Position Statement: What Is Currently Happening to Fukushima Children?

Original Japanese version
http://1am.sakura.ne.jp/Nuclear/kou131Matsuzaki-opinion.pdf


Consideration of thyroid disorders, pulmonary function, bone marrow function based on the studies from the Chernobyl nuclear accident, etc.

Michiyuki Matsuzaki, M.D.
Internal Medicine Department
Fukagawa Municipal Hospital, Hokkaido, Japan

May 19, 2012

1. Brief biography of author

Name: Michiyuki Matsuzaki   DOB: June 26, 1950

March 1975  M.D.(provisional), School of Medicine, Hokkaido University

April 1975  Internship and Residency, Internal Medicine 1, Graduate School of Medicine, Hokkaido University

June 1986  Executive Board Member of Hokkaido Physicians and Dentists Against Nuclear War

September 1986  Doctoral thesis for M.D. accepted, School of Medicine, Hokkaido University

April 2010  Head of Internal Medicine Department, Fukagawa Municipal Hospital, Hokkaido

April 2012  Professor of Clinical Administration, Asahikawa Medical University, Hokkaido

May 2012  Special member of Cancer Policy Board, Hokkaido Prefecture

2. Thyroid Disorders

(1) Thyroid cysts found in 35% of Fukushima children examined with an average age of 10. 

Thyroid examinations of Fukushima children have been implemented as part of the “Fukushima Prefecture Health Management Survey” to monitor the health effects of the Fukushima Daiichi Nuclear Power Plant nuclear accident.  The results of the thyroid examinations released on April 26, 2012 are summarized here.

【The official document in Japanese may be downloaded from the following link.】

http://www.pref.fukushima.jp/imu/kenkoukanri/240426shiryou.pdf

The implementation status of the examinations and the summary of the results are shown in the above document, the sixth report of Fukushima Prefecture Health Management Survey.  

(Translator note: As of the date of translation in late July, 2012, the seventh report was available, which covered further analysis of the same data from the sixth report.  For a complete description of the thyroid examination and analysis of data from both reports in English, please refer to this article. http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html)

Age distribution of the children who received thyroid examinations (average age of 10 in 4^th or 5^th grades), follow.

Ages 0-5:  9,826 children

Ages 6-10: 10,662 children

Ages 11-15: 11,466 children

Ages 16-18: 6,160 children 

Actual examination findings are evidenced in the chart below.

“Nodules” comprised 1% and “cysts” 35.1%.

In regards to Fukushima thyroid examinations including children from babies and infants up to high school students, I would like to discuss the prevalence of “cysts” detected by thyroid ultrasound examinations in comparison to the research result reported in the past.

(2)  In 250 children ages 7 to 14, two children (0.8%) had thyroid cysts.

(Based on a study co-authored by Shunichi Yamashita)

【This paper may be downloaded from the following link】

http://1am.sakura.ne.jp/Nuclear/kou131attach2.pdf

Nagasaki University’s study in 2006, co-authored by the current Fukushima University Medical School vice president Shunichi Yamashita, examined 250 children in Nagasaki prefecture with ultrasound.  Two children (0.8%) were found to have thyroid cysts.  (Cited in second paragraph on page 593 of the above study.)

(3) There are few incidences of thyroid nodules or cysts at birth.  Thyroid abnormalities begin to gradually increase past age 5.  By age 20, one in ten has thyroid nodules and/or cysts.  (Study by Mazafferri in New England Journal of Medicine.) http://1am.sakura.ne.jp/Nuclear/kou131attach3.pdf

The study published in 1993 (Mazzarerri EL, et al. Management of a solitary thyroid nodule. N Engl J Med 1993 Feb 25;328(8):553-9.) examined mostly Americans with ultrasound examinations and autopsy/biopsy.  The study revealed that few thyroid “nodules” (The study defined both tumors and cysts as nodules.) were found at birth.  Incidence began to gradually increase past the age of five, proportionate with age, with one in ten having thyroid nodules and/or cysts by age 20.  (The graph below has been compiled from Figure 1 in this study:  ● represents the prevalence of thyroid nodules detected at autopsy or by ultrasound.  □ represents the prevalence of thyroid nodules detected by palpation.)  In addition, the study stated that 25-35% of the “nodules” were “cysts.’

