Curious Remarks About “Whole Genome Analysis” Made by Goshi Hosono, Minister of Environment

Recently there was an NHK (Nippon Hoso Kyokai) news story on the NHK World website regarding the announcement made by Goshi Hosono, Minister of Environment, for “genetic studies” to be conducted in Fukushima.  (NHK, or Japan Broadcasting Association, is Japan's national public broadcasting television station.)

Curiously, this news story was deleted from the NHK World site after only two days.  NHK websites do not maintain archives of news stories for some reason, but the deletion after two days seemed like an exceptional decision.

For reference, NHK also has a track record of maintaining a “double standard” for domestic and international coverage of the same news story.  For instance, NHK was very slow at broadcasting anti-nuclear demonstrations preceding the July restart of Oi nuclear power plant.  Initially, they simply did not cover the story.  Eventually they did a 27-second segment of the onsite demonstration the day before Oi restart in NHK World.  However, the domestic coverage was a cursory mention that a demonstration happened (as in past tense) but the restart was to happen as scheduled.

http://fukushimavoice-eng.blogspot.com/2012/07/nhks-double-standard.html

In this case, however, the original Japanese news story and the English version were not too far off, except the Japanese version was more detailed.  Please compare the two versions below, followed by the screenshots of both.

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NHK World English news story published at 10:45 am (JST) on August 31, 2012.

Government to study genetic effects of radiation

The Japanese government plans to study the possible effects of radiation on genes of people affected by the Fukushima nuclear accident. It will begin the tests in the next fiscal year.

Environment minister Goshi Hosono revealed the plan at a meeting in Fukushima City on Thursday.

Fukushima residents have been voicing concerns over possible genetic effects of radioactive substances emitted in the nuclear accident at the Fukushima Daiichi nuclear power plant in March last year.

The ministry plans to conduct blood and other tests. The ministry says it will work with the Fukushima Medical University and research institutions. The first priority will be testing children.

Hosono said after the meeting that the health of Fukushima residents needs to be monitored for more than 50 years. He said understanding radiation influences on the genetic level could help these people in the future.

The ministry plans to request funding to carry out the study in its budget for the next fiscal year.

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English translation of an original Japanese version of the NHK news story published at 6:45 am on August 31, 2012.  http://www3.nhk.or.jp/news/html/20120831/k10014669541000.html

Nuclear accident: Genetic effects to be studied

Ministry of Environment has decided on a policy to begin studying the effects of radiation on human genes in people who were affected by TEPCO Fukushima Dai-ichi nuclear power plant accident.  The study will begin in the next fiscal year.

The plan was revealed by Minister of Environment, Goshi Hosono, at a meeting held in Fukushima-city in the evening of August 30th.

After the nuclear accident, Fukushima residents have been voicing their concerns that  genes might be affected by the spread of radioactive material after the nuclear accident.

For this reason, Ministry of Environment has decided on a policy to study, beginning in the next fiscal year, the possible effects of radiation on human genes by collecting blood samples from those who wish to be tested among the residents who were affected by the nuclear accident.  

He said they have not decided when the study would begin or who would be included in the study.  However, Ministry of Environment will cooperate with Fukushima Medical University and other research institutions to conduct the study, giving priorities to children.

After the meeting, Minister of Environment Hosono stated, “Fukushima residents’ health will need to be monitored not just 5 to 10 years, but for over half a century from now on.  I think understanding the effect (of radiation) on the gene level will prepare us for the future.”

Ministry of Environment plans on including the cost of the study in the request for budgetary appropriations for the next fiscal year.





Curiously, though, a Sankei News website story, published six hours before the original NHK story, at 00:35 am on August 31, 2012, has a slightly different take on the news.

http://sankei.jp.msn.com/affairs/news/120831/dst12083100360000-n1.htm

English translation and the screenshot of the news story to follow.

