Fukushima's children's situation

Last update March 2017
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Children’s physical health,
Children’s emotional well-being,
Radiation, information and families,
Food safety
Campaigning

Introduction

Fukushima’s children are still living with the consequences of the earthquake, tsunami and on-going nuclear disaster of 11th March 2011. However because of commercial interests, political pressure on the media and secrecy due to the strategic nature of nuclear power, combined with insufficient medical and environmental research to produce clear science, we will never have a full picture of the health effects of Fukushima.

Of more than 250,000 children tested, 185 children have officially been confirmed to have thyroid cancer (as of 11.3.17), of which 145 have been operated on. In some cases cancer had spread to the children’s lymph nodes or lungs. Before the disaster official rates for child thyroid cancer in Japan were low, at from 0 to 1.3 (depending on age) per 100,000 per year, so this is a huge rise. Stable Iodine, which helps to protect the thyroid, was not distributed for children and WHO recommendations (1999) were not followed.

Some families in Fukushima and other contaminated parts of Japan are reporting that children’s overall health has deteriorated, their immune systems are low, and that successive infections, viruses, nosebleeds, eye and respiratory problems and exhaustion are common. Despite this, no screening for other health effects of radiation exposure has taken place, and the publishing of morbidity figures in Fukushima across illnesses ceased after the year 2011-12 showed an increase of 12%.

More than 17,000 children (6.3% of Fukushima’s children) have left Fukushima prefecture, but the majority remain in Fukushima, and some are living in areas with annual radiation dose levels higher than the international limits for adult nuclear workers of 20 millisieverts (20mSV) per year; twenty times the ICRP recommended limit of 1mSV per year. After Chernobyl, evacuation was triggered by levels above 5mSV per year, so areas where Japanese communities are still living with similar levels of contamination would have been evacuated and would still be exclusion zones. Some children have been officially evacuated from the 20km zone around Fukushima Daichi, but some of those were moved to areas close by that also have seriously elevated levels of radiation, like Iwaki and Fukushima City, places from which other families have self-evacuated. 6 years on many evacuated families are still living in temporary accommodation, including small pre-fabricated units.

The policy of the Japanese central government and Fukushima prefectural governments is to keep people in place, claiming that this definitely ‘safe’, with no differentiation in dose limits for children and young women who are more vulnerable than older males. They are promoting ‘decontamination’ over evacuation, pressuring evacuees to return and trying to stop support for them in other prefectures. Housing support for voluntary evacuees will cease on 31st March 2017, putting added pressure on families to move back to areas they know to be highly contaminated, and with radiation still being released into the air and sea from Fukushima Daichi, which is far from being stable. Fukushima is still subject to large earthquakes, including one of 7.4 Mw on 22^nd November 2016. 



The New York Times have reported that decontamination has not resulted in habitable levels, and that levels have risen again, as radionuclides, leaves and soil are washed or blown in from surrounding areas. This was confirmed in a February 2017 report from Greenpeace. ‘Decontamination’ is done by scrubbing, sweeping and digging, often by hand, a risk in itself – and there is no agreement about where to put this contaminated matter, so it is often re-buried on site without special measures, or left stacked in the open in bags. Decontamination is in effect simply moving contamination around. Some municipalities near Fukushima Daichi are asking children to return to live in these conditions, whilst others are against it, just one example of the wide variation in opinion within Fukushima and beyond.

The behaviour of Tepco, owners of the plant, and the Japanese government in deliberately hiding information and resisting responsibility at every stage is consistent with previous public health emergencies, such as Minamata disease where victims of industrial mercury poisoning were not fully acknowledged until a court case 17 years later.  Internationally a similar pattern has been seen in relation to asbestosis and tobacco.

Japan is still a country divided against itself on responses to the disaster and nuclear power in general, with multiple court cases in progress and unreported demonstrations around the country. The division is usually between those who are convinced by official reassurances and those with access to wider, more independent information, rather than on party-political lines. Ex Prime Ministers Junichiro Koizumi of the right of centre Juminto (LDP) party, and Naoto Kan and of the Democratic Party, having been supporters of nuclear power while in office, are now severe critics, while current PM Abe is pro-nuclear.