Prevalence of Palpable Thyroid Nodules Detected at Autopsy or by Ultrasound (●) or by Palpation (□) in Subjects without Radiation Exposure or Known Thyroid Disease.

The above graph indicates that the prevalence of thyroid nodules in children around the age of ten is about 1-2%.  Since 25-35% of them turned out to be cysts, the prevalence of thyroid cysts is estimated to be about 0.5-1%.

(4) Prevalence of thyroid cysts in Chernobyl children under the age of 18 was 0.5%.

(The Nippon Foundation study)

【The above article may be downloaded from the following link】

http://nippon.zaidan.info/seikabutsu/1999/00198/contents/012.htm

From 5 to 10 years after the Chernobyl accident, Shunichi Yamashita, the vice president of Fukushima University Medical School, conducted ultrasound thyroid examinations in a total of 160,000 children in Gomel and surrounding areas with marked radioactive contamination.  In this study, “nodules” and “cysts” were recorded separately: “nodules” mean solid tumors.  The results show that cysts were seen in 0.5% and also “nodules (solid tumors)” were seen in 0.5%.  Below is Figure 11 from this study, seen in above URL.

Figure 11. Dynamics of prevalence of abnormal findings by thyroid ultrasound examinations (1991-1996).

(5) Prevalence of thyroid “cysts” in Fukushima children is higher than in any other studies.

When the above four studies are tallied in one table, it becomes obvious that the result of the thyroid examinations of children in the “Fukushima Prefecture Health Management Survey” is astonishing.  This is because one-third of the children had developed “ cysts.” A “cyst” is a fluid-filled sac.  Cysts don’t mean there is an immediate chance of developing thyroid cancer.  However, it is apparent that something extraordinary is happening inside the thyroid gland, such as inflammation or changes in cellular properties.

Subject description	History of accidental radiation exposure	Prevalence of thyroid cysts
Fukushima children ages 0-18 (average age 10)	Yes	35 %
Nagasaki children ages 7-14	No	0.8 %
American children age 10	No	0.5-1 %
Chernobyl children under age 18	Yes	0.5 %

【Section 2 Summary】

1. Summarizing the thyroid ultrasound examination results from Japan and overseas, prevalence of “cysts” detected in children around the age of 10 is approximately 0.5-1.0%.                                                                                                  
2. The fact that 35% of Fukushima children (average age around 10) have thyroid cysts strongly suggests that these children’s thyroid glands are negatively affected by undesirable environmental factors.                            
3. There is a strong concern that waiting for further analysis of above data and the completion of follow-up examinations will lead to irreversible health damages in these children.                                                   
4. Consequently, it is strongly desired that small children living in Nakadori (adjacent to the coastal region) and Hamadori (the coastal region) in Fukushima receive immediate implementation of preventive measures such as evacuation and more frequent screening examinations.                                                           
5. Based on above findings, a letter from Shunichi Yamashita to thyroid specialists all over Japan, instructing them not to offer second opinions to concerned families, can only be considered a repressive conduct: a violation of human rights for those exposed to radiation and current patients.

3. Pulmonary Function

Sevendsen et al, from the Department of Epidemiology and Biostatistics, University of South Carolina, demonstrated in 2010 that children who had been living in areas heavily contaminated with radioactive cesium have decreased pulmonary function.

【This article may be downloaded from the following link】

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866691/?tool=pubmed

Svendsen et al. ¹³⁷Cesium Exposure and Spirometry Measures in Ukrainian Children Affected by the Chernobyl Nuclear Incident. Environmental Health Perspectives 2010 May;118(5): 720-725.