“Whole genome analysis” in Fukushima declared as part of radiation exposure investigation by Minister of Environment

Ministry of Environment, Goshi Hosono, revealed on August 30, 2012, that the government would begin a “whole genome (genetic information) analysis study” on Fukushima residents, in the next fiscal year, in order to investigate the effects of radiation exposure on genes from the TEPCO Fukushima Dai-ichi nuclear power plant accident.  He told the press corps after a private round-table conference at Fukushima Medical University in Fukushima-city.

Ministry of Environment Hosono said, “The government intends to squarely face (issues in) Fukushima.  A study on genes might not immediately resolve anxiety (of residents), but an investigation of fundamental genes in humans would lead to future prevention.”  MInistry of Environment will primarily study children.

Ministry of Environment Hosono revealed a plan to include 6.1 billion yen (about $80 million) in the request for budgetary appropriations for the next fiscal year for a new center planned by Fukushima Medical University.  The new center will become a hub for perinatal and pediatric medical care, in addition to Fukushima Prefecture Health Management Survey and radiation researches.

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The Sankei story strikingly differs from the NHK stories in the use of the term, “whole genome analysis.”  However, their use of the term in the headline suggests that the term was actually used by Minister Hosono.

On the video in the NHK news story, Minister Hosono says, “Health of Fukushima residents will have to be monitored by us, not just for 5 to 10 years, but for over half a century.  I think a clear understanding on the gene level will prepare us for the future.”

What was it that he said prior to this statement referring to genes?  What does he mean by “prepare for the future”?  
　　
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It is a well-known fact that it is not “whole genome analysis” but a chromosomal aberration  study that can be used as an objective and sensitive index of radiation exposure.

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Chromosomal aberrations have been studied since the atomic bombs in Hiroshima and Nagasaki.

Cytogenetic Study of the Offspring of Atomic Bomb Survivors, Hiroshima and Nagasaki
http://www.nap.edu/openbook.php?record_id=1800&page=344

Chromosome aberrations and malignant disease among A-bomb survivors
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1348854/

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Chromosomal aberrations were also studied after the Chernobyl nuclear accident.

Chromosomal aberrations and sickness rates in Chernobyl clean-up workers in the years following the accident
http://www.ncbi.nlm.nih.gov/pubmed/20065691

The Follow-up Study of Chromosomal aberrations in Chernobyl Clean-up Workers
http://www.rri.kyoto-u.ac.jp/NSRG/reports/kr79/kr79pdf/Slozina.pdf
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The Hiroshima International Council for Health Care of the Radiation-exposed (HICARE) has a publication called “Genbaku Hoshasen no Jintai Eikyou 1992 (Effects of A-bomb Radiation on the Human Body) --Digest Edition--.”
http://www.hicare.jp/en/13/hi01.html

Chapter 7 of this publication covers chromosomal aberrations.
http://www.hicare.jp/en/13/e_chapter07.pdf

On page 20, it states, “A strong correlation exists between aberration frequency and distance from the hypocenter, and hence with radiation dose” and “In follow-up studies, chromosomal aberrations in the bone marrow act as an important indicator for the development of various hematopoietic disorders (particularly leukemia).”

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Japanese researchers have known, from the human effects of the atomic bomb, that chromosomal aberrations are correlated with radiation exposure dose and act as an important index for radiation exposure.  Despite this existing knowledge, even at 18 months after the Fukushima accident, the government has not only failed to initiate chromosomal aberration studies but insists on “whole genome analysis.”

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Dr. Alexey Yablokov, a Russian biologist and ecologist and one of the authors of ”Chernobyl: Consequences of the Catastrophe for People and the Environment,” made the following statement upon hearing the news of impending “whole genome analysis” in Japan.
　　　
“It's really a pity that nobody is conducting studies on chromosomal aberrations in Japan.  I can hardly believe it.  Chromosomal aberrations are one of the objective indexes of radiation exposure.

Genetic studies for chromosomal aberrations were started several months after the Chernobyl accident by researchers at the Institute of General Genetics of USSR Academy of Science in Moscow.  All liquidators were examined at the initial study.  Several months later, multiple genetic institutes from Minsk and Kiev joined and examined the evacuees and later thousands of inhabitants in all contaminated territories.  Hundreds of scientific papers have been published as a result of these genetic studies.”

