Twelve years on: An evaluation of mental health status in Tomioka Town, located within 20 km of the Fukushima Daiichi Nuclear Power Station
Twelve years on: An evaluation of mental health status in Tomioka Town, located within 20 km of the Fukushima Daiichi Nuclear Power Station
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十二年后：福岛第一核电站 20 公里范围内的富冈镇心理健康状况评估
DOI：
10.1088/1361-6498/acce44
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发表时间：
2023
影响因子：
1.5
通讯作者：
Takamura Noboru
中科院分区：
文献类型：
--
作者：
Matsunaga Hitomi;Xu Xiao;Orita Makiko;Kashiwazaki Yuya;Taira Yasuyuki;Takamura Noboru
自2011年东京电力公司控股的福岛第一核电站（FDNPS）事故以来，已经过去了12年。福岛县的富冈镇位于FDNPS的20公里范围内，事故发生时所有居民都被疏散。我们之前对富冈的调查显示，疏散但尚未返回的居民的心理健康状况较低，但生活满意度高于疏散但返回富冈的居民[1]。截至2023年2月，富冈的居住率为17.8%，这意味着即使在2017年疏散令开始解除后，大多数居民仍继续住在城外[2]。2021年11月和2022年1月，我们对截至2021年3月11日持有富冈在留卡的18岁以上的9655人进行了邮寄调查。令人惊讶的是，即使在事故发生十多年后，我们也证实了14.3%的受访者患有严重的抑郁症，而在日本，根据Kessler六项心理困扰量表（K6）的评估，一般人群中只有3%。K6量表表示过去30天的情绪困扰。它已被经验验证，用于筛选FDNPS事故的疏散人员，得分为13或更高被定义为“严重痛苦”[4]。72.3%（1263人）的受访者表示对富冈社区没有归属感。此外，27.3%（477人）的居民回答说，他们的健康因FDNPS的辐射而恶化，尽管没有记录表明福岛县居民的不良健康影响直接归因于FDNPS事故的辐射照射[5]（表1）。此外，我们注意到，严重的抑郁症与以下因素独立相关：“感觉他们的健康状况因FDNPS的辐射而恶化”（比值比（OR）= 2.5，95%置信区间（CI）：1.9-3.4; p< 0.001），“未决定是否返回”（ITR）（OR= 1.7，95% CI：1.2-2.3，p= 0.001），“过去一年内未访问过富冈”（OR= 1.6，95%CI：1.2-2.3，p= 0.004），和“没有感觉到属于富冈社区”（OR= 1.4，95%CI：1.2-1.7，p< 0.001;表2）。我们进一步分析了受访者的K6分数与ITR之间的关系，发现“已经返回并居住在富冈”的人中抑郁症的比例增加（11.1%）及“决定不回港”人士（12.4%），其次是“想返回”（17.1%）和"尚未决定是否返回富冈“（18.7%;图1）。这项研究证实，那些想要返回和那些尚未决定ITR的人的心理健康状况较差。该研究还澄清，77.6%的前居民在过去一年内访问过富冈一次或多次，尽管他们对访问相关的辐射暴露感到焦虑。先前的研究澄清了大约一半的居民认为FDNPS事故造成的辐射暴露会影响他们的健康或后代[6]。这些结果表明，持续的辐射风险疏散人员的沟通是至关重要的，他们的心理健康，无论他们的ITR。富冈“难以返回”地带的疏散令将从2023年春季开始逐步解除。在此之后，99.9%的居民（截至2023年3月1日，11 433/11 977）将被允许返回富冈的家园[6]。然而，已经澄清的是，与返回者相比，撤离者不知道与辐射有关的最新信息或有关重建的细节。
Twelve years have passed since the Tokyo Electric Power Company Holdings’ Fukushima Daiichi Nuclear Power Station (FDNPS) accident in 2011. The town of Tomioka, in the Fukushima Prefecture, is located within 20 km of the FDNPS, and all residents were evacuated at the time of the accident. Our previous survey on Tomioka revealed that residents who were evacuated but have not yet returned had low mental health status but greater life satisfaction than residents who had evacuated but have returned to Tomioka [1]. The residential rate of Tomioka was 17.8% as of February 2023, meaning most residents have continued living outside of the town, even after the evacuation order began to be lifted in 2017 [2]. In November 2021 and January 2022, we conducted a postal survey of 9655 people aged 18 years and older who held Tomioka residence cards as of 11 March 2021. Surprisingly, even more than a decade after the accident, we confirmed that 14.3% of respondents suffered from severe depression, in contrast to 3% of the general population in Japan, as assessed by the Kessler six-item psychological distress scale (K6)[3]. The K6 scale indicates emotional distress over the past 30 d. It has been empirically validated for screening evacuees of the FDNPS accident, and a score of 13 or higher was defined as ‘severe distress’[4]. Among the respondents, 72.3%(1263) indicated that they did not feel a sense of belonging to the Tomioka community. Moreover, 27.3%(477) of residents responded that their health had deteriorated because of the radiation from the FDNPS, although no adverse health effects among Fukushima prefecture residents have been documented that are directly attributable to radiation exposure from the FDNPS accident [5](table 1). In addition, we noted that severe depression was independently associated with the following factors:‘felt that their health had deteriorated because of radiation from the FDNPS’(odds ratio (OR)= 2.5, 95% confidence interval (CI): 1.9–3.4; p< 0.001),‘undecided of their intention to return’(ITR)(OR= 1.7, 95% CI: 1.2–2.3, p= 0.001),‘have not visited Tomioka within the last year’(OR= 1.6, 95% CI: 1.2–2.3, p= 0.004), and ‘did not feel a sense of belonging to the Tomioka community’(OR= 1.4, 95% CI: 1.2–1.7, p< 0.001; table 2). We performed a further analysis of the relationship between respondents’ K6 scores and ITR and found that the rate of depression increased among those who had ‘already returned and were living in Tomioka’(11.1%) and those who ‘decided not to return’(12.4%), followed by those who ‘want to return’(17.1%) and those who are ‘undecided about their return to Tomioka’(18.7%; figure 1). This study confirmed poor mental health among those who want to return and those who were undecided regarding ITR. The study also clarified that 77.6% of former residents had visited Tomioka once or more within the past year, regardless of their anxiety about visiting-related radiation exposure. The previous study clarified that about half of residents thought that radiation exposure due to the FDNPS accident would affect their health or offspring [6]. These results indicated that continuing radiation risk communication for evacuees was crucial for their mental health, regardless of their ITR. The evacuation order for the ‘difficult-to-return’zone in Tomioka will gradually be lifted beginning in the spring of 2023. Following this, 99.9% of the residents (11 433/11 977, as of 1 March 2023) will be allowed to return to their homes in Tomioka [6]. However, it has been clarified that, compared with returnees, evacuees did not know updated radiation-related information or details about the the reconstruction of …