In this study, pulmonary function of 415 children under the age of 18 (mode age 8-9) was followed from 1993 to 1998.  The result showed that children who continuously lived in areas with the highest Cs-137 soil contamination (average 355 kBq/㎡) had 4-5% less forced expiratory volume in 1 sec (FEV₁) than children who continuously lived in areas with the lowest soil contamination (average 90 kBq/㎡).  

Forced expiratory volume per 1 sec (FEV₁) is the portion of the forced vital capacity exhaled in the first second of forced exhalation.  Elementary school children can normally exhale over 3 liters in the first second of forced exhalation.  A decrease of 4-5 % FEV₁ means a decrease of 100 -150 cc of absolute volume of exhaled air.

Normally pulmonary function peaks around age 20, and from then on, FEV₁ decreases by 20-30 cc per year.

A decrease of FEV₁ by 150cc means either an early aging of lungs or a failure of pulmonary maturity by 5-7 years. 

Children who continuously live in areas of Ukraine with 355 kBq/㎡ soil contamination will have pulmonary function aging five years faster than those living in uncontaminated areas.

Currently in Fukushima, which areas have Cs-137 levels of 355 kBq/㎡ vs.  90 kBq/㎡?

This is a soil contamination distribution map created by the Ministry of Education, Culture, Sports, Science and Technology last year and depicts the total soil concentration of Cs-134 and Cs-137(Bq/m²) calculated to the value estimated for August 28, 2011.

Deep blue ■ indicates a soil contamination level of 60-100 kBq/㎡, framing the hillsides of Nakadori: this is comparable to the “low contamination area” in the Sevedsen study.

Light blue ■ indicates a soil contamination level of 300-600 kBq/㎡, comparable to the highest contaminated areas in Ukraine.  All areas in Nakadori, such as Fukushima-city and Koriyama-city, have contamination levels somewhere between “low” and “the highest.”

Therefore, children currently living in Hamadori (coastal region) and Nakadori (adjacent to the coastal region) are at risk of accelerated pulmonary aging by several years.

Furthermore, this study underestimates the effect of radiation exposure by using the control group in low contamination areas in comparison.  We must therefore be prepared to face much greater health damage in reality. 

4. Bone Marrow Function

The next study to be presented exhibits data about hematopoietic dysfunction due to radiation exposure in children who kept living in highly contaminated areas leading to leukopenia and anemia.  This is a 2008 study published in Environmental Health by Dr. Stepanova from Scientific Center for Radiation Medicine, Academy of Medical Sciences of Ukraine.  It’s a follow-up study of blood counts in 1,251 children living in Narodichesky region, Zhitomir Oblast, Ukraine from 7 to 11 years after the accident.

【This article may be downloaded from the following link】

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2459146/

Stepanova et al. Exposure from the Chernobyl accident had adverse effects on erythrocytes, leukocytes, and, platelets in children in the Narodichesky region, Ukraine: A 6-year follow-up study. Environ Health. 2008; 7: 21-.

The study revealed that children living in high contamination areas (350-879 kBq/㎡) had a 20% less leukocyte count (5,810 vs. 6,870) than those living in low contamination areas (29-112 kBq/㎡).  Platelet count and erythrocyte count were also less by 5-10%.

Currently in Fukushima, areas around Nakadori indicated in deep blue ■ in the previous map is similar to low contamination areas and Kawamata-machi (outside edge of Iitate-mura) area in green ■ is similar to high contamination areas. 

Therefore, what we need to medically assume from this study is that there is a possibility that hematopoietic function of the bone marrow might be suppressed for a long time in children who are currently living in Hamadori and Nakadori of Fukushima.  Leukopenia reduces body’s resistance against bacteria and viruses.  Low red blood cell count can cause anemia more easily.  Low platelet count interferes with blood coagulation when hemorrhaging from injuries. 

