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      Associations Between External Radiation Doses and the Risk of Psychological Distress or Post-traumatic Stress After the Fukushima Daiichi Nuclear Power Plant Accident: the Fukushima Health Management Survey

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          Abstract

          Background

          The relationship between radiation levels and mental health status after a nuclear disaster is unknown. We examined the association between individual external radiation doses and psychological distress or post-traumatic stress after the Fukushima Daiichi nuclear power plant accident in March 2011 in Japan.

          Methods

          The Mental Health and Lifestyle Survey was conducted from January 2012. Based on the estimated external radiation doses for the first 4 months, a total of 64,184 subjects were classified into <1 mSv, 1 to <2 mSv, and ≥2 mSv groups. Odds ratios (ORs) and 95% confidence intervals (CIs) of psychological distress and post-traumatic stress, with the <1 mSv group as the reference, were calculated using logistic regression analysis adjusted for age, sex, evacuation, perception of radiation risk, and subjective health status.

          Results

          The prevalence of psychological distress/post-traumatic stress in the <1 mSv, 1 to <2 mSv, and ≥2 mSv groups was 15.1%/22.1%, 14.0%/20.1%, and 15.0%/21.7%, respectively. In women, although the ≥2 mSv group tended to have a higher risk of psychological distress with the age-adjusted OR of 1.13 (95% CI, 0.99–1.30), the adjusted OR decreased to 1.00 (95% CI, 0.86–1.16) after controlling for all variables. On the other hand, there were no dose-dependent associations between radiation dose and post-traumatic stress.

          Conclusion

          Although external radiation doses were not associated with psychological distress, evacuation and perception of radiation risk may increase the risk of psychological distress in women in the higher dose group.

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          Most cited references32

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          Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls

          Most studies have some missing data. Jonathan Sterne and colleagues describe the appropriate use and reporting of the multiple imputation approach to dealing with them
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            Screening for Serious Mental Illness in the General Population

            Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI.
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              Multiple imputation of discrete and continuous data by fully conditional specification.

              The goal of multiple imputation is to provide valid inferences for statistical estimates from incomplete data. To achieve that goal, imputed values should preserve the structure in the data, as well as the uncertainty about this structure, and include any knowledge about the process that generated the missing data. Two approaches for imputing multivariate data exist: joint modeling (JM) and fully conditional specification (FCS). JM is based on parametric statistical theory, and leads to imputation procedures whose statistical properties are known. JM is theoretically sound, but the joint model may lack flexibility needed to represent typical data features, potentially leading to bias. FCS is a semi-parametric and flexible alternative that specifies the multivariate model by a series of conditional models, one for each incomplete variable. FCS provides tremendous flexibility and is easy to apply, but its statistical properties are difficult to establish. Simulation work shows that FCS behaves very well in the cases studied. The present paper reviews and compares the approaches. JM and FCS were applied to pubertal development data of 3801 Dutch girls that had missing data on menarche (two categories), breast development (five categories) and pubic hair development (six stages). Imputations for these data were created under two models: a multivariate normal model with rounding and a conditionally specified discrete model. The JM approach introduced biases in the reference curves, whereas FCS did not. The paper concludes that FCS is a useful and easily applied flexible alternative to JM when no convenient and realistic joint distribution can be specified.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 December 2022
                5 December 2022
                2022
                : 32
                : Suppl 12
                : S95-S103
                Affiliations
                [1 ]Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
                [2 ]Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
                [3 ]Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
                [4 ]Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan
                [5 ]Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
                [6 ]Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
                [7 ]Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan
                [8 ]Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
                Author notes
                Address for correspondence. Itaru Miura, MD, PhD, Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan (e-mail: itaru@ 123456fmu.ac.jp ).
                Author information
                http://orcid.org/0000-0002-2133-5809
                http://orcid.org/0000-0002-3783-2914
                http://orcid.org/0000-0002-6888-6640
                http://orcid.org/0000-0001-7755-1888
                http://orcid.org/0000-0002-0562-5160
                http://orcid.org/0000-0003-4532-7165
                http://orcid.org/0000-0002-9608-3669
                http://orcid.org/0000-0002-4715-2840
                Article
                JE20210226
                10.2188/jea.JE20210226
                9703924
                36464305
                a2c0a9fa-5de8-48ee-87a7-a42541b1271a
                © 2022 Itaru Miura et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 May 2021
                : 30 August 2021
                Funding
                Funded by: n/a
                Award ID: n/a
                Categories
                Original Article
                Public Health
                Yes

                fukushima nuclear disaster,external radiation dose,psychological distress,post-traumatic stress

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