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Radiation and Children’s Heath: Separating Fact From Fiction. Mitsuyoshi Urashima MD, PhD, MPH Associate Professor, Jikei University School of Medicine http://dr-urashima.jp. 核戦争防止国際医師会議 : 1985 年ノーベル平和賞. 圧力制御室. Fukushima 3/11 ~ 4/5 131I: ~150PBq 137Cs: ~ 12PBq. - PowerPoint PPT Presentation
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Radiation and Children’s Heath:Separating Fact From Fiction
Mitsuyoshi Urashima MD, PhD, MPHAssociate Professor, Jikei University School of Medicinehttp://dr-urashima.jp
核戦争防止国際医師会議: 1985 年ノーベル平和賞
圧力制御室
Chernobyl 131I: ~1760PBq 137Cs: ~ 86PBq
Fukushima 3/11 ~ 4/5 131I: ~150PBq 137Cs: ~ 12PBq
Global Release of Atmospheric Nuclear Weapon Testing 131I: ~675,000PBq 137Cs: ~ 948PBq
330microSv/hr
270microSv/hr
255microSv/hr
Mark Twain
"There are three kinds of lies: lies, damned lies, and statistics. “
External irradiation
Effective dose ( 実行線量): Sv, mSv, Sv吸収線量 : dose (D): Gy (= Sv)
1Ci = 3.7×10 Bq = 37GBq 10
Effective dose ( 実行線量) : 全身影響を表わす量 組織毎の係数をかけるEquivalent dose ( 等価線量) : 放射線の種類によって異なる X 線やベータ線、ガンマ線は1、
中性子線は5~20、アルファ線は20
イメージとしては、1kgの放射線を放っている物質が放射線を出し終わるまでの、放射線の総量
Internal irradiation131
I137Cs
I : 100Bq/kg (=litter) = 100 x 0.022 = 2.2 microSv x 100 days = 220 microSv
* X 0.016 の係数を使う場合もある
131
Cs : 100Bq/kg (=litter) = 100 x 0.013 = 1.3 microSv x 100 days = 130 microSv
137
Image
Half life = 8 days
Half life = 30 years
Deterministic Effects
骨髄被曝線量 (Gy)
骨髄移植(+) 骨髄移植(-)
患者数 皮膚・腸管傷害による死亡
GVH反応による死亡
生存者
患者数 皮膚・腸管傷害による死亡
GVH反応による死亡
生存者
< 6.5 4 0 3 1 5 0 0 5
6.5 – 9.0 3 2* 0 1 4 3 0 1
9.0 < 6 5 1 0 5 5 0 0
合計 13 7 4 2 14 8 0 6
Stochastic Effects
被曝量 (mGy) 癌発症リスク
0.5 正常範囲内
0.5 ~ 5 0.04% 上昇
5 ~ 50 0.04% ~0.4%上昇
50~100 0.4~0.8% 上昇
100 ~ 250 0.8~2%上昇
250~700 2~5.6%上昇
喫煙リスク 受動喫煙 x 2 =100% 上昇通常喫煙 x 10 =900% 上昇ヘビー x 20 = 1900% 上昇
検査時年齢
グループ I事故後に妊娠・出
産
グループ II事故時妊娠中
グループ III事故時既に小児
男児 女児 男児 女児 男児 女児8 0/67 0/759 0/651 0/66710 0/138
30/128
711 0/152
30/154
70/156 0/149 0/28 0/26
12 0/897 0/858 0/501 0/406 0/333 1/34513 0/305 0/302 0/437 1/437 1/989 6/90614 0/164 0/159 2/144
98/146
015 3/133
99/131
916 0/579 2/75717 1/93 0/100合計 0/482
60/464
60/125
80/115
17/481
024/49
10
Stochastic Effects
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
Bias
Ecological study
Case Control Study
Cohort Study
Exposure Outcome
Confounders
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
被爆量( Gy) 平均被爆量(Gy)
甲状腺がん /全体(人)
オッヅ比 (95%信頼区間 )
0.00 - 0.24 0.11 9/6357 1
0.25 - 0.74 0.44 9/3521 2.31 (0.91 – 5.88)
0.75 – 1.49 1.07 10/1591 6.25 (2.56 – 15.6)
1.50 – 2.99 2.06 8/944 8.97 (3.99 – 23.7)
3.00 – 47.63 6.48 9/699 15.3 (5.88 – 40.0)
• 男性の過剰相対リスク = 2.21 (95% 信頼区間 0.40 – 13.80)/Gy• 女性の過剰相対リスク = 16.57 (95% 信頼区間 1.08 – 1651)/Gy• • 女性の方が被爆した際、甲状腺がんになるリスクは高い(しかし
統計学的有意差は無かった)。• • 0~4 歳児の過剰相対リスク = 9.08 (95% 信頼区間 1.33 – 84.8)/Gy• 5~9 歳児の過剰相対リスク = 7.00 (95% 信頼区間 1.76 – 33.04)/Gy• 10~18 歳児の過剰相対リスク = 3.39 (95% 信頼区間 0.68 – 19.68)/Gy• • 年齢が小さい小児が被爆した際、甲状腺がんになるリスクは高い
(しかし統計学的有意差は無かった)。
因子 甲状腺がん /PY 過剰相対リスク( 95%信頼区間) 相乗効果
性別 0.40男 28/35,240 1.20 (0.03 – 6.74)女 37/37,764 2.66 (0.46 – 12.49)
事故時年齢 0.400 ~ 4 歳 18/21,236 7.43 (1.67 – )
4 ~ 12 歳 31/34,941 1.57 (-0.02 – 8.51)12 ~ 18 歳 16/16,827 0.69 (-0.04 – 6.31)
検査時年齢 0.71<22 歳 16/26,440 2.08 (0.10 –13.65)
22 ~ 30 歳 25/34,374 1.83 (0.01 – 11.97)30 ~ 40 歳 24/12,190 0.74 (0.06 – 4.95)
事故時住所 0.005チェルノブイリ 42/38,746 5.20 (-0.001 – 1.27)
キエフ 11/34,374 1.22 (-0.02 – 12.59)ジトミル 12/20,816 0.08 (1.45 – 21.40)
事故以降住所 0.008チェルノブイリ 39/37,988 4.07 (0.95 – 16.80)
キエフ 15/14,710 2.70 (0.27 – 27.52)ジトミル 11/20,254 0.06 (-0.02 – 1.08)