Children’s physical health

It is accepted that children, young people and females are at greater risk of health effects from exposure to radiation, which can occur externally from proximity; or internally by being breathed in, or swallowed in dust, food or drink.

Thyroid Cancer

Of 250,000 children tested, 185 children in Fukushima have thyroid cancer (official figures at March 2017). 145 have had operations and in some cases malignant cells have been found in other parts of their bodies.

•        1^st round of screening 2011-2013: Thyroid cancer confirmations 116, of which 101 had an operation.

•        2^nd round of screening 2014-2015: Additional thyroid cancer confirmations 68, of which 44 had an operation

•        Announced 27/12/16: a further one confirmed case

•        Total: Thyroid cancer diagnoses: 185, of which 145 have had an operation.

•        Source: Fukushima Prefectural Government website accessed 7.3.17 http://www.pref.fukushima.lg.jp/site/portal/43-7.html

After the first round of thyroid testing in Fukushima 36% of children from the highest radiation areas whose thyroids were tested were found to have cysts. At the time it was widely suggested that this demonstrated the ‘testing effect’: that if you test a population with sensitive equipment you will always find abnormalities, but that this was ‘normal’.  As with all medical issues that have arisen so far, officials said there was ‘no reason for concern’, ‘no link with radiation’ and no further testing was required for two years. The second round of testing two years later found 68 cancers in children that had previously been screened and found to be clear. Only testing by Fukushima University Medical Teaching Hospital is included in the figures. Results from other bodies and areas are not allowed into official figures. After pressure from the Japan Thyroid Association headed by the controversial Professor Shunichi Yamashita some hospitals beyond Fukushima in the northern half of Japan have been refusing to test or treat thyroid issues.

Before the disaster official rates (National Cancer Centre website, information since removed) for child thyroid cancer in Japan were low, at from 0 to 1.3 (depending on age) per 100,000 per year. This suggests that up to 3.5 cases might be expected amongst Fukushima’s 250,000 children, although the actual official number for 2008 was zero cases, so 185 is a huge rise. We know that children were exposed to Iodine-131 before the radioactivity of the plume was acknowledged, and only the staff of Fukushima University Teaching Hopital and their families were given protective medical iodine.  This, along with the fact that cancers were detected in children who had previously been screened as clear, suggests that the ‘testing effect’ hypothesis is not credible.

During one of the public meetings held by the Fukushima University teaching Hospital there was criticism of the number of operations carried out, on the basis that thyroid cancer is not seen as being aggressive. Interestingly the surgeons explained that they needed to as it was urgent. This probably reflects reports that for many the cancer has progressed rapidly and has begun to spread to lymph nodes or lungs.

Some, including reporters for mainstream western news services, have blamed mothers for worrying too much for taking children for too many tests, suggesting that stress will be the only significant health effect. However, there is no evidence that stress or scans cause thyroid cancer.

Until the age of 18 children with thyroid cancer will receive free medical care if they are still registered in Fukushima – after that there will be no on-going help. Children under 18 who have moved their family registration have to pay whatever their age.

Here is a website collating official thyroid cancer statistics before and after the disaster, with links to the original information (Japanese)

Other health effects and lack of testing

Many parents are reporting that children’s health has deteriorated, their immune systems are low, and that successive infections, viruses, nosebleeds, eye and respiratory problems and exhaustion are common. Parents are campaigning for detailed lifelong health checks for all children in Fukushima and other areas across Tohoku and Kanto and where hotspots have been found.

There is no programme of testing for anything other than thyroid cancer, despite findings by independent doctors that the blood of children living in contaminated areas is undergoing changes which would in normal circumstances lead to a range of adverse health effects. When they move to un-contaminated areas their blood has been seen to return to normal, suggesting that a sensible policy would be for children to move away from contaminated areas.

There is resistance to the idea that radiation may have a wide range of adverse health effects on children other than hard cancers. This is an anti-scientific attitude, as new information from Fukushima’s children should be sought with an open mind, not rejected because it doesn’t fit a pre-judged, fixed position. Fukushima is a missed opportunity to expand our knowledge.

Before the disaster Fukushima prefecture published morbidity statistics, and in the first year after the disaster deaths across the Fukushima population were up were up 12% on the previous year (this did not include tsunami deaths). Publication was stopped after this and information has been removed from the prefecture’s website.

