced for the first time the result of the early test of thyroid gland on the children who were in Fukushima Prefecture and were under the age of 18 at the time of the Fukushima I Nuclear Power Plant accident. Of 3765 children who were tested with ultrasound, 26 children or 0.7% of the children tested were found with lumps that measure more than 5.1 millimeters in diameter.

　検査を担当した福島県立医科大は「良性のしこりで、以前から存在していた可能性が高く、放射線の影響は考えにくい」としているが、念のために超音波や採血などの追加検査を行う。

Fukushima Medical University, who conducted the test, says, "They are benign lumps. It is highly likely that these lump had existed before, and it is hard to believe there is any effect of radiation". However, just in case, the university will conduct additional ultrasound testing and blood testing.

　先行調査の対象は事故当時に浪江町と飯舘村、川俣町山木屋地区に住んでいた子ども。２６人の大半は６歳以上で、がんの疑いがあるケースはなかったという。

The early test was done on children who lived in Namie-machi, Iitate-mura, and Yamakiya District of Kawamata-machi at the time of the accident. Most of the 26 children are over the age of 6, and according to the Fukushima prefectural government there was no case of suspected cancer.

Fukushima Medical University, as you recall, has Dr. Shunichi Yamashita as the vice president. He and his associates are responsible for telling the residents in Iitate-mura and other high radiation cities and towns in Fukushima that it was safe to be outside, to eat vegetables, to drink water, when the radioactive fallout was falling heavily in Fukushima in March and April.

Of course these lumps are benign. They have to be.

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