Report #4
Case collection period: October 21, 2011 to August 10, 2012
Total number of reported cases: 529
Total number of reported symptoms and categories: 31 categories and 270 symptoms
Commentary
1. Distribution map of individuals who reported cases
At the seventeenth month since the Fukushima Dai-ichi nuclear power plant accident, the distribution map of individuals who reported cases has covered just about the entire country, as seen in colored portions of Figure 1. Considering that there are evacuees living in a few uncolored prefectures left, all prefectures now have people with symptoms. As I have stated from the beginning and as I insist on stating repeatedly, physicians in every specialty medical field all over Japan need to acquire understanding and discernment in regards to medical care for radiation exposure: this is an obvious and urgent matter.
After reviewing all the symptoms reported so far over and over and asking additional questions, I speculate that the main point of drastic symptoms currently reported in the section, “2. Symptoms,” is influenced by where they were and what they did during the fallout from March 11 through 21, especially on March 14 and 15. (Reference 1: Hourly still images of the fallout simulation animation from IRSN. http://frmr-jp.blogspot.com/2012/09/20113.html)
Radioactive material was spread and fell in places by air currents. An extremely progressive onset of symptoms have certainly been seen in those who were in neighboring municipalities at the time of the accident, but also subsequently in anybody who was outdoor under the contaminated atmosphere, children who have high sensitivities to radiation, and people with chronic illnesses within the area approximately 200 km from ground zero: This is speculated to be due to the initial intake of high-concentration/high-dose radionuclides through inhalation. At the present time (September 2012), we are beginning to see health effects on thyroid gland and leukocytes (white blood cells), and onset of cancer: This fast progression is understandable when considering the effect of potentially involved radionuclides. In addition, the fact that an abnormally prominent increase was seen in complaints of bone pain, which quadrupled from January to February, and muscle pain, which doubled from February to March, is thought to reflect the effect of high-concentration/high-dose radionuclides.
All people who live in the areas where the fallout passed through need to watch any changes in their own physical conditions, keeping track of blood tests and a thyroid thyroid examination. At least children need to get thyroid ultrasound examination regardless of the presence of subjective symptoms. The issue of “cumulative dose,” as discussed in internal radiation exposure, goes without saying, but in this accident, in terms of the time factor, whether you were exposed to high dose radionuclides or not is an extremely huge reason for onset of symptoms.
In addition, the effect of topography on air currents is such that the wind from the Pacific Ocean coast blows into the inland and stops at mountain ranges. This explains the characteristic in a 250-km area where reports originate in cities located at the base of mountains yet facing the Pacific Ocean. In particular, contamination is expected to go through “city concentration” in cities where air circulation is poor, and ”accumulation” from hills into low-lying areas. Therefore, there is a higher probability of being exposed to high-dose radionuclides as you spend more time in cities.
The extent of radiation contamination in the Metropolitan region is a concern. Thus I calculated average radiation levels from measurements at 5 cm above ground and 50 cm above ground at a total of 70 elementary and middle schools in Adachi-ward in east Tokyo, as reported in April 2012. (Reference 2 https://docs.google.com/spreadsheet/ccc?key=0Aq8f83tqq7QudGxiLW9hVVZtVE9qanZzdnhSYlBmc3c#gid=0)
An overall average is 0.65 microsievert/hr at 5 cm and 0.40 microsievert/hr at 50 cm. Averaging of these two numbers yields 0.53 microsievert/hr up to 50 cm above ground. In other words, an annual exposure dose of 4.30 mSv is obtained after adding a natural background radiation dose of 1.4 mSv to the dose from being outside for four hours a day, calculated on this site by using an average of 0.53 microsievert/hr: http://radi-y.com/. The distance between the accident location and Adachi-ward is 213 km, but this exposure dose is about the same as the areas along the Pacific Ocean in Minamisoma-city, which is 25.5 km from Fukushima Dai-ichi or even higher in some places. (Reference 3： http://www.city.minamisoma.lg.jp/mpsdata/web/5462/minamisoma_120416.jpg) Many residents of the Metropolitan region are either concerned about contamination in Fukushima or totally oblivious to it, living as if nothing ever happened, but they need to become aware that they themselves are in a similarly contaminated environment.