Moreover, we must take into consideration that, if there are any children with illnesses or disabilities currently living in Fukushima Nakadori and Hamadori, this degree of effect on bone marrow function might exacerbate their existing conditions.

Furthermore, this study underestimates the effect of radiation exposure by using the control group in low contamination areas as comparison.  Therefor, we must be prepared to face much greater health damage in reality

【Sections 3 & 4 summary】

1. Fukushima Nakadori area continues to have radiation contamination comparable to highly contaminated areas in Chernobyl.　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　
2. Chernobyl epidemiological studies indicated that children who keep living in such areas have serious abnormalities in pulmonary function and bone marrow function. 　　　　　　　　　　　　　　　　　　　　　　　　　　　　
3. It is clear that an immediate evacuation from highly contaminated areas is imperative in order to prevent a possibility of irreversible health damages in children with future potential for life and improved health.  This is the lesson we must all learn from the tragedy of Chernobyl.

What Really Happened in Fukushima : A Report From a Medical Care Provider

Part 1
Wednesday, December 21, 2011

I am a medical care provider.  At my workplace we began taking care of patients from the evacuation zone from Fukushima Daiichi nuclear power plant in the evening of March 11, 2011.

The president of the hospital where I am employed says people live longer when irradiated and Fukushima people now will be healthier because of radiation hormesis.  There is no argument allowed.  Since this statement comes from a physician, many people believe this in Fukushima.

Those who were contemplating on evacuating from Fukushima are now in a mental state that is not even conducive to thinking about it any longer.  This was becoming obvious beginning in April or May, 2011, and it might have been a coping mechanism for mass psychology and dangers.  However, it is entirely different now.  I feel they are no longer capable of avoiding dangers.

This is what I heard from a clinical laboratory technician at work.  Thyroid ultrasound examinations for children, which have already been done in my town and which will be held in other cities from now on, are being performed by Fukushima University Medical School Hospital laboratory technicians who have only done blood tests before.  In other words, they are being done by people who have never used ultrasound equipment before.

Technicians are being dispatched from Fukushima University Medical School.  For instance, there is a whole body counter car stationed in Kawamata-machi, Date district, where a part of the town is a deliberate evacuation area.  There are physicians and clinical laboratory technicians stationed there, and they are all young.

Currently there is ”that” Yamashita stationed at Fukushima University Medical School.  After being dismissed as the radiation advisor for Fukushima prefecture, he became a vice president for Fukushima University Medical School.  The reason not a single Fukushima physician even mentions medical care for radiation exposure is because of the power of Fukushima University Medical School.  Physicians in Fukushima who are not self-sufficient are not allowed to provide medical care for radiation exposure, and those who are self-sufficient left Fukushima.

Yamashita and Fukushima University Medical School are planning on creating a cancer center (already publicized).  Minami Tohoku General Hospital in Koriyama-city, which has been introducing Gamma Knife and PET for cancer treatments on a large scale, has not had any say.  It is obvious this is because of Fukushima University Medical School.

I have also learned the following from a radiology technician in mid-March, 2011.  Test  anomalies began to show in Kanto summer of 2011 also.  But in mid-March, X-rays for a particular patient began to show white spots.  They didn’t show up if the patient was undressed.  They didn’t show up in X-rays of other patients who were examined at the hospital.  This particular patient was actually not even an evacuee but a resident who lived 45 kilometers from the Fukushima Daiichi nuclear power plant.

The technician initially thought they were dust specks, but they were clearly bright spots.  It was determined that clothes hung up to dry outside must have radioactive materials attached to them.  This “finding” was reported as such to the hospital president as well as the prefectural office.  At the time we had no idea what was going on at Fukushima Daiichi, and it was reported as a proof that “the radioactive materials have reached as far as here,” but it was never publicized.
     

Part 2
Thursday, December 22, 2011

Please let me explain about what happened immediately after the earthquake.

On March 11, 2011, we began to have more and more evacuees from Futaba-machi.