The State Secrecy Law (2013) has the effect of suppressing the acknowledgement and sharing of information on health effects as its provisions are so blurred as to include information about civil nuclear power and public health, with intimidating punishments of 10 years in prison for civil servants leaking information and five years for civilians and journalists helping them. A projected conspiracy law is viewed by many as a further effort to stifle openness. 


In the meantime some are arguing that results from examining insects and other wildlife should be used as an early warning system to change policy for children now. Studies are already showing health impacts on wildlife including genetic effects because of the faster turnover of generations. Wild boar living in the evacuated areas have been found to contain extremely high levels of contamination.


Incineration and use of contaminated waste

A further concern to many parents is the policy of the incinerating contaminated rubble and debris from Tsunami-hit areas and the subsequent disposal of the highly concentrated ash produced, usually in non-specialist facilities without adequate filtration - now largely completed. This occured in other, less affected areas across Japan, thus spreading radiation, asbestos, cadmium and so on further than necessary. Whilst it is again difficult to quantify the risk to children’s health it is hard to see why the risk would be taken at all. The reason given that it is to support Tohoku and ‘share the pain’ despite some local mayors from the Tsunami areas saying that they prefered to deal with it themselves. Campaigners suggest that it is more to do with profit and the grants available for refurbishing ageing incinerators. Successful protests by families and concerned citizens have prevented this in many areas, but Tokyo, Yokohama, Osaka, Kita Kyushu and Akita have done it among others. Waste with less than 8,000Bq/kg of caesium can be used to make concrete or compost, for example in venues for the Tokyo Olympics 2020.



For a more detailed overview on children’s health, please see this letter by a Japanese doctor.
And a 2012 comparison of various health markers for children's health from Fukushima before and after the disaster in context with with Chernobyl and Nagasaki is here  (Accessed 18.3.17)

Children’s emotional well-being

Children are likely to have seen distressing television coverage of the tsunami and explosions at the Fukushima Daiichi plant, and witnessing their parents’ confusion may have amplified their own fear. They may have absorbed some of the stress and arguments in the following period, and divorce is not unusual, with differing views on radiation risk and separation when mothers evacuate with children, leaving fathers behind to work and look after the family home a common factor.  Their attempts to make sense of all this will have been made difficult by very mixed and conflicting messages from schools, parents, and perhaps their friends. Some of this stress and conflict will have been internalised, and may be ‘acted out’ in various ways over time, with Japan’s relatively high suicide rate a potential concern: 2007 figures .


Childhood in Fukushima has changed greatly, as many children in the eastern half (Hamadori and Nakadori including the cities of Fukushima and Koriyama) are not allowed to play outside, help in allotments or gather wild food as they used to. Not being able to play properly is probably what has had the most day to day psychological impact in that it is what children notice most. Parents have been dressing their children in long sleeves, long trousers and facemasks even in the hottest weather. Windows were kept closed at home and in schools, in the early months of the disaster even in very hot weather  -concerned families still do this. Children have had to begin thinking about everything they do in terms of radiation risk, from where they play, to dust during school sports, to the food they eat.



Some evacuee children are thriving, while others have experienced adjustment difficulties, missing their family, friends and school, and some are still living in temporary accommodation. Many children are really missing their fathers, who have often stayed behind in the family home because of commitment to work and worries about finding it elsewhere. Some previously successful learners are struggling with school or dropping out. Bullying of children from Fukushima by other children in their new area is not uncommon, echoing the ostracism of hibakusha (those affected by the atomic bombing of Hiroshima and Nagasaki) and of victims of Minamata mercury poisoning.

Some claim that stress will be the only significant impact of the Fukushima disaster, and that mothers are to blame for burdening their children with their ‘emotional’ reaction and exaggerated fear. In fact most women have assessed the available information from a variety of official and unofficial sources and have made a considered decision based on what they consider best for their children. Nearly all had no previous experience of activism but are now campaigning hard to protect Japan’s children from radiation exposure.

It remains to be seen how the disaster will impact on Fukushima’s children’s mental health long-term, and most initiatives initially concentrated on practical needs. After Hurricane Katrina Save The Children estimated that 37% of Louisiana children suffered Post Traumatic Stress Disorder, including clinically diagnosed depression, anxiety, or behaviour disorders. PTSD can manifest itself in younger children in regressive, needy behaviour and increased frustration and anxiety, and in teenagers in increased risk–taking behaviours, school avoidance and difficulty in talking amongst other things.