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The Japanese government simply cannot fool the world by using the term, “whole genome analysis.”

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What needs to happen in Japan is NOT to use Fukushima children exposed to radiation for an "experiment" named "whole genome analysis," but an immediate evacuation of those children from contaminated areas.  

Instead of “calculating estimated exposure doses” from theoretical yet uncertain factors, such as where they were, how long they were there, what they ate, etc., we need to determine “actual damages” the body sustained from radiation exposure.  This could include baseline studies including blood tests, thyroid ultrasound examination and EKG,  urine testing for radioactive material, whole body counter testing, chromosomal aberration studies known to correlate with radiation exposure dose from the atomic bomb research, and observation of lens opacity in the eyes known to correlate with radiation exposure dose from the Chernobyl research.  These studies could be used to assess the current condition of these children (and adults) and to monitor them.  (Dr. Yablokov also suggests the following:  tooth enamel EPR or Electron Paramagnetic Resonance dosimetry; and monitoring changes in buccal epithelium, which is being done in Bryansk, the most polluted area in Russia after Chernobyl.)

Rather than simply conducting follow-up studies for the purpose of gaining data for epidemiological researches to publish, at a later date, “what the occurrence of a certain cancer was,” we need to take care of the children.  We need to thoughtfully and thoroughly help them lead comfortable, happy lives, after they were “forced to sustain radiation exposure,” by closely monitoring their health conditions so that any signs of illness can be caught early for appropriate and swift medical managements.  

Children are a nation’s treasure.  Without taking care of our children, our nation will not survive.  When will they realize that?

Medical Food Services in Japan

Involuntary internal radiation exposure from consumption of contaminated food

The Japanese government has been trying very hard to “promote” food products from disaster-affected regions.  It’s called, “Tabete Ouen Shiyou!” or “Let’s Eat and Help!” campaign, which uses celebrities and politicians for “showing” that it is safe enough for them to eat.  Prime Minister Noda has been seen sampling sashimi from fish caught off the Fukushima coast and juicy peaches grown in Fukushima Prefecture.

It might be one thing for ignorant people to accept the government propaganda campaign, but it is inexcusable when the campaign is extended to school lunches and now medical food services which cater to hospitals, nursing homes, and welfare facilities.  Those already compromised by illnesses, aging, or disabilities are basically force-fed food, without any option, which might be contaminated with radioactive material such as cesium, strontium and possible more.

Below is complete translation of a letter sent from the Chief of Food Industry Affairs Bureau in the Ministry of Agriculture, Forestry and Fisheries, to the president of the Japan Medical Food Services Association.

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Original letter in Japanese is found here:
http://www.maff.go.jp/j/press/shokusan/ryutu/pdf/120822-04.pdf

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24 Shokusan No. 2511
August 22, 2012

To: President of Japan Medical Food Services Association, Public Interest Incorporated Foundation

From: Chief, Food Industry Affairs Bureau,  Ministry of Agriculture, Forestry and Fisheries

Regarding promotion of use of food produced in disaster-affected regions for the purpose of reconstruction of areas affected by Great East Japan Earthquake.

I hope this letter finds you well.

I would like to express my appreciation for various support and cooperation you have provided to disaster-affected regions since the Great East Japan Earthquake last March.

It has been about a year and a half since the earthquake happened.  Disaster-affected regions have begun recovery of major infrastructures in earnest, and attempts are in progress towards reconstruction of industries.  In addition, as of July 13, Basic Policy for the Reconstruction and Rebirth of Fukushima was approved by the Cabinet, based on the Special Measures for the Reconstruction and Rebirth of Fukushima.  The Government will continue to put full effort into recovery and reconstruction of the disaster-affected regions including Fukushima.