At the time, the media reported that nobody needed decontamination for high radiation levels after evacuees were “screened.”  However, some evacuees had already discarded all the clothing and belongings, decontaminated (showered), and had brand-new clothes on.  There were some who evacuated without screening examination because the system wasn’t available.  There were some elderly evacuees who were carried to the hospital by Self-Defense Force soldiers in protective clothing.  They did not go through screening.

We accepted both inpatients and outpatients without any manual or instruction for medical care for radiation exposure.  However, Fukushima University Medical School Hospital only accepted the seriously injured (essentially refusing to accept evacuees) and the Red Cross medical team said “we were told by the headquarters not to provide medical care for those exposed to radiation.”

They stayed for three days, but the Red Cross medical team went to another prefecture without seeing any patients.

More and more evacuees were coming in.  There was a talk of making this hospital a screening center in order to provide adequate screening examinations, but it was stopped by Fukushima University Medical School.  By the way, what was called screening examination was contamination examination of body surface by gamma survey meters.

As a result, the screening center was established at a nearby evacuation center.  Those who were determined to require medical care for radiation exposure were sent to Fukushima University Medical School.  Soon after Minami Tohoku General Hospital was also designated as the screening center.

Incidentally there is something important I would like to add.  There was a “thyroid examination” of children from Iitate-mura and Kawamata-machi at the end of March, 2011, but it was just like this screening examination.  Of course there was nothing abnormal found.  The children had taken a shower and changed their clothes beforehand.

The thyroid examination was carried out because there were many children who evacuated from Kawamata-cho.  Residents from Iitate-mura and Kawamata-machi did not receive stable iodine tablets even though evacuees from near the Fukushima Daiichi nuclear power plant had taken them.

Soon the residents began to be required to go through screening examination.  More people were being denied entry into other areas for evacuation: they were told they needed proof of normal screening examination.  They went through screening examinations by staff of National Institute of Radiological Sciences (NIRS) at each evacuation center.  They should really screen thyroids or the back of hands, but what they did was a less detailed scanning.  That’s how they did the examination because it was assumed to be “okay.”

Yamashita went around declaring “It’s safe.” after March 20, 2011.  He said he would conduct children’s thyroid examination, and he repeated said, “Everything is fine.”

Thyroid Examination by Fukushima Prefecture

Fukushima Prefecture has been conducting “Prefecture Health Management Survey” including estimation of external radiation exposure dose, thyroid examination, basic medical examination, psychological questionnaire, survey of pregnant women and women with babies.

The result of the initial round of preliminary thyroid examination of 38,114 children, out of approximately 360,000 eligible children, was released in the sixth report of Fukushima Prefecture Health Management Survey on April 26, 2012.  

http://www.pref.fukushima.jp/imu/kenkoukanri/240426shiryou.pdf

Further analysis of the same result from these 38,114 children was published in the seventh report of Fukushima Prefecture Health Management Survey on June 12, 2012.

http://www.pref.fukushima.jp/imu/kenkoukanri/240612shiryou.pdf

Please refer to the previous article in regards to the letter from Shunichi Yamashita to Japan Thyroid Association members, dated January 16, 2012, asking them to adhere to the guidelines set by Fukushima Medical University in managing thyroid abnormalities.

http://fukushimavoice-eng.blogspot.com/2012/05/fukushima-childrens-thyroid-examination.html

Below is the straight translation of the thyroid examination section of the Fukushima Prefecture Health Management Survey.

******************************************************************************************************

The Sixth Report of Fukushima Prefecture Health Management Survey
April 26, 2012

Implementation status for “thyroid examination” in Prefecture Health Management Survey

1. Purpose of survey

The health effects from Tokyo Electric Company Fukushima Dai-ichi Nuclear Power Plant accident due to East Japan Great Earthquake are considered to be extremely unlikely, considering the current radiation levels.  However, Chernobyl nuclear accident revealed pediatric thyroid cancer from internal radiation exposure due to radioactive iodine.
Thus, children’s health is to be watched on a long-term basis. Thyroid examination was implemented in October 2011 to assess the current thyroid conditions to track children’s lifetime health and to relieve children and parents of worries.

