Radiation Exposure Concern and Distress in Rescue Workers
Radiation Exposure Concern and Distress in Rescue Workers
The present findings suggest that concern over radiation exposure was strongly associated with depressive and posttraumatic stress symptoms. Even among medical workers, who would likely be more knowledgeable than other public service workers about radiation exposure dangers, uncertainty about radiation exposure did have a significant adverse effect on their mental health. Thus, reliable and accurate information on radiation would be helpful for rescue workers, as well as residents, in disaster areas in order to minimize unnecessary psychological distress.
The prevalence of probable severe mental illness as determined by the K6 and depression as determined by the CES-D was 4.0% and 21.4%, respectively, in this study. For reference, the prevalence of depressive disorder was 14.9% among clean-up workers 18 years after the Chernobyl accident. An epidemiological study of a representative sample of community-dwelling Japanese (n = 43,716) using the K6 showed that 6.7% had severe mental illness and a large cohort study among Japanese workers with high and low socioeconomic status showed that 20–27% of men and 30–32% of women met the criteria for depression as determined by the CES-D. Thus, the prevalence of depression in the present study was assumed to be equivalent to that of the general Japanese population or average workforce.
The present study has some limitations. First, 1,390 DMAT members who were invited to participate in the study did not respond, which could limit the external validity of the findings. The lack of response could be attributable to the fact that many rescue workers dedicated themselves to continuing important work at their own hospitals immediately after returning from their deployment and could not find the time to participate in this study. It remains unclear whether similar findings would have been obtained if the full cohort had been recruited successfully. There is the possibility that subjects who responded were more anxious or were more likely to be deployed in areas with high radiation exposure; however, this cannot be confirmed as it is not known if differences in demographic characteristics exist between DMAT members who responded and those who did not. Second, we could not directly examine whether individual personnel were actually exposed to radiation or examine the geographic sites where they were deployed. We also did not assess the exact nature of the disaster work they undertook during their deployment, and this constitutes a weakness in the assessment of the traumatic event. Third, it is important to note that over 70% of participants in the present study were nurses and physicians, which may limit the generalizability of our findings to other rescue worker populations such as the police, local fire departments, and self-defense force, although they all have similar occupational responsibility to the public. Fourth, concern over radiation exposure might be influenced by the level of psychological distress. A longitudinal study is needed to examine the causality. Further research is needed to examine more closely the association between actual exposure level of radiation and psychological distress in individuals at risk from radiation exposure.
Discussion
The present findings suggest that concern over radiation exposure was strongly associated with depressive and posttraumatic stress symptoms. Even among medical workers, who would likely be more knowledgeable than other public service workers about radiation exposure dangers, uncertainty about radiation exposure did have a significant adverse effect on their mental health. Thus, reliable and accurate information on radiation would be helpful for rescue workers, as well as residents, in disaster areas in order to minimize unnecessary psychological distress.
The prevalence of probable severe mental illness as determined by the K6 and depression as determined by the CES-D was 4.0% and 21.4%, respectively, in this study. For reference, the prevalence of depressive disorder was 14.9% among clean-up workers 18 years after the Chernobyl accident. An epidemiological study of a representative sample of community-dwelling Japanese (n = 43,716) using the K6 showed that 6.7% had severe mental illness and a large cohort study among Japanese workers with high and low socioeconomic status showed that 20–27% of men and 30–32% of women met the criteria for depression as determined by the CES-D. Thus, the prevalence of depression in the present study was assumed to be equivalent to that of the general Japanese population or average workforce.
The present study has some limitations. First, 1,390 DMAT members who were invited to participate in the study did not respond, which could limit the external validity of the findings. The lack of response could be attributable to the fact that many rescue workers dedicated themselves to continuing important work at their own hospitals immediately after returning from their deployment and could not find the time to participate in this study. It remains unclear whether similar findings would have been obtained if the full cohort had been recruited successfully. There is the possibility that subjects who responded were more anxious or were more likely to be deployed in areas with high radiation exposure; however, this cannot be confirmed as it is not known if differences in demographic characteristics exist between DMAT members who responded and those who did not. Second, we could not directly examine whether individual personnel were actually exposed to radiation or examine the geographic sites where they were deployed. We also did not assess the exact nature of the disaster work they undertook during their deployment, and this constitutes a weakness in the assessment of the traumatic event. Third, it is important to note that over 70% of participants in the present study were nurses and physicians, which may limit the generalizability of our findings to other rescue worker populations such as the police, local fire departments, and self-defense force, although they all have similar occupational responsibility to the public. Fourth, concern over radiation exposure might be influenced by the level of psychological distress. A longitudinal study is needed to examine the causality. Further research is needed to examine more closely the association between actual exposure level of radiation and psychological distress in individuals at risk from radiation exposure.
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