However, despite these efforts towards recovery and reconstruction, economic situations of disaster-affected regions are still grim.  In order to solve this, we think it is important that we erase the anxiety of consumers towards the agricultural, forest and fishery products produced and processed in disaster-affected regions and surrounding areas (called “food produced in disaster-affected regions” from hence on), in an attempt to expand their consumption.

For this purpose, Ministry of Agriculture, Forestry and Fisheries, in cooperation with other related ministries and agencies, have widely and accurately released to the public such information as the test results for radioactive material in food and shipment restrictions of products.  At the same time we have called for a campaign, “Let’s Eat And Help!,” to actively consume food produced in disaster-affected regions.　Under approval of private business operators and others, we have taken initiatives to sell and use, with priority, food produced in disaster-affected regions all over the nation with, by holding sales fairs and encouraging their use in company cafeterias.

Promoting expansion of nationwide consumption of food produced in disaster-affected regions will bring a powerful aid to fast recovery and reconstruction of disaster-affected regions.  In addition, it will maintain and increase nationwide opportunities for supporting disaster-affected regions.

Therefore, even though some of you have already made efforts to help disaster-affected regions, I would like to ask you to encourage members of your association, who are offering food services at medical, nursing and welfare facilities, to promote the use of food produced in disaster-affected regions.  This will help with expansion of nationwide consumption of food produced in disaster-affected regions.

The Medical Act of Japan

Portion of the Medical Act of Japan that pertains to “duty to provide medical care” was excerpted and translated into English.

http://www.houko.com/00/01/S23/201.HTM (The entire Medical Act in Japanese)
Originally enacted on July 30, 1948, and most recently revised on June 27, 2007.


Article 19　
Section 1.  Practicing physicians may not refuse a request for medical examination or treatment, unless there is a just cause.
Section 2. Physicians who performed examination, autopsy or delivery may not refuse a request for an issuance of a medical, autopsy, birth, or stillbirth certificate, unless there is just cause.

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Duty to provide medical care
http://ja.wikipedia.org/wiki/%E5%BF%9C%E6%8B%9B%E7%BE%A9%E5%8B%99

“A duty to provide medical care” is a duty imposed upon physicians and medical care facilities to provide medical care to patients under Article 19 of the Medical Act.  There are no penalty provisions established.

However, Ministry of Health, Labour and Welfare states the following:

1. “Just cause” as described in the Medical Act Article 19 is limited to situations where medical care by a physician is practically impossible due to the absence or illnesses of the physician.  Refusal of repeated requests by the patient due to a mild case of fatigue will constitute violation of Article 19.

2. No penalty provisions are set for physicians who violate Article 19, but such conduct qualifies as “disgracing conduct as a physician” stated in the Medical Act Article 7.  In cases of repeated violations, revocation or suspension of medical license might be ordered under Article 7.

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Article 7
Section 2.  When a physician falls under any of Article 4 Sections, or when exhibiting a disgracing conduct as a physician, the Minister of Health, Labour and Welfare may apply one of the following punishments.
  1. Warning
  2. Suspension of medical license for less than three years
  3. Revocation of medical license

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Article 4  A person who falls under one of the following Sections may not be given a medical license.
  1. Those who are defined by the regulation of the Ministry of Health, Labour and Welfare to be incapable of performing proper work as a physician due to mental or physical disorders.
  2. Those addicted to narcotics, marijuana or opium.
  3. Those who have received a punishment of more than a fine.
  4. Those who committed a crime or dishonesty in medical practice.

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医師法

http://www.houko.com/00/01/S23/201.HTM

第19条　診療に従事する医師は、診察治療の求があつた場合には、正当な事由がなければ、これを拒んではならない。
２　診察若しくは検案をし、又は出産に立ち会つた医師は、診断書若しくは検案書又は出生証明書若しくは死産証書の交付の求があつた場合には、正当の事由がなければ、これを拒んではならない。

http://ja.wikipedia.org/wiki/%E5%BF%9C%E6%8B%9B%E7%BE%A9%E5%8B%99

応招義務とは、医師法第19条で「診療に従事する医師は、診察治療の求があった場合には、正当な事由がなければ、これを拒んではならない」と規定する、医師や医療機関に課せられた患者の診療義務のこと。罰則規定はない。

