The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation.

Although many experts have attempted communication about radiation risk, fears about radiation exposure stemming from the Fukushima Daiichi Nuclear Power Plant accident remain deeply rooted. The characteristics of the anxiety vary with social background, which makes it difficult to alleviate with one approach. Our ultimate goal is therefore to create risk-communication materials tailored to various groups with differing social backgrounds. Towards that end, the purpose of the present study was to clarify potential factors associated with radiation-related anxieties within these groups. After obtaining informed consent, we conducted focus group interviews (FGIs) with Fukushima residents from various social groups, including evacuees, emergency responders, government personnel, medical staff, and decontamination workers. We obtained narrative comments specifically related to the following two themes: (i) lessons learned (at work or home) in light of one’s position in society, and (ii) health issues. After transcribing the comments, we examined potential factors associated with radiation-related anxieties using both quantitative and qualitative study methods simultaneously, using the KH Coder software and the Steps for Coding and Theorization (SCAT) method respectively. FGIs were undertaken with 141 persons. Categories, words and storylines extracted in this study might indicate potential anxieties that are unique to each group, but our analysis also suggested that some anxieties were common to all groups. We expect to continue the analyses and, ultimately, to establish group-tailored risk-communication materials for achieving our final goal of adapting and better managing risk-communication efforts to help people deal more effectively with the scientific, technological and societal changes that came about after the disaster.

Willingness to participate in activities during a nuclear disaster situation among firefighters is low. Thus, we aimed to identify the factors affecting the intention to participate in nuclear disaster activities. A questionnaire survey was conducted among firefighter training students (n = 186) and firefighters (n = 410), and a multivariate logistic regression analysis was performed to identify factors affecting the intention to participate in nuclear disaster activities. The percentage of students and firefighters who were willing to participate in nuclear disaster activities was 70.4% (n = 131) and 56.3% (n = 231) (P < 0.01), respectively. The factors affecting the students’ intention to participant were “wish to learn more information about radiation” and “firefighters should actively work in a nuclear disaster.” Meanwhile, the factors affecting the firefighters’ intention to work were “have self-confidence during nuclear disaster activities,” “participate if there is an incentive,” “unable to get a family member to understand the need to participate in a nuclear disaster activity,” and marital status. A student’s decision might be strongly connected to social norms about participating in nuclear disaster activities. The willingness to participate in nuclear disaster activities among firefighters might be improved by facilitating activities that can build their self-confidence, providing sufficient incentives, and helping their families understand their work. Therefore, not only direct education for responders but also educational activities for the general public and their families are essential.

To ensure human resource availability for a smooth response during various types of disasters, there is a need to improve the intent of those involved in responding to each hazard type. However, Disaster Medical Assistance Team personnel’s intent to engage with specific hazards has yet to be clarified. This study therefore aimed to clarify the factors affecting Disaster Medical Assistance Team members’ (n = 178) intent to engage with each type of hazard through an anonymous web questionnaire survey containing 20 questions. Our results show that the intent to engage in disaster response activities was significantly lower for chemical (50), biological (47), radiological/nuclear (58), and explosive (52) incidents compared with natural (82) and man-made hazards (82) (p < 0.01). Multiple regression analysis showed that incentives were the most common factor affecting responders’ intent to engage with all hazard types, followed by self-confidence. Thus, creating a system that provides generous incentives could effectively improve disaster responders’ intent to engage with specific hazards. Another approach could be education and training to increase disaster responders’ confidence. We believe that the successful implementation of these measures would improve the intent of responders to engage with hazards and promote the recruitment of sufficient human resources.

Introduction: Different disaster activities should be performed smoothly. In relation to this, human resources for disaster activities must be secured. To achieve a stable supply of human resources, it is essential to improve the intentions of individuals responding to each type of disaster. However, the current intention of Disaster Medical Assistance Team (DMAT) members has not yet been assessed.Study Objective: To facilitate a smooth disaster response, this survey aimed to assess the intention to engage in each type of disaster activity among DMAT members.Methods: An anonymous web questionnaire survey was conducted. Japanese DMAT members in the nuclear disaster-affected area (Group A; n = 79) and the non-affected area (Group N; n = 99) were included in the analysis. The outcome was the answer to the following question: “Will you actively engage in activities during natural, human-made, and chemical (C), biological (B), radiological/nuclear (R/N), and explosive (E) (CBRNE) disasters?” Then, questionnaire responses were compared according to disaster type.Results: The intention to engage in C (50), B (47), R/N (58), and E (52) disasters was significantly lower than that in natural (82) and human-made (82) disasters (P <.001). The intention to engage in CBRNE disasters among younger participants (age ≤39 years) was significantly higher in Group A than in Group N. By contrast, the intention to engage in R/N disasters alone among older participants (age ≥40 years) was higher in Group A than in Group N. However, there was no difference between the two groups in terms of intention to engage in C, B, and E disasters. Moreover, the intention to engage in all disasters between younger and older participants in Group A did not differ. In Group N, older participants had a significantly higher intention to engage in B and R/N disasters.Conclusion: Experience with a specific type of calamity at a young age may improve intention to engage in not only disasters encountered, but also other types. In addition, the intention to engage in CBRNE disasters improved with age in the non-experienced population. To respond smoothly to specific disasters in the future, measures must be taken to improve the intention to engage in CBRNE disasters among DMAT members.

When responding to disasters, emergency preparedness is essential to ensure that disaster activities are performed smoothly, safely and efficiently. Investigations on the Fukushima accident revealed that lack of preparedness, poor communication and unsuitable emergency measures contributed to an inadequate emergency response to the nuclear disaster. In this study, we conducted a questionnaire survey on the establishment of a personal radiation exposure dose among Disaster Medical Assistance Team (DMAT) members in Japan who might be involved in the initial response to a nuclear disaster. Establishing personal exposure doses for personnel can encourage emergency preparedness and inform decisions on appropriate role assignments during nuclear response activities. Valid responses were obtained from 178 participants, and the response distribution was as follows: ‘Already have own acceptable dose standard,’ 16 (9%); ‘Follow own institution’s standard (and know its value),’ 30 (17%); ‘Follow own institution’s standard (but do not know its value),’ 59 (33%); ‘Haven’t decided,’ 63 (35%) and ‘Don’t understand question meaning,’ 10 (6%). We also assessed intention to engage in nuclear disaster activities among respondents via engagement intent scores (EIS) and found that participants who had established personal exposure standards had significantly higher EIS scores than those who had not decided or who did not understand the question. Thus, educating potential nuclear disaster responders on personal exposure doses may contribute to a higher intention to engage in emergency responses and improve preparedness and response efficiency.