A Comparative Survival Analysis Between Evacuees and Nonevacuees Among Dialysis Patients in Fukushima Prefecture After Japan's 2011 Fukushima Nuclear Incident

Disaster Med Public Health Prep. 2019 Dec;13(5-6):898-904. doi: 10.1017/dmp.2019.4.

Abstract

Objective: There has been little research on the health consequences of evacuation in the disaster context. A comparative analysis of survival between evacuated and nonevacuated hospital dialysis patients was conducted following Japan's Fukushima Dai-ichi nuclear power plant incident, which occurred on March 11, 2011.

Methods: The study included 554 patients (mean age: 70.9) receiving dialysis therapy at one of the Tokiwakai Group hospitals-all of which are located in and around Iwaki City, approximately 50 km from the Fukushima nuclear plant-as of the incident date. The patients' survival after the incident was tracked until March 3, 2017. Significant differences in mortality rates between postincident evacuees and nonevacuees were tested using the Bayesian survival analysis with Weibull multivariate regression.

Results: Out of 554 dialysis patients, 418 (75.5%) were evacuated after the incident. The postincident mortality rate (adjusted for covariates) of evacuees was not statistically significantly different from that of nonevacuees. The hazard ratio was 1.17 (95% credible intervals: 0.77-1.74).

Conclusions: If performed in a well-planned manner with satisfactory arrangements for appropriate selection of evacuees and their transportation, evacuation could be a reasonable option, which might save more lives of vulnerable people.

Keywords: disaster planning; disasters; health policy; mortality; public health practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bayes Theorem
  • Dialysis / statistics & numerical data*
  • Female
  • Fukushima Nuclear Accident*
  • Humans
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Kidney Diseases / epidemiology
  • Kidney Diseases / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Refugees / statistics & numerical data*
  • Survival Analysis