ABSTRACT: On 11 March 2011, a magnitude 9.0 earthquake caused a huge tsunami that struck Northeast Japan, resulting in nearly 20 000 deaths. We investigated mortality patterns by age, sex, and region in the 3 most severely affected prefectures.Using police data on earthquake victims in Iwate, Miyagi, and Fukushima prefectures, mortality rates by sex, age group, and region were calculated, and regional variability in mortality rates across age groups was compared using rate ratios (RRs), with the rates in Iwate as the reference.In all regions, age-specific mortality showed a tendency to increase with age; there were no sex differences. Among residents of Iwate, mortality was markedly lower among school-aged children as compared with other age groups. In northern Miyagi and the southern part of the study area, RRs were higher among school-aged children than among other age groups.The present study could not address the reasons for the observed mortality patterns and regional differences. To improve preparedness policies, future research should investigate the reasons for regional differences.
Project description:To evaluate the impact of the 2011 great east Japan earthquake on body mass index (BMI) of preschool children.Retrospective cohort study and ecological study.Affected prefectures (Fukushima, Miyagi and Iwate) and unaffected prefectures in northeast Japan.The cohort study assessed 2033 and 1707 boys and 1909 and 1658 girls in 3 affected prefectures and unaffected prefectures, respectively, all aged 3-4 years at the time of the earthquake. The ecological study examined random samples of schoolchildren from the affected prefectures.The cohort study compared postdisaster changes in BMIs and the prevalence of overweight and obese children. The ecological study evaluated postdisaster changes in the prevalence of overweight children.1 month after the earthquake, significantly increased BMIs were observed among girls (+0.087 kg/m(2) vs unaffected prefectures) in Fukushima and among boys and girls (+0.165 and +0.124 kg/m(2), respectively vs unaffected prefectures) in Iwate. 19 months after the earthquake, significantly increased BMIs were detected among boys and girls (+0.137 and +0.200 kg/m(2), respectively vs unaffected prefectures) in Fukushima, whereas significantly decreased BMIs were observed among boys and girls (-0.218 and -0.082 kg/m(2), respectively vs unaffected prefectures) in Miyagi. 1 month after the earthquake, Fukushima, Miyagi and Iwate had a slightly increased prevalence of overweight boys, whereas Fukushima had a slightly decreased prevalence of overweight girls, compared with the unaffected prefectures. The ecological study detected increases in the prevalence of overweight boys and girls in Fukushima who were 6-11 and 6-10 years of age, respectively.These results suggest that in the affected prefectures, preschool children gained weight immediately after the earthquake. The long-term impact of the earthquake on early childhood growth was more variable among the affected prefectures, possibly as a result of different speeds of recovery.
Project description:OBJECTIVE:On 11 March 2011, the Great East Japan Earthquake struck off Japan. Although some studies showed that the earthquake increased the risk of pneumonia death, no study reported whether and how much a tsunami increased the risk. We examined the risk for pneumonia death after the earthquake/tsunami. DESIGN:This is an ecological study. SETTING:Data on population and pneumonia deaths obtained from the Vital Statistics 2010 and 2012, National Census 2010 and Basic Resident Register 2010 and 2012 in Japan. PARTICIPANTS:About 5.7 million participants residing in Miyagi, Iwate and Fukushima Prefectures during 1 year after the disaster were targeted. All municipalities (n=131) were categorised into inland (n=93), that is, the earthquake-impacted area, and coastal types (n=38), that is, the earthquake-impacted and tsunami-impacted area. OUTCOME MEASURES:The number of pneumonia deaths per week was totalled from 12 March 2010 to 9 March 2012. The number of observed pneumonia deaths (O) and the sum of the sex and age classes in the observed population multiplied by the sex and age classes of expected pneumonia mortality (E) were calculated. Expected pneumonia mortality was the pneumonia mortality during the year before. Standardised mortality ratios (SMRs) were calculated for pneumonia deaths (O/E), adjusting for sex and age using the indirect method. SMRs were then calculated by coastal and inland municipalities. RESULTS:6603 participants died of pneumonia during 1 year after the earthquake. SMRs increased significantly during the 1st-12th weeks. In the 2nd week, SMRs in coastal and inland municipalities were 2.49 (95% CI 2.02 to 7.64) and 1.48 (95% CI 1.24 to 2.61), respectively. SMRs of coastal municipalities were higher than those of inland municipalities. CONCLUSIONS:An earthquake increased the risk of pneumonia death and tsunamis additionally increased the risk.
