Abstract
ObjectiveThe shortage of physicians after a major disaster is a crucial issue. We aimed to evaluate the characteristics of physicians who left affected areas following the accident at Fukushima Daiichi Nuclear Power Plant caused by the Great East Japan Earthquake on March 11, 2011.MethodsUsing data from a physician census conducted in 2010 (pre-disaster) and 2012 (post-disaster), we evaluated changes in the number of physicians in affected areas. We then calculated the odds ratios and 95% confidence intervals using a logistic regression model to evaluate the association between physician characteristics and outflow. We also conducted stratified analyses based on physician characteristics.ResultsThe number of physicians decreased in Fukushima Prefecture (–5.3%) and increased in Miyagi Prefecture (2.8%). The decrease in Fukushima and increase in Miyagi were evident even after taking the prefecture’s population change into account (change in physician to population ratios: –1.9% and 3.2%, respectively). Compared with physicians who lived in areas >100 km from the nuclear power plant, physicians living 20–50 km and 50–100 km were, respectively, 3.9 times (95% confidence interval, 2.6–5.7) and 2.6 times (95% confidence interval, 1.7–3.8) more likely to migrate to distant areas. In the stratified analysis, younger physicians and those earlier in their careers had higher odds ratios for outflow than other physicians (P for interaction = 0.02 and <0.01, respectively).ConclusionsThe risk of outflow was greater among younger and early-career physicians in areas around the power plant. Political support may be necessary to recruit and retain such physicians, who will be responsible for future community health in the disaster area.
Highlights
The large-scale Great East Japan Earthquake struck the northeastern part of the country on March 11, 2011
The number of physicians decreased in Fukushima Prefecture (–5.3%) and increased in Miyagi Prefecture (2.8%)
Compared with physicians who lived in areas >100 km from the nuclear power plant, physicians living 20–50 km and 50–100 km were, respectively, 3.9 times (95% confidence interval, 2.6–5.7) and 2.6 times (95% confidence interval, 1.7–3.8) more likely to migrate to distant areas
Summary
The large-scale Great East Japan Earthquake struck the northeastern part of the country on March 11, 2011. This earthquake caused a massive tsunami, which hit the Pacific coast and damaged Fukushima Daiichi Nuclear Power Plant (FDNPP) [1]. A 15-meter tsunami disabled the cooling system of three Fukushima Daiichi reactors. This resulted in the melting of their cores and a radiation leak; radioactive elements were released northwest and south of the plant (Fig 1) [2, 3]. Many other individuals, including health-care professionals, who lived outside the restricted area left their homes owing to fear of the potential radioactive hazard. Providing medical care services is a basic social necessity, and the lack of such care following the nuclear accident has become a serious issue for both local governments and residents [5, 6]
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