ただし、厚生労働省（当時の厚生省）は以下のように述べている。

１．　医師法第十九条にいう「正当な事由」のある場合とは、医師の不在又は病気等により事実上診療が不可能な場合に限られるのであって、患者の再三の求めにもかかわらず、単に軽度の疲労の程度をもってこれを拒絶することは、第十九条の義務違反を構成する。

２．　医師が第十九条の義務違反を行った場合には罰則の適用はないが、医師法第七条にいう「医師としての品位を損するような行為のあったとき」にあたるから、義務違反を反覆するが如き場合において同条の規定により医師免許の取消又は停止を命ずる場合もありうる[1]。

第７条　医師が、第３条に該当するときは、厚生労働大臣は、その免許を取り消す。
２　医師が第４条各号のいずれかに該当し、又は医師としての品位を損するような行為のあつたときは、厚生労働大臣は、次に掲げる処分をすることができる。
     1．戒告
     2．３年以内の医業の停止
     3．免許の取消し

第４条　次の各号のいずれかに該当する者には、免許を与えないことがある。
1．心身の障害により医師の業務を適正に行うことができない者として厚生労働省令で定めるもの　2．麻薬、大麻又はあへんの中毒者　
3．罰金以上の刑に処せられた者　
4．前号に該当する者を除くほか、医事に関し犯罪又は不正の行為のあつた者

法医学
http://tsstudio.s12.xrea.com/med/lmedduty.html

Consent Form for Thyroid Examination for Fukushima Prefecture Resident Health Management Survey

http://www.env.go.jp/jishin/rmp/conf-health/b02-mat07.pdf



The left side of this form is an announcement about the implementation of thyroid examination as part of Prefecture Resident Health Management Survey.

The box contains details of the examination such as the examinee’s name, date, place, and type (a free, 5-minute ultrasound examination of thyroid) of examination, and how to apply for it.  Under item 5, it states that “As a rule, the thyroid examination will not be performed without submission of the consent form.”

The right side of this form is the actual consent form.  The box contains personal information, such as name of the examinee and the legal guardian, address, phone number, height and weight of the examinee, and the method of transportation to get to the examination site.  The part above the box is translated as follows.

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Consent Form

To:  Fukushima Prefecture Governor and Municipal University Corporation Fukushima Medical University President

“This thyroid examination is intended to assess current thyroid conditions in order to implement health management of children.  You will be notified of the examination result, and the data will be stored by Municipal University Corporation Fukushima Medical University.  There is a possibility that part of the data, kept anonymous in consideration of privacy, might be publicized and utilized as basic material for statistical processing and continuous health management.”

Upon understanding the above statement, I give consent to Prefecture Resident Health Management Survey Thyroid Examination for the following examinee under my legal guardianship.

Moreover, I append that the consent was given under the following conditions.
　
Consent conditions:

1. I (or the examinee once becoming a legal adult) may be able to revoke this consent at my (or examinee’s) convenience.

2. I and the examinee will not receive any disadvantage from the consent being revoked.

3. I (or the examinee once becoming a legal adult), may obtain information related to the examinee himself/herself anytime I or the examinee should wish.

4. Any personal information provided for this survey will be strictly confidential.

Yamashita will be too dead to take responsibility

“I won’t be able to take responsibility … I will be dead
before the consequence are known.”

(This is a screenshot from a television program.  Captions are translated below.)

What is going on in Fukushima schools?

Uncertain radiation safety standards

Nagasaki University Professor

Fukushima Prefecture Radiation Health Risk Management Adviser

Shunichi Yamashita

When the government set the radiation limit of 20 mSv per year:

“By the time I die, I won’t be able to take responsibility for all of your lives.

However, we have an obligation to obey the standard set by the government.  I will be dead before the consequence are known.”