ヨウ素剤予防内服 0.56いいえ 50/51,674 2.11 (0.36 – 9.28)はい 12/18,154 1.03 (0.08 – 9.84)
びまん性甲状腺腫 0.89いいえ 45/45,122 1.78 (0.33 – 6.41)はい 20/15,882 2.07 (0.03 – 28.4)
サイログロブリン ng/mL 0.92<15 20/30,854 1.58 (0.32 – 13.77)
15 ~ 30 21/20,687 1.89 (0.18 – 12.21)31 ~ 643 21/16,108 2.58 (0.16 – 34.73)
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
Tsunami
A series of EarthquakesNuclear Power Point Accident
Explosion Continuous Leakage
Destruction ofThe communities
Huge numberOf causalities > 20,000
Loss of FamiliesLoss of WorkLoss of Properties
Evacuation
Settlement
131I137Cs
EarthWater
FoodWater
Human
Internal Exp.
External Exp.
Economy
Analysis of Situation
Risk Communication by Government
This level of irradiation has no hazardous effects on health for now.
People think: That’s means some problems later, cancer, congenital anomalies, infertility?
This level of irradiation in water and food has no hazardous effects on health if you do not take long term. However, if you can avoid taking, please do so. But if you can’t, it’s OK. Doesn’t matter.
People think: This must be quite danger.
Earthquake
ContaminationIn food supplyAnd water
Broadcast
Audience rate = 14%2011/3/24 (Thur) 8 – 9 PM
Risk communication
Demonstrate Chernobyl as scientific evidence
Increase of thyroid cancer in childrenNo significant increase of cancer in adultsNo significant increase in congenital anomalies
What we need to do is protecting children.
1. People outside the area of disaster do not have to worry about yourself.
2. We should have sympathy to the causalities with serious anxiety as if they are our family or friends.
3. If the society be confused and depressed, the situation will be much more worsened. So, we should seek more positive side of things.
Try to keep unequivocal attitude to wipe out anxiety and suspicion of the people in their hard time
Shock
Panic
Positive thinking
Change in Value of People
Family, Friends, Community
Money, Business
We have only the way for recovery.
1. Power of Media Many e-mails and phone calls
I felt the atmosphere of Japanese society had been changed totally after that.
2. Dynamic changes of behavior in such a short period. Go home earlier.
People seek behavior: Do the right things, Justice.
3. Things have both negative and positive side.
Crisis made us notice what is the most important in lifeand gave us a chance to change dramatically.
AgendaI. Basics a. Mechanisms of harm by irradiation b. Bias in epidemiological studiesII. Lesson learned from Chernobyl a. Thyroid cancer b. Leukemia c. other cancer d. congenital defectsIII. Social psychology
@ high risk
1. Women and mothers
2. Older adults
3. Evacuees and those with a high degree of exposure to the disaster
Depression
Anxiety
Somatization
Chronic distress
Distrust of politics
A variety of chronic stressors
Invisible stress coming from radiation
Uncertainty of future disease
Economic and political turmoil
Low life satisfaction
Depression
FemaleOlder age
Occupation
Relocation history
Chronic stressors
Negative life events
Mastery/Controllability
Family problem
RegionContamination level
Family history of leukemia
Anxiety
Female
Occupation
Relocation history
Chronic stressors
Negative life events
Mastery/Controllability
Family problem
RegionContamination level
Family history of leukemia
Older age
Somatization
Female
Occupation
Relocation history
Chronic stressors
Negative life events
Mastery/
Controllability
Family problem
RegionContamination level
Family history of leukemia
Older age
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