Traditionally there are few opportunities for discussion and debate in the Japanese education system, and certainly not to discuss emotions. There have been reports that some teachers in Fukushima prefecture who attempted to talk about the subject of the nuclear disaster and radiation were sacked; and that children were prevented from eating lunches prepared at home or were humiliated in front of the others for refusing to drink milk from Fukushima because their parents are concerned. It is to be hoped these are exceptional cases.

Central and Fukushima government initiatives focussed on the idea of standing up, fighting for Fukushima, smiling, and so on. Children could be forgiven for thinking that if they feel sad or angry, or have left the area, they have somehow let down Fukushima and their friends.
Families vary in their care-giving style, but again discussing an individual’s emotions is culturally quite rare. There are some very positive protective factors in the closeness of family life (often including up to four generations living together) and very strong community life across Fukushima, especially outside town centres. In an ageing population children are highly valued, particularly in rural areas of Fukushima where young people have been leaving for decades. It may be that cultural factors like the idea of group harmony and the tradition of being ‘ganbaro’ (determined to struggle), while it can repress expression, will help some children who have grown up with it. To a degree, children are taking their cue from children and adults around them, as they have little information from anywhere else to work with.

In recent years voluntary groups have been developing that include emotional support in their range of activities.

Radiation, information and families

There is a scientific consensus on the dangers of very high doses of radiation; and also that that pregnant women and their unborn children, children, young people and young women are the most affected by radiation in general. However there is no scientific consensus on the cumulative risks of long-term exposure to lower levels of radiation in food and the environment, or the mechanisms of internal exposure. Nature Magazine and the British Medical Journal, for example, have both carried articles detailing why the studies have not yet been done to make the science of this clear. And yet official information is always that it is categorically ‘safe.’ 
This unscientifically categorical approach makes it extremely difficult for children’s parents to decided what to do, as they juggle concerns  - about their children’s health, school continuity and family and friend support networks - with the practicalities of work, home ownership, and eligibility for compensation.

There is a clear difference between parents with access to independent information via the Internet and foreign media, and those who rely on official information via mainstream television and newspapers. Before the disaster Japan was 11th out of 180 countries in the press freedom index, but by 2016 Japan had slumped to 72nd, the lowest of the G7 countries; and media have been threatened with closure by politicians and critical reporters including well known news anchors sacked as reported in the LA Times and here.

The ex-governor of Niigata prefecture, Izumida, who opposed the re-start of the local nuclear reactor, felt it necessary to repeatedly state in public that he would never commit suicide, and that if he was found dead it would definitely not be suicide.

Many say that few trust official information any more, as critically important information about the severity of the disaster, contamination levels and the direction of the radioactive plume was withheld, resulting in unnecessary exposure for children and families. NHK, Japan’s national broadcaster has largely failed to achieve balanced reporting: from next to useless or missing weather and wind direction reporting in the early days, and a lack of critical analysis or hard questioning of officials in general; to a failure to report mass protests for more evacuation or against nuclear power. The few useful programmes on the subject have often been shunted to the early hours when few can watch, and the director of one was sacked. As a consequence many families are now refusing to pay the license fee. Other TV stations relying on advertising have strong links with the nuclear industry, with the results you would expect – no critical reporting, and contracts cancelled for those who make anti-nuclear statements.

 It has been hard for parents to know where to turn to for impartial or balanced advice. Due to a 1959 agreement even the World Health Organisation’s materials and statements have to be passed by the International Atomic Energy Authority, which exists to promote the use of atomic energy. 


Professor Yamishita who was the official advisor on radiation protection to the Fukushima prefectural government is notorious among parents for having toured Fukushima telling people that if they smiled they would be protected from radiation; and telling children that they were lucky, as working out their exposure would make them good at maths; and that exposure of up to 100mSV a year was safe.  He was apparently paid very high fees for his role, but later admitted he had given a false picture of safety and resigned when the first thyroid cancer cases were announced.