〈Thyroid Examination〉 The Cabinet Office policy to compare with children outside Fukushima Prefecture

http://www.excite.co.jp/News/society_g/20120826/Mainichi_20120826k0000e040108000c.html?_p=1
This is a complete translation of a Mainichi Shimbun article linked above and published online on August 26, 2012.


In relation to the thyroid examination of children started by Fukushima Prefecture after the Fukushima Dai-ichi nuclear accident, the Japanese government decided to implement a similar examination outside Fukushima Prefecture in order to assess the effect of radiation on children.  Comparative data will be obtained by the end of the current fiscal year (the end of March, 2013).  In Fukushima Prefecture, about 35% of children examined had thyroid abnormalities such as nodules.  Even though Fukushima Prefecture explains that “Small, benign cysts and nodules are not unusual,” parents are anxious and worried as there is no good comparison data of normal prevalence.  The government official says, “We would like to collect data that can be used for comparison to relieve anxiety of Fukushima residents.”

Because pediatric thyroid cancer increased after the Chernobyl nuclear accident, Fukushima Prefecture began thyroid ultrasound examination in approximately 360,000 children who were between the ages of 0 and 18 at the time of the accident.  Of 38,114 children who were examined by the end of March, 2012, 35.8% or 13, 646 children had either nodules (lumps) or cysts (fluid-filled sac); 186 children went on to receive secondary examinations.  No cases of cancer have been found.

For details about the thyroid examination by Fukushima Prefecture, please refer to this article:
http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html

Professor Shinichi Suzuki from Fukushima Medical University, which is implementing the examination, says that “There should be no effect of radiation seen at this point of time.” as pediatric thyroid cancer cases began to increase 4 to 5 years after the Chernobyl accident.  On the other hand, radiation specialists have pointed out that “There is no way to judge the presence or absence of the effect of radiation exposure unless the results are compared to prevalence of thyroid nodules/cysts in an average population of children.”

According to the Team in Charge of Assisting the Lives of Disaster Victims in the Cabinet Office, the project will be commissioned to an organization which wins an open competitive bidding.  A free examination will be performed on a total of over 4,500 children under age 18 in more than three locations in Japan.  The examination will be performed by specialists belonging to the Japan Thyroid Association, just as in Fukushima Prefecture, and the quality of ultrasound equipments and the result assessment guidelines will be standardized.  Professor Toshihide Tsuda of Okayama University (environmental epidemiology) says, “This is a meaningful investigation, as the current situation is too insufficient for residents to accept explanation by Fukushima Prefecture.”

Data from examination will be compiled into a report by the end of March 2013.  Before the start of the examination, an investigation committee consisting of specialists, such as epidemiologists, will be established to make concrete plans.  Selection of areas to be examined will most likely require agreements by the Board of Education, schools, and parents/guardians.

Examination results will be sent to those examined.  The government will provide counseling and advice as needed and hold information sessions when most results come out.


Insufficient explanation causing anxiety

The thyroid examination for children under age 18, offered free of charge by Fukushima Prefecture, in order to “watch over children’s health to bring a sense of relief,” is increasing anxiety of parents/guardians.  Many are taking their children to hospitals outside Fukushima Prefecture, looking for a second opinion.  The reason for that is the insufficient explanation about the result from the prefecture.

A sixty-year-old woman from Kawamata-machi, Fukushima, took her four-year-old grandchild to Nakadori General Hospital in Akita-city, Akita Prefecture, in June.  It took them three hours each way by car and Shinkansen bullet train.  They stayed there the night before in order for the grandchild to undergo palpatory and ultrasound examinations of thyroid gland as well as blood test for thyroid function.  As the visit was considered a health check-up, insurance could not be applied.  They paid about 14,000 yen ($178) for the visit, in addition to about 40,000 yen ($509) for travel expenses.

The family received the prefectural examination result from Fukushima Medical University in February.  All it said was, “There are small nodules and cysts (fluid-filled sacs), but there is no need for secondary examination.”  They grew anxious about having to wait until the next examination two years later.  They were upset when multiple cysts were confirmed at the Akita hospital.  The doctor recommended a follow-up examination six months later and told them, “Now that there is a diagnosis, you will be able to use insurance next time.”