Project description:To investigate the impact of the Great East Japan Earthquake on preschool children's physical growth in the disaster-affected areas, the three medical universities in Iwate, Miyagi, and Fukushima Prefectures conducted a health examination survey on early childhood physical growth.The survey was conducted over a 3-year period to acquire data on children who were born in different years. Our targets were as follows: 1) children who were born between March 1, 2007 and August 31, 2007 and experienced the disaster at 43-48 months of age, 2) children who were born between March 1, 2009 and August 31, 2009 and experienced the disaster at 19-24 months of age, and 3) children who were born between June 1, 2010 and April 30, 2011 and were under 10 months of age or not born yet when the disaster occurred. We collected their health examination data from local governments in Iwate, Miyagi, and Fukushima Prefectures. We also collected data from Aomori, Akita, and Yamagata Prefectures to use as a control group. The survey items included birth information, anthropometric measurements, and methods of nutrition during infancy.Eighty municipalities from Iwate, Miyagi, and Fukushima Prefectures and 21 from the control prefectures participated in the survey. As a result, we established three retrospective cohorts consisting of 13,886, 15,474, and 32,202 preschool children.The large datasets acquired for the present survey will provide valuable epidemiological evidence that should shed light on preschool children's physical growth in relation to the disaster.
Project description:The body mass index (BMI) of preschool children from 4 years of age through primary school has increased since the Great East Japan Earthquake, but that of children aged under 3 years has not been studied. This study evaluated how the anthropometrics of younger children changed following the earthquake.Height and weight data of children living in northeast Japan were collected from 3-, 6-, 18-, and 42-month child health examinations. We compared the changes in BMI, weight, and height among infants affected by the earthquake between their 3- and 6-month health examinations, toddlers affected at 21-30 months of age (affected groups), and children who experienced the earthquake after their 42-month child health examination (unaffected group). A multilevel model was used to calculate the BMI at corresponding ages and to adjust for the actual age at the 3-month health examination, health examination interval, and gestational age.We recruited 8,479 boys and 8,218 girls living in Fukushima, Miyagi, and Iwate Prefectures. In the infants affected between their 3- and 6-month health examinations in Fukushima, the change in BMI at 42 months of age was greater than among the unaffected children. In the toddlers affected at 21-30 months of age in Fukushima, the change in BMI was greater, but changes in weight and height were less.Affected infants and toddlers in Fukushima suggested some growth disturbances and early adiposity rebound, which can cause obesity. The future growth of children affected by disasters should be followed carefully.
Project description:OBJECTIVE:The impact of the 2011 Great East Japan Earthquake on renal failure (RF) risk remains unclear. We examined the 1-year impact of this disaster on RF mortality. SETTING:This ecological study focused on the year before and after the earthquake. The data sources were national vital statistics (2010-2012), the national census (2010) and the Basic Resident Registration (2010-2012). PARTICIPANTS:Our study included all residents in Iwate, Miyagi and Fukushima, 1?year before and after the earthquake. PRIMARY AND SECONDARY OUTCOME MEASURES:We calculated standardised mortality ratios (SMRs) for RF, chronic RF and acute RF. Postearthquake weekly SMRs were calculated using the number of RF deaths for the corresponding weeks in 2010 as a reference. The SMRs for RF were compared between the coastal and inland municipalities using kernel-weighted polynomial smoothing. RESULTS:There were 1290 RF deaths in the three prefectures during the year after the earthquake (chronic RF: 804 and acute RF: 236). The SMR for RF increased significantly in the first week after the earthquake in coastal areas (3.11; 95% CI: 1.84 to 4.37), but did not increase in inland areas (0.93; 95%?CI: 0.47 to 1.38). A similar trend was observed for chronic RF (coastal: 4.0; 95%?CI: 2.0 to 6.0; inland: 1.1; 95%?CI: 0.4 to 1.7). SMRs for RF and chronic RF decreased over time and reached 1.0 approximately 20 weeks after the disaster. Changes in SMRs for acute RF were not apparent due to the low number of deaths. CONCLUSIONS:Mortality due to RF and chronic RF, but not acute RF, increased in coastal areas after the earthquake. Chronic RF may have been exacerbated by disaster-induced sympathetic activation and poor management of renal dysfunction. Increased hypertension and damage to essential infrastructure and medical equipment may also have increased mortality in people with kidney disease.