2. Symptoms
The number of symptoms per person increased from 4.9 in January to 5.6. (Reference 4: https://docs.google.com/spreadsheet/ccc?key=0Aq8f83tqq7QudDNMTWdaS0c3Qkd5QnBWOHZwSXJLOEE#gid=0)
Each category showed an average rate of increase of 1.1 to 1.2 times since the previous survey result. Categories whose rates of increase exceeded the average rate of increase are: upper gastrointestinal system including vomiting and nausea at 1.3 times; tumors including pituitary adenoma and cystic tumor at 1.4 times, and endocrine system mainly related to thyroid gland at 1.6 times.
Reports of tumors have begun to come in. There has been a rapid increase of endocrine symptoms, which might be a preliminary stage before tumors appear. In addition, there have been multiple reports of pediatric thyroid cancer from the Kanto region and the Metropolitan area, 250 km away from the Fukushima Dai-ichi nuclear power station. In other words, even before a diagnosis of thyroid cancer is established by physicians, it seems that cancer was germinating and growing within one year of the Fukushima nuclear accident. In Chernobyl, pediatric cancer developed over a period of 5 to 10 years after the accident; but in the case of Fukushima, it appears that canceration took only one-third of the time. The effects of the Fukushima Dai-ichi nuclear accident on human body revealed an onset of cancer within one year to one and a half year; the speed of symptom progression is three to five times that of Chernobyl.
In the thyroid examination conducted on 38,114 Fukushima children, 13,460 which represented 35.8% of the total examined had thyroid nodules and/or cysts. In Chernobyl, 5% of the population had some physical findings/symptoms one year after the accident: In Fukushima the occurrence was seven times as many as Chernobyl in one year. Consequently, in comparison with Chernobyl, it is estimated that the speed of onset of symptoms would be 3 to 5 times faster and the number of cases would be more than 7 times as many.
From the beginning of the survey up to this month, symptoms constantly increasing include fatigue, sleepiness, headaches, dizziness, eczema, urticaria, pruritis, epistaxis, canker sores, sore throat, chest pain, cough, sputum, and diarrhea. In menstruating women, almost 100% have reported symptoms such as irregular menstrual periods, hypomenorrhea, and amenorrhea.
In addition, from winter to spring, there were unusual increases in all types of infectious diseases, such as an explosive spread of influenza, food poisoning such as E. Coli O-157 in rainy season, rubella, mycoplasma pneumonia, chlamydial pneumonia. (Refer to the Infectious Disease Surveillance Center at the National Institute of Infectious Diseases. http://www.nih.go.jp/niid/en/) It is possible to attribute an increase in infectious diseases to depressed resistance, but on the other hand, these symptoms could be attributable as early symptoms of leukemia. It is a pathophysiological fact that Merkmal of leukemia includes fatigue, cold-like symptoms, and bleeding tendency such as easy bruising and epistaxis. If the recurrent cold-like symptoms since last year are due to changes in white blood cells, the number of future leukemia cases might be beyond our imagination. Already there are many reports of abnormalities in white blood cell count and neutrophils.
Part of hematology-related reports (all reports are from a 250-km radius area).
*A relative has chronic myelomonocytic leukemia with a prevalence of 1 in 100,000.
*A fifty-year-old man from Higashimurayama had abnormal blood test at a health check-up in March, 2012, and was eventually was diagnosed with leukemia.
*Seven-year-old boy: WBC over 10,000 with 43% neutrophils in January 2012, but WBC was 6,300 with 25% neutrophils in June 2012. Three-year-old boy: WBC over 10,000 with 28% neutrophils in October 2010 and WBC 7,300 with 28% neutrophils in June 2012.