This hospital has seen 65 children from Fukushima Prefecture in the last five months since March 14, 2012.  Similar visits are seen in Niigata, Hokkaido, and Tokyo Metropolitan region.  The prefecture examination implemented by Fukushima Medical University restricts examining physicians to specialists belonging to one of seven specialty associations, such as the Japan Thyroid Association, but an examination can be done at any medical facility with the right equipment and experience.

However, there are quite a few cases of people traveling far for the examination after being denied medical care in Fukushima Prefecture.  A 38-year-old mother of two who evacuated to Aizu wakamatsu-city called five hospitals in the city, yet nobody agreed to examine them.  She resented that “It is just not right that we can’t be seen by a doctor when we want to be seen.”

We asked physicians the reason for refusal to provide medical care and received the following responses.

A pediatrician in Fukushima-city:  “It will be confusing if our result is different from the result by Fukushima Medical University.”

A hospital in Aizu district:  “It’s not a duty of a private hospital to relieve the anxiety of parents/guardians.”

One of the physicians involved with the prefectural examination:  “This examination by Fukushima Medical University is an unprecedented epidemiological study in the world to follow up on health effects by radiation.  If some undergo examinations at another hospital instead of the prefectural examination, it will interfere with the study.　

Some point out the influence by a letter sent in January by Fukushima Medical University vice president Shunichi Yamashita to seven specialty associations including the Japan Thyroid Association. The letter tells members of those specialty associations to “Please explain to them well to make sure they understand that any further testing is not necessary before the next examination unless symptoms appear,” in case they receive inquiries or consultations from parents regarding the results of the prefectural examination.  One of the physicians belonging to the Japan Thyroid Association said, “If I follow what’s in this letter, I will be going against the Medical Act which says physicians cannot refuse to provide medical care.”

For the letter sent by Shunichi Yamashita, please refer to this article.
http://fukushimavoice-eng.blogspot.com/2012/05/fukushima-childrens-thyroid-examination.html

Regarding this letter, Yamashita explained, “It tells them to explain to parents/guardian the fact the prefecture is conducting an extremely accurate examination.  It does not tell them not to give a second opinion.”

As the anxiety of parents/guardians spreads, Namie-machi began an independent project in July:  Town clinic will provide thyroid examination in the year it’s not provided by the prefecture.

Norio Konno, the chief for health insurance section, said, “The prefecture does not understand how parents/guardians and children feel.  They need to provide more detailed support and offer the data.


Request for information disclosure needed for detailed results

Results of the thyroid examination by Fukushima Prefecture are divided into four assessment categories [A1], [A2], [B] and [C], based on the presence or absence of nodules and/or cysts and their sizes.  Those in categories [B] and [C] will undergo secondary examination.

For details about the thyroid examination by Fukushima Prefecture, please refer to this article:
http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html

The category that attracts the most anxiety from parents/guardians is [A2].  Thyroid nodules and/or cysts found are too small to qualify for secondary examination.  Moreover, the notification does not have detailed information about the number, location, and size of the nodules and/or cysts.  Fukushima Medical University began improving the process after receiving over 250 phone calls.  From now on they plan on informational meetings to explain the results to the residents.

However, there are other issues.  Consent forms signed by parents/guardians prior to the examination clearly states that the result “can be released any time upon request (by parents/guardians or examinees themselves),” yet request for information disclosure must be filed according to the prefecture regulations in order to obtain physician’s diagnosis or see ultrasound images.

There have been six requests for information disclosure.  Three of them had information disclosed three weeks later, but the still image of ultrasound was printed on a regular copy paper, and the actual digital image data which is more clear was not given to them “for fear of alteration” (per Fukushima Medical University).  Professor Shiro Matsui, Fukushima Medical University Public Relations Officer, explains, “We have to be extremely careful in handling information relating to physical body.　In order to confirm that it’s actually the person the information belongs to, the best way is for them to file a request for information disclosure.