2. Subjects

All Fukushima residents (including those who evacuated out of Fukushima) who were ages 0 to 18 on March 11, 2011.  Approximately 360,000 residents.  In concrete terms it covers all Fukushima Prefecture residents (including those who evacuated out of Fukushima) who were born between April 2, 1992 and April 1, 2011.

3. Implementation plan details

(1) Method:  

If thyroid mass (nodular lesion) is detected upon thyroid ultrasound examination, secondary examination (more detailed ultrasound examination, blood test, urine test, and biopsy if needed) at Fukushima Medical University Hospital.

(2) Implementation schedule:  

Preliminary examination (examination for assessment of current status) will be performed on all eligible residents from October 2011 to March 2014.
In addition, after April 2014, standard examination will be done every two years up to age 20 and every five years after age 20, watching over the health of residents for the remainder of their lives.
Also the target group will be expanded to include those who were born before April 1, 2012.

4. Fiscal Year 2011 Implementation status

(1) Subjects:  

47,766 residents from evacuated areas specified by the government, including Tamura-city, Minamisoma-city, Date-city, Kawamata-machi, Hirono-machi, Naraha-machi, Tomioka-machi, Kawauchi-mura, Okuma-machi, Futaba-machi, Namie-machi, Katsurao-mura, and Iitate-mura.

(2) Implementation status:

• Primary examination:  Examination was started at Fukushima Medical University Hospital on October 9, 2011.  Examination was then performed off-site at public facilities in Kawamata-machi, Minamisoma-city, and other places.  By the end of fiscal year 2011 (the end of March 2011), 38,114 residents (79.8% of eligible residents) were examined.

• Reporting of primary examination result: Assessment Committee established within Fukushima Medical University evaluated and analyzed the ultrasound images.  As for those who received examination within fiscal year 2011 have already received the results by mail.

• Secondary examination:  For those requiring secondary examination, Fukushima Medical University officially notified them of the date, time and place of the examination.  Specialists have been conducting secondary examination since March 2012 at Fukushima Medical University Hospital.  In regards to the result of the secondary examination, subjects were asked to come back to the hospital one to two weeks later to have the specialists explain the result in person.  By this time (April 12, 2012), 14 have undergone secondary examination and 6 have received the result.

(3) Major efforts made to implement examination:

In fiscal year 2011, the following efforts were made in implementing the examination.  They were intended to take into consideration the convenience of examination subjects and structure more effective and efficient examination system, so that as many residents could receive examination as possible.

[1] Consideration in securing examination opportunities for subjects

• For those not examined, effort was made to secure examination opportunities as much as possible by re-sending new examination schedule.
• Examination was performed at locations (16 locations in Fukushima Prefecture not including schools) as close to evacuation locations as possible.
• For school-age children and older students, examination was performed at their schools.
• At the examination site, a fast examination process was made possible by designing an integrated system including reception, actual examination (including explanation) and saving of ultrasound images.
• Implementation of examination was made possible for the age 0 to 5 group, which had been anticipated to be difficult examination subjects.

[2] Securing the quality of the examination

• Support of thyroid specialists in and outside Fukushima Prefecture was obtained by widely publicizing the thyroid examination and asking for cooperation through Japan Thyroid Association, Japan Association of Endocrine Surgeons, Japan Society of Thyroid Surgery, The Japanese Society for Pediatric Endocrinology, The Japan Society of Ultrasonics in Medicine, Japanese Society of Sonographers, and The Japan Association of Breast and Thyroid Sonology.
• Quality of examination over a certain standard was secured by direct involvement of thyroid specialists in the examination.  Also an effort was made to secure qualified personnel through direct instruction by the said specialists.  

