The Journal Of Clinical Investigation Visits Fukushima and Writes On Scathing Piece On The Ongoing Disaster

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The Journal of Clinical Investigation                                                                                                                                OP-ED


The Fukushima nuclear disaster is ongoing


Andrew R. Marks

Department  of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA.




The 5th anniversary of the Fukushima disaster and the 30th anniversary of the Chernobyl disaster, the two most catastrophic nuclear accidents
in history, both occurred recently. Images of Chernobyl are replete with the international sign of radioactive contamination (a circle with three broad spokes radiating outward in a yellow sign). In contrast, ongoing decontamination efforts at Fukushima lack international warnings about radioactivity. Decontamination workers at Fukushima appear to be poorly protected against radiation.

It is almost as if the effort is to make the Fukushima problem disappear. A more useful response would be to openly acknowledge the monumental problems inherent in managing a nuclear plant disaster. Lessons from Chernobyl are the best predictors of what the Fukushima region of Japan is coping with in terms of health and environmental problems following a nuclear catastrophe.
homes, many  of which  are  still decorated with plantings of flowers and the blossom- ing cherry  trees  that are found  in the yards of most homes in this region. The readings on  the   radiation  monitors ranged  from 0.2115 to  1.115 microsieverts per  hour,  a measure of the  relative risks  imparted to biological tissues  by  ionizing   radiation.

One microsievert per hour is equivalent to four  airport security screenings per  hour and  is almost twice  the  annual limit  for occupational  whole-body radiation  dose limits  established by  the  nuclear regula- tory  commission. One  sievert total  expo- sure causes a 5.5% risk of cancer (1).
To  understand the  health risks  associated  with   ongoing  radiation  contamination  and   cleanup  in  Fukushima

Five years  after  a tsunami caused the Fukushima nuclear accident in Japan, cleanup of radioactive contamination is ongoing  and   a  formerly vibrant  farming region lays largely  fallow.  A recent visit to northeast Japan revealed wholly unexpected aspects of the  impact of the  meltdown of three nuclear reactors. The area devastated by the nuclear accident is easily accessed by a two-hour train ride from Tokyo to the city of Fukushima. It is then  possible to rent  a car and drive to within 18 kM of the reactors, which are still in meltdown.
On  the  train, digital  banners in  Jap- anese  and    English    encourage  passen- gers  to  visit  the  beautiful cherry  trees  in the  Fukushima district. In  the  rental car agency,  glossy   pamphlets  exclaim the beauty of the  region and  feature the  bril- liant  pink blossoms. On a recent April afternoon,   the    cherry    blossoms   were indeed spectacular. The  roads  deep  into the   region  affected  by  the   radioactive plume that  engulfed the  area  in March  of
2011 are clearly marked and readily acces- sible in a car rented at the Fukushima rail station. My  Japanese-speaking colleague translated the rental agency’s map as indi-
cating  an “area not to return to,” which we carefully avoided.

Following route 114 traveling east toward the  coast,  progressively larger  piles of large  black  plastic  bags  filled  with  dirt appeared on  the  roadside. At  first,  there were  piles  of  several hundred such  bags, each  approximately five  feet  wide  by five feet  in  height, methodically stacked one upon the other. Of note, similar bags appear to be used elsewhere in Japan to hold debris at construction and yard cleaning sites. Each bag was numbered with a white marker.
Approaching the eastern coast of Japan, the piles of bags on the roadside were more frequent and  larger  and  larger  and  larger. As route 114 progresses toward the  exclusion zone indicated on the car rental agency’s map, the piles of plastic bags filled with dirt reach unimaginable dimensions. Numbered in the  many  thousands, they  even- tually fill entire valleys that  recede off into the  horizon. In  some  instances, the  piles of black plastic  bags are covered with blue tarps  with  pipes  inserted into  their  tops, presumably to provide ventilation.

Roadside radiation monitoring sta- tions   are   placed  near   now   abandoned
region, the best  comparator is Chernobyl. Two of the  most  important public  health issues  related to both  the  Chernobyl and the  Fukushima disasters are  thyroid can- cers and  posttraumatic stress disorder (PTSD). Assessing the effects of these nuclear accidents on  the  risk  of  thyroid cancer is confounded by the  fact  that  the mere collection of data  required to make the diagnosis (e.g., thyroid scans and ultra- sounds) necessitates extranormal surveil- lance.  Thus,  true  control populations are not   available.

Nevertheless,  there  have been  reports of increased rates  of thyroid cancer following   the  Chernobyl nuclear accident (2), and  extrapolation from  that incident to  Fukushima is reasonable but as-yet  unproven. The  incidence of PTSD is understandably quite  high following nuclear accidents (3). There are  no  con- trolled experimental data  available to assess  the  ongoing risks  of  chronic low- level radiation now present throughout the Fukushima region. Thus,  it is imperative that  epidemiological data  are collected as thoroughly as  possible to  provide insight concerning  the   risks   of  long-term  low- level  environmental radiation. Similarly, it is imperative that data  are collected concerning the  spread of  radioactivity from

Conflict of interest: The author has declared that no conflict of interest exists.
Reference information: J Clin Invest. 2016;126(7):2385–2387. doi:10.1172/JCI88434.
the  nuclear plant  disaster via water  (e.g., streams running through the region should

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The Journal of Clinical Investigation



Figure 1. Worker at radioactivity decontamination site near Fukushima labeling bags filled with topsoil removed from contaminated areas. Image credit: Andrew R. Marks.