To this, an attorney Tsutomu Shimizu, a chairman of the Japan Federation of Bar Association Information Issue Countermeasure Committee, states, “This is meant to be an examination to protect children, and they have their priorities wrong.  Information like test results which is compelling to both children and parents/guardians should be promptly disclosed to them once it is being given out to the right person.”  Even if the image given out might be altered, “All they have to do is keep track of the original data, and it is no excuse for nondisclosure,” he says.


Listening to parents’ voices humbly

We asked Fukushima Medical University vice president Shunichi Yamashita, who is in charge of the thyroid examination, about his challenges.

Reporter:: What is the objective of the examination?

Yamashita:  It is a medical service to promote the health of prefectural residents.  It is by no means a research study.  WHO dose estimation study says radiation exposure dose of Fukushima residents is at most 100 mSv.  International consensus by scientists says that the health risk under 100 mSv has either been not clearly shown or extremely small.

Reporter:  What do you think about more and more parents/guardians seeking second opinions outside Fukushima Prefecture?

Yamashita:  We must figure out a better way of dealing with it.  There is a gap between physician’s opinions and mothers’ understandings.  We need to listen to them humbly to establish a trusting relationship.  

Reporter:  What do you think about the effect of radiation?

Yamashita:  We might find small cancer, but thyroid cancer can occur at a certain frequency under normal circumstances.  We won’t know the conclusive trend until over 10 years later.  We cannot get into oppositional relationships with the prefectural residents.  I would like to guide them so that Japan as a country will not fall apart.  After the Chernobyl accident, many lawsuits happened regarding health effects, with compensatory expenses cut into the national budget.  When that happens, the ultimate victims are people of the country.

　

Radiation Effects Research Foundation (RERF) “alters” a Japanese summary of their research paper

RERF published a research paper earlier this year, “Studies of the Mortality of Atomic Bomb Survivors, Report 14, 1950–2003:　An Overview of Cancer and Noncancer Diseases.”
http://www.rrjournal.org/doi/pdf/10.1667/RR2629.1

RERF released a 4-page Japanese summary of the study in the spring.  It was recently revealed that the content of the Japanese summary has been tampered with.

Concerns of tampering are in regards to the following phrase in the first paragraph before Introduction:

“The estimated lowest dose range with a significant ERR (Excess Relative Risk)  for all solid cancer was 0 to 0.20 Gy, and a formal dose-threshold analysis indicated no threshold; i.e., zero dose was the best estimate of the threshold.”

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In the Japanese summary that was released in the spring and happened to be printed by this author, the following phrase was used (translated into English):

ERR for all solid cancer deaths showed a linear dose-response relationship to radiation dose in all dose ranges, indicating no threshold, and the estimated lowest dose range with a significant ERR was 0 to 0.20 Gy

The Japanese summary currently available online, apparently altered in July, shows the following:

ERR for all solid cancer deaths showed a linear dose-response relationship to radiation dose, and a threshold for the most compatible linear model is zero, but the estimated dose range with a significant ERR was over 0.20 Gy.

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This information was originally published by a blogger in this blog:   http://ameblo.jp/megumi-jk/entry-11238511139.html  
In an addendum dated July 31, 2012, the blogger stated that a phone conversation with RERF representative revealed that RERF “changed it because the previous expression was largely misunderstood by the general public.  The content remains the same.”
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The significance of this difference of expression relates to the fact that dose ranges below 0.20 Gy (200 mSv) are being ignored.

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By the way, this study was covered brilliantly by Ian Goddard in one of his videos.

☢ Low-Dose Radiation ☢ NEW A-Bomb Study

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Japanese summary (see lines 2 through 4 in the first paragraph):

May 2012 (original version)
https://docs.google.com/document/d/1ODzgGge5Vnp5ngxDwyN0M789AtPadD4qbO1hNjwHqmQ/edit

July 2012 (current version)
http://www.rerf.or.jp/news/pdf/lss14.pdf