*As many as 61 specialists outside of Fukushima Medical University assisted with examination multiple times during the fiscal year 2011.

[3] Establishing the base for thyroid examination within Fukushima Prefecture

• In order to solidify the thyroid examination system within Fukushima Prefecture, a thyroid examination workshop was held in Fukushima-city on March 4 for physicians and technicians.

5. Fiscal year 2012 implementation plan (proposal)

In fiscal year 2012, examination will be implemented in a planned, effective and efficient manner for subjects living in areas other than the government-specified evacuation areas.  In addition, medical facilities outside Fukushima Prefecture will be certified to provide thyroid examination so that those who evacuated out of Fukushima will be able to receive the examination in relocated areas.

Summary of examination schedule and target groups:

First examination:

Initial preliminary examination

Date: October 2011 to November 2011

Location: Fukushima Medical University

Target group: Part of subjects from planned evacuation areas (Yamakiya region of Kawamata-machi, Namie-machi and Iitate-mura)

All-prefecture preliminary examination

Date: November 2011 to March 2014

Location: Facilities such as health centers, community centers and schools (Performed by physicians from Fukushima Medical University and also with cooperation of physicians in and outside Fukushima Prefecture.)

Target group: Unexamined residents from planned evacuation areas and all other subjects.

Second examination and beyond:

All-prefecture standard examination
Date: April 2014 -

Location:  Examination centers in Fukushima Prefecture and medical facilities outside Fukushima Prefecture.

　Target group: All subjects..
*Every two years up to age 20 and every 5 years after age 20.

Fiscal Year 2011 Thyroid Examination Implementation Status
(as of the end of March, 2012)

• In the fiscal year 2011, examination was done in residents of evacuated areas.
• In the examination period from October 2011 through March 2012, 79.8% (38,114) of eligible residents had thyroid examinations.

Captions for the table from left to right:
Town/village name, number of subjects (A), number of examined residents (B), % examined (B/A), breakdown by age group, number of examined residents living outside Fukushima (C), % out-of-prefecture residents examined (C/B).

Town/Village names from top to bottom: Tamura-city, Minamisoma-city, Date-city, Kawamata-machi, Hirono-machi, Naraha-machi, Tomioka-machi, Kawauchi-mura, Okuma-machi, Futaba-machi, Namie-machi, Katsurao-mura, Iitate-mura.

Fiscal Year 2011 Thyroid Examination Summary (as of the end of March, 2012)


Total Number of children tested: 38,114

Explanation for assessment results:

• A1 and A2 will be followed until the next examination (after 2014)
• B and C will have secondary examination (They will be notified of date and place.)

*In A2, those in need of secondary examination will be categorized in B.

Summary

Some cases had both nodules and cysts.

***************************************************************************************************

The Seventh Report of Fukushima Prefecture Health Management Survey
June 12, 2012

Fiscal Year 2012 Thyroid Examination Implementation Status (as of June 8, 2012)For original document, please refer to this link so that you may zoom in.
https://docs.google.com/file/d/0B68f83tqq7Qud05vOWNGaXpkUU0/edit
(Page 11 of the report, which is page 14 of the actual document.)

Thyroid examination (primary examination) implementation summary for subjects in Fukushima-city

• Beginning May 14, 2012, subjects in Fukushima-city began receiving thyroid examination.
• Subjects in Fukushima-city will have thyroid examination until August 31, 2012.
• In Fukushima-city, thyroid examinations will be held at elementary and junior high schools, Fukushima-city Active Senior Center (AOZ), National Sports Festival of Japan Memorial Gymnasium, and Fukushima Youth Hall.
• In the 20-day implementation period up to June 8, 2012, 11,751 out of expected 13,304 actually received the examination.
• Of 53,619 subjects in Fukushima-city, 45,331 (84.5%) already expressed interest in receiving thyroid examination by June 8. (Based on the consent form submission as of June 8)