*A six-year-old daughter with a slight decrease in WBC in blood test from last June. She has not gained weight.
*A sixteen-year-old girl and her mother both had decreased WBC. The daughter lost weight. Blood test from November 2011 showed decreased WBC, platelets and RBC. CK, GPT, ALP and lymphocytes were slightly high.
At a hospital in west Tokyo, there have been more patients with multiple myeloma. The hospital pharmacist reports an increased demand for Velcade (Bortezomib), a multiple myeloma medication, and the doctors cannot figure out why there are so many cases of esophageal cancer or findings of abnormalities in upper GI endoscopy. Moreover, in terms of cancers, there have been reports of breast cancer and colon cancer.
Also, there have been significant increases in diagnosed cases of “Kawasaki Disease” in hospitals within a 300-km radius range. Kawasaki Disease was discovered in 1961 by a Japan Red Cross Hospital pediatrician, Dr. Tomisaku Kawasaki. The disease was named after him in 1967. (Reference 5: Kawasaki Disease Wikipedia entry and Japan Kawasaki Disease Association case photos) Main symptoms include ocular conjunctival injection, enlarged cervical lymph nodes, rash and erythema. The cause is supposedly unknown, but these symptoms are extremely similar to radiation exposure symptoms.
Regarding childbirth, a birth weight of less than 1,500 grams is defined as a very low birth weight baby. There have been several reports of abortions for fetal weight never exceeding 1,000 grams. Also there has been a baby born with a birth weight of 1,000 grams with a hole in the heart. And there are other reports of premature births and miscarriages. It seems that the number of abortions is increasing. On August 29, 2012, it was announced that the National Center for Child Health and Development (Tokyo) and Showa University (Tokyo) decided a policy to begin testing blood of pregnant women for presence of Downs Syndrome with 99% accuracy. Other medical institutions are also in consideration of introducing the same test. Reports of an introduction of such tests, in anticipation of increased needs, and a new development of medical technology seem to be more common and even seem intentional in timing.
Within a 300-km radius, there are marked occurrences of dizziness and hearing loss. Several days after the accident, there were reports of severe dizziness in a 20-km zone from ground zero. These symptoms are spreading to people living in a 250-km radius area one year after the accident. In connection with this expansion of affected areas, effects on the central nervous system are also serious.
The central nervous system effects include such symptoms as lassitude with fatigue, memory decline/loss, forgetfulness, agraphia, loss of mental calculation, motor dysfunction such as falling, but it is difficult to collect data because they may not be aware of changes in their own characteristics other than what they can perceive themselves for self-reporting. However, this issue is actually more serious than specific physical symptoms. It is speculated the number of these cases might be as many as or even more than the cases with physical symptoms. This constitute an extremely large social issue as Japan continues a process of restoration from now on.
Mental symptoms, just like physical symptoms, get worse in those who already had chronic conditions. For instance, if someone already had depression, there will be worsening of depression. In addition, there is an accentuation of basic personality or characteristics. Someone who was already nervous will become even more nervous as if driven into a corner. On the other hand, someone can gain overly positive attitudes, ignoring many symptoms including chest pain. These changes in personality and characteristics may be subtle at this point of time, but they will worsen with time.
In particular, those living in contaminated areas who have subjective symptoms such as lassitude with fatigue need to evacuate at an early stage. Symptom progression is fast, and they won’t be able to make appropriate decisions. In other words, they might lose a will to evacuate or become unable to act on it.
The person himself/herself is not aware of these extremely slow yet certain changes. The entire society as a whole will slowly change. For instance, Japan is known as a country that takes a long time to make a decision due to its vertically-structured society with an emphasis on relationship of “master and servant.” On the other hand, Japan was strict with time and has maintained the world’s highest quality in the manufacturing industry. There are already many occurrences of human errors at a work place, as in increases in returned products due to defects, and the error is unnoticed even after the product is eventually finished.