be sampled regularly) and  via animals (in particular  birds   should  be  banded and monitored to determine how they  may be vectors for spreading radioactivity in seeds and other forms throughout Japan).
Just outside the town of Iitate, brilliant pink flags,  which  are  the  same  color  used for the advertisements designed to attract tourists to  view  the  cherry   blossoms in the region, flap in the breeze, announcing (only in Japanese) “radioactivity removal.” At one particularly large site near the town of Iitate, a constant stream of large  trucks with entirely open  containers was stream- ing into an excavation site located at a large mountain  of  brown   dirt.   Huge   shovels were  digging  dirt and  placing  it onto  con- veyer  belts  pouring the  dirt  into  the  open trucks, which were leaving the site heading south. The men  and  women handling this contaminated dirt   were   wearing  outfits similar to  construction workers observed in  other regions of Japan,  including hel- mets, masks, gloves,  and  overalls (Figure
1). Over an approximately 5-hour period of driving  through the region, the only police
observed were at the turn  around marking
the  edge  of the  restricted zone.  No  mili- tary  presence was  observed. On  several occasions, workers were seen handling the plastic  bags of radioactively contaminated dirt without gloves.
During the entire afternoon of driving through the region not a single sign warn- ing of the potential dangers of radioactive contamination was  observed in  any  lan- guage  other than  Japanese. There was no security at most of the contaminated sites, and  thousands of plastic  bags of contami- nated dirt were piled high in areas without any supervision or even a fence  to prevent access  from the public roadway. Birds flew all  through the  area,   presumably  trans- porting radioactive seeds  and leaving  con- taminated droppings throughout Japan.
It is estimated that over 100,000 indi- viduals   have   been   displaced from   their homes due  to  the  reactor meltdown (4). Some   have   been   relocated  to  far  away cities,  including Tokyo.  During my  visit, a group  of five elderly women arrived on the same train as we did and were escorted onto  a waiting bus to be driven to see the
cherry   blossoms  decorating  the   village
they  used  to live in. Other displaced for- mer residents of now unlivable villages are perhaps less fortunate and have been relo- cated to one of the numerous “temporary” dwellings dotting the  region indicated by convenient roadside signs.  Many  of these were  immediately adjacent to radioactiv- ity detectors indicating levels  of at least  1 microsievert per hour.
Ironically, during my visit to Fukushima on  April  14, 2016,  an  earthquake rocked the Kumamoto region of Japan,  ultimately causing at  least  42 deaths and  displacing thousands. This  region contains the  only working    nuclear  reactor   remaining  in Japan. Too far away to be felt in Fukushima, it was nevertheless a harsh reminder of the continued risk  for  further damage to  the reactors already in meltdown.
The  continued high  level  of radioac- tivity  removal efforts in  the  Fukushima region (entire hill sides have been denuded of  surface  soil)  indicate  that   the   Japa- nese  government knows  the health threat caused  by  the   contamination  remains. The  lack  of  security, the  failure   to  pro-
vide  any  of the  internationally accepted


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The Journal of Clinical Investigation                                                                                                                                  OP-ED


protective warnings against radioactivity contamination (e.g.,  the  universal three- armed black  and  yellow  sign  warning of radioactivity), and  the absence of any warning signs  for non-Japanese-speaking individuals, despite the active  advertising campaign to  attract tourists to  view  the cherry  blossoms on  this  beautiful region of  Japan,   is  disturbing.  The   possibility that   individuals could   access   enormous amounts of radioactively contaminated dirt  and  transport it to a sensitive area  in Japan or elsewhere is frightening.

About the author
Andrew R. Marks is the chair of the Depart- ment of Physiology, founding director of the Clyde and Helen Wu Center for Molec-
ular Cardiology, and professor of Medicine
and  Physiology and  Cellular Biophysics at Columbia University. He  is a member of the   National  Academy of  Sciences,  the National Academy of  Medicine, and  the American Academy of Arts and  Sciences and  served as  editor in  chief  of  the  JCI from  2002 to 2007. His research focuses on  the  regulation of  ryanodine receptor calcium release channels that control exci- tation-contraction coupling in cardiac and skeletal muscle.

Address correspondence to: Andrew  R. Marks,   Department  of   Physiology and Cellular Biophysics, Clyde  and  Helen Wu Center for Molecular Cardiology, College of Physicians and  Surgeons, Columbia University Medical Center, 1150 St. Nicho- las  Avenue, Russ  Berrie  Medical Science
Pavilion, Room  520, New York, New York
10032, USA. Phone: 212.851.5340; E-mail:
arm42@columbia.edu.

1. [No authors listed]. The 2007 Recommenda- tions of the International Commission on Radio- logical Protection. ICRP publication 103. Ann ICRP. 2007;37(2–4):1–332.
2. Tuttle RM, Vaisman F, Tronko MD. Clinical presentation and clinical outcomes in Cherno- byl-related paediatric thyroid cancers: what do we know now? What can we expect in the future? Clin Oncol (R Coll Radiol). 2011;23(4):268–275.
3. Ben-Ezra M, et al. From Hiroshima to Fukushima: PTSD symptoms and radiation stigma across regions in Japan. J Psychiatr Res.
2015;60:185–186.
4. Yamashita S, Radiation Medical Science Center for the Fukushima Health Management Survey. Comprehensive health risk management after the Fukushima nuclear power plant accident. Clin Oncol (R Coll Radiol). 2016;28(4):255–262.















































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