Primary thyroid examination implementation status (bottom table)

Captions from left to right: number of subjects (A), number of examined residents (B), % examined (B/A), breakdown by age group for B, out-of-prefecture residents in B (C), % of out-of-prefecture residents examined (C/B)

Captions from top to bottom: H24 (Heisei 24 = 2012) Fukushima-city, examination status as of June 8, H24 (2012) outside Fukushima-city, examination implemented in H23 (Fiscal year 2011)

*The”outside Fukushima-city” category includes subjects from Minamisoma-city, Date-city, Kawamata-machi, Naraha-machi, Tomioka-machi, Okuma-machi, Futaba-machi, Namie-machi and Iitate-mura.

**************************************************************************************************
Fiscal Year 2011 Thyroid Examination Summary (as of the end of March, 2012)
For original document, please refer to this link so that you may zoom in.
https://docs.google.com/file/d/0B68f83tqq7Qud05vOWNGaXpkUU0/edit
(Page 12 of the report, which is page 15 of the actual document.)

Note that the first table in this summary is basically the same as one from the 6th report except the number with cysts smaller than 20.0 mm is 13,383 instead of 13,379 for some reason.

Subsequent tables and graphs show more detailed information of the data reported in the 6th report, such as the breakdown by sex, age, and size of nodules and cysts.


Total Number of children tested: 38,114

Explanation for assessment results:

• A1 and A2 will be followed until the next examination (after 2014)
• B and C will have secondary examination (They will be notified of date and place.)

*In A2, those in need of secondary examination will be categorized in B.

Summary

Some cases had both nodules and cysts.

***************************************************************************************************

Fiscal year 2011 thyroid examination summary (as of the end of March 2012)
For original document, please refer to this link so that you may zoom in.
https://docs.google.com/file/d/0B68f83tqq7Qud05vOWNGaXpkUU0/edit
(Page 13 of the report, which is page 16 of the actual document.)

1. Assessment status
Captions from left to right: age groups, A1, A2, B, C, Total (Each assessment result subdivided into male/female/total.)
Captions from top to bottom on left: age groups, 0-5 years, 6-10 years, 11-15 years, over 16 years
2. Breakdown by sex and age groups
Left bar graph: male
Right bar graph: female

blue=A1, red=A2, green=B, purple=C



Following data shows the thyroid examination subjects who had nodules in the fiscal year 2011 examination.
For original document, please refer to this link so that you may zoom in.
https://docs.google.com/file/d/0B68f83tqq7Qud05vOWNGaXpkUU0/edit
(Page 14 of the report, which is page 17 of the actual document.)
The table on bottom left shows breakdown by size of nodules and sex.

Left column shows size.

Of 38,114 examined, 37,729 (19,036 boys and 18,693 girls) had no nodules.
201 had nodules graded A2, smaller than 5.0 mm.
184 had nodules graded B, larger than 5.0 mm.

The graph on right shows further breakdown of size of nodule at 1 mm increments.
Girls shown in red line and boys in green.

Following data shows the thyroid examination subjects who had cysts in the fiscal year 2011 examination.
For original document, please refer to this link so that you may zoom in.
https://docs.google.com/file/d/0B68f83tqq7Qud05vOWNGaXpkUU0/edit
(Page 15 of the report, which is page 18 of the actual document.)

The table on bottom left shows breakdown by size of cysts and sex.

Left column shows size.

Of 38,114 examined, 24,730 (12,890 boys and 11,840 girls) had no cysts..
12,414 had cysts smaller than 5.0 mm.
969 had cysts graded A2, smaller than 20.0 mm.
1 had cysts graded B, larger than 20.0 mm.

The graph on right shows further breakdown of size of cysts at 1 mm increments.

Girls shown in red line and boys in green.

Download ：Thyroid Examination by Fukushima Prefecture
https://docs.google.com/open?id=0B68f83tqq7QuZUdCZXhTLVl2dEE