Lessons learned from the Fukushima Daiichi nuclear power plant accident; the initial 5 days medical activities after the accident

Abstract

The Great Eastern Japan Earthquake was an unprecedented combined disaster involving a huge earthquake and tsunami, and a nuclear power plant accident. On March 11th, 2011, a huge earthquake and tsunami severely damaged the Fukushima Daiichi nuclear power plant. The next day, on March 12th, a hydrogen explosion occurred at the No. 1 reactor, and the government ordered the evacuation of a 20 km radius around the plant. On March 14th, the No. 3 reactor exploded, followed by the No.2 and 4 reactors on March 15th, which caused the emission of a vast nuclear plume. At this critical moment, the Fukushima Nuclear Disaster Management Center, which was supposed to function as the nuclear disaster headquarters, was also damaged, resulting in the loss of the control center. Most of the residents left, but approximately 700 patients in hospitals and nursing care facilities remained in the area. An emergency evacuation was planned for these patients on March 14th. However, difficulties were encountered in finding appropriate facilities for these patients, and some of them had to wait in buses or at evacuation sites for longer than 24 hours. These evacuation conditions unfortunately resulted in more than 20 casualties due to deterioration of underlying illnesses, dehydration and/or hypothermia.Fifteen power plant workers were injured in the series of explosions. Later, efforts were made to restore the cooling systems of the damaged reactors. Injuries occurred because of trauma and exposure to high levels of radiation. The radiation emergency medical system in Fukushima did not function properly, and great difficulties were encountered in treating those with radioactive contamination.Fortunately, no deaths due to explosion or acute radiation injury were reported for the Fukushima Daiichi nuclear power plant accident. However, the evacuation of patients from the 20 km evacuation zone was accompanied by loss of life. Temporary shelters should be developed for those in hospitals and other care facilities in such areas. Alternative hospital and other facilities for patients should be designated in advance, and staged evacuation should be considered. In addition, further development of emergency medical systems for radiation exposure, and education of medical staff and students, are urgently needed.