The second-generation and the third-generation descendants of Hiroshima/Nagasaki atomic bomb victims report miscarriages, stillbirths, pneumonia, cancer, thyroid diseases, epistaxis, Kawasaki Disease, joint pain, cystitis and hematuria. It is speculated that sensitivity to radiation might be high when ancestors have been exposed to radiation. It is truly unforgivable that these people are exposed to radiation again.
3. Medical Care
Despite the presence of subjective symptoms in many people, the governmental medical system is not facing the reality at all, only creating appearance of pretending to do something, and also implementing a powerful cover-up.
The person that is at the top of this scheme is Shunichi Yamashita, who is the vice president of Fukushima Medical University and Fukushima Prefecture Radiation Health Risk Management Adviser. Yamashita told a German weekly news magazine, Spiegel, on August 19, 2011, that he would examine all 2 million residents of Fukushima prefecture to set a science record.
Yamashita: “All 2 million residents of Fukushima prefecture. It is a big task and would set a science record. The government just decided about compensation payments for people affected by the nuclear accident. Through such applications we want to try to contact also those who moved outside of Fukushima.”
(Reference 6: http://www.spiegel.de/international/world/studying-the-fukushima-aftermath-people-are-suffering-from-radiophobia-a-780810.html)
In other words, as you can see in this letter to the Japan Thyroid Association members, he intends to actively ignore thyroid abnormalities in children, merely observing how the effect of radiation exposure progresses in the body.
(Translation of this letter can be found here: http://fukushimavoice-eng.blogspot.com/2012/05/fukushima-childrens-thyroid-examination.html)
Translation of the letter shown below:
To: Japan Thyroid Association Members
From: Shunichi Yamashita, president, Japan Thyroid Association
Subject: How to respond to Fukushima nuclear accident--No need for thyroid-blocking in children; please have correct knowledge of radiation.
“As of March 18, 2911, the Japanese Society of Nuclear Medicine has published a statement that says, “No need for thyroid-blocking in children.” with a title, “For those affected by the disaster, especially those with children,” as shown here. http://www.jsnm.org/japanese/11-03-18
In addition, a remark titled “Correct knowledge of radiation” by Professor Keigo Endo of Gunma University Department of Nuclear Medicine has been posted in the local newspaper.
I hope you find this information helpful.”
Moreover, because of letters such as these and their own ignorance, many physicians are either disinterested in, or negative about the relationship between patients’ poor physical health and radiation. There are some malicious cases: Some physicians refuse to provide medical care or refuse to hand over test results, such as ultrasound images of thyroid, to patients; in some cases patients have been charged a large “fee” for copies of radiological images.
There is a concern regarding physicians practicing medicine in areas receiving fallout as seen in Reference 1 above. If they are either oblivious of or negative about the radiation contamination, they might not be actively taking protective measures. In other words, there is a possibility that physicians themselves have been exposed to radiation, developing central nervous system symptoms. We might begin to see an increase in medical errors in the future.
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This is an issue not just in Fukushima: There are nuclear power plants and nuclear weapons all over the world. Most people know very little about what radiation exposure is even though radiation kills every living organism and affects generations after generations of descendants. Whether it was from an act of war, such as Hiroshima and Nagasaki, or the result of accidents as in Chernobyl, Three Mile Island and Fukushima, everything is covered up in full force in order to maintain an appearance of economic and military power: Every country affected always acts as if nobody has been exposed to radiation. There is no honest and decent medical care for radiation exposure due to powerful cover-up and pressure which is enabled by accompanying makeshift measures: This is despite the fact that there were 18,125 nuclear weapons and 436 nuclear power plants accounted for around the whole world in 2010.
Reported by Shino Yasutomo
Executive Director
FRCSR
English translation by Dr. Yuri Hiranuma
Medical Information Director
FRCSR
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