Project description:<h4>Objectives</h4>To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.<h4>Design</h4>A population-based ecological study using publicly available data.<h4>Setting</h4>Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi).<h4>Participants</h4>Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008-2010) and after GEJET (2012-2014).<h4>Results</h4>Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (?=-189.9, p=0.02) and public health nurses (?=-1.7, p=0.01) was negatively associated with mortality rate per person in 2011.<h4>Conclusions</h4>In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.
Project description:We show possible scenarios for the occurrence of M?~?7 interplate earthquakes prior to and following the M?~?9 earthquake along the Japan Trench, such as the 2011 Tohoku-Oki earthquake. One such M?~?7 earthquake is so-called the Miyagi-ken-Oki earthquake, for which we conducted numerical simulations of earthquake generation cycles by using realistic three-dimensional (3D) geometry of the subducting Pacific Plate. In a number of scenarios, the time interval between the M?~?9 earthquake and the subsequent Miyagi-ken-Oki earthquake was equal to or shorter than the average recurrence interval during the later stage of the M?~?9 earthquake cycle. The scenarios successfully reproduced important characteristics such as the recurrence of M?~?7 earthquakes, coseismic slip distribution, afterslip distribution, the largest foreshock, and the largest aftershock of the 2011 earthquake. Thus, these results suggest that we should prepare for future M?~?7 earthquakes in the Miyagi-ken-Oki segment even though this segment recently experienced large coseismic slip in 2011.
Project description:The Great East Japan (T?hoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.
Project description:The Great East Japan Earthquake (GEJE) and resulting tsunami of March 11, 2011 gave rise to devastating damage on the Pacific coast of the Tohoku region. The Tohoku Medical Megabank Project (TMM), which is being conducted by Tohoku University Tohoku Medical Megabank Organization (ToMMo) and Iwate Medical University Iwate Tohoku Medical Megabank Organization (IMM), has been launched to realize creative reconstruction and to solve medical problems in the aftermath of this disaster. We started two prospective cohort studies in Miyagi and Iwate Prefectures: a population-based adult cohort study, the TMM Community-Based Cohort Study (TMM CommCohort Study), which will recruit 80 000 participants, and a birth and three-generation cohort study, the TMM Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which will recruit 70 000 participants, including fetuses and their parents, siblings, grandparents, and extended family members. The TMM CommCohort Study will recruit participants from 2013 to 2016 and follow them for at least 5 years. The TMM BirThree Cohort Study will recruit participants from 2013 to 2017 and follow them for at least 4 years. For children, the ToMMo Child Health Study, which adopted a cross-sectional design, was also started in November 2012 in Miyagi Prefecture. An integrated biobank will be constructed based on the two prospective cohort studies, and ToMMo and IMM will investigate the chronic medical impacts of the GEJE. The integrated biobank of TMM consists of health and clinical information, biospecimens, and genome and omics data. The biobank aims to establish a firm basis for personalized healthcare and medicine, mainly for diseases aggravated by the GEJE in the two prefectures. Biospecimens and related information in the biobank will be distributed to the research community. TMM itself will also undertake genomic and omics research. The aims of the genomic studies are: 1) to construct an integrated biobank; 2) to return genomic research results to the participants of the cohort studies, which will lead to the implementation of personalized healthcare and medicine in the affected areas in the near future; and 3) to contribute the development of personalized healthcare and medicine worldwide. Through the activities of TMM, we will clarify how to approach prolonged healthcare problems in areas damaged by large-scale disasters and how useful genomic information is for disease prevention.
Project description:BackgroundWe established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environmental interactions on the incidence of major diseases such as cancer and cardiovascular diseases.MethodsWe asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria was aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), for example, carotid echography, calcaneal ultrasound bone mineral density, and so on. All participants agreed to measure genome information and to distribute their information widely.ResultsAs a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants with Type 1 survey were more likely to have psychological distress than those of Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents regardless of sex.ConclusionThis cohort comprised large sample size and it contains information on disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.