Given all this, it is not surprising that families have been divided by differences of opinion, often leading to divorce, with reports of concerned parents who want to evacuate or be as careful as possible about their children’s food being ostracised by those who want to trust official assurances or simply not think about it. Japanese education emphasises learning by rote and discourages learning to make critical judgements. As one mother told me, “Really, we Japanese don’t want to think.” This is now changing, driven by people’s concern for their children.



For my summary of how many Japanese parents are attempting to minimise their children's radiation exposure please see here.

Food safety

The safety of food is a concern for people throughout Japan, from the principle of avoiding internal exposure and minimising risk to children where a choice is possible. Many are pressing for all school meals to be sourced from west Japan and Hokkaido, and particularly in Fukushima’s schools where children already have exposure to radiation in the environment. The effort of researching which food companies are using what products for home shopping, and of pressing education authorities to change their policy is exhausting for busy parents. Meanwhile, all food is officially ‘safe’ if it is in the shops, though it is often only tested by small samples of land and produce rather than comprehensively, and there is no specific labelling. Detailed testing of all produce and land is still urgently needed. When concerned people have done their own more detailed testing, or requested it from independent scientists, they have often found levels well above official safety limits, even from within areas officially cleared as ‘safe.’ Official testing reluctantly followed only once independent efforts proved it necessary. Some farmers in Fukushima have refused to grow until their land specifically is tested, while others have carried on as normal. Food from contaminated areas has sometimes been discovered to have been re-labelled as coming from elsewhere, and Fukushima rice has been blended with that from other areas. Education authorities have been slow to take the food issue seriously, and anecdotal evidence suggests a few are illegally preventing children eating lunches prepared by their parents. Pressure has been put on families to eat food from Fukushima in order to support the economy there.

Wild vegetables gathered from wooded mountains (sansai) were an important part of the diet and culture of Tohoku before the disaster, but it has been found that the rate of absorption of radionuclides (bio-availability) is particularly high in wild food, especially mushrooms, berries, freshwater fish, and extremely high levels of contamination have also been found in wild boar meat. Families that are aware of this have stopped feeding sansai to children, while those unaware, and older people wishing to continue the tradition, continue to eat them, in some cases getting them tested first.

There are many independent testing centres around Japan where anyone can bring food, soil, water, and anything from clothes and shoes to dust from domestic vacuum cleaners to be tested. Levels found are often higher than in official testing, partly determined by the sensitivity of equipment used.

Campaigning

Many groups organised by families, academics, scientists and other citizens have formed in Fukushima, throughout Japan, and the wider world focussing on issues related to Fukushima’s children, often with mothers taking the lead. Activities include:

•        Legal cases against the re-starting of nuclear power stations; seeking compensation for those affected; and successfully looking for acknowledgement of responsibility for Tepco and the government. Many of the 12,000 plaintiffs are mothers, with legal work provided free by concerned lawyers

•        Campaigning for more evacuation, especially of children from eastern areas of Fukushima  including Fukushima City, Koriyama City, and Iwaki City

•        Campaigning for families (including those who have evacuated unofficially) to be directly compensated rather than money being channelled through corporations

•        Campaigning for regular long-term health checks for all Fukushima’s children and those in hot spots elsewhere – not just for thyroid cancer

•        Campaigning for school meals throughout Japan (and especially in Fukushima) to be either sourced from west Japan and Hokkaido or individually tested

•        Campaigning for a credible and transparent food safety system

•        Campaigning against the use of contaminated waste in products including concrete and compost.

•        Reforming the energy system to prevent further disasters, ending nuclear power, increasing renewable energy, and moving towards locally owned ‘micro generation’ and away from the area monopoly system.

•        Supporting children and evacuees practically and emotionally through the establishment of numerous voluntary groups offering free services including medical checks, psychological support

Please note, I am not a scientist or specialist. The above is my current understanding of the subject as a father living in Fukushima at the time of the disaster and endeavoring to make a balanced judgement and share information, both from official sources and from the ordinary Japanese community who are working to protect children as best they can. After evacuating in the immediate aftermath we returned to examine how practical it might be to live safely and only finally left after a further 3 months, during which time I joined local people in tsunami clean-up close to the exclusion zone. This is not an hypothetical subject for me. I have met and drawn with many children in Fukushima, and we have friends and extended family living there now, with whom we are in regular contact. 

Geoff Read, March 2017


http://strongchildrenjapan.blogspot.com