Occupational health in disasters: Valuable knowledge gained from experience with the Fukushima Daiichi Nuclear Power Plant accident

Various natural and man‐made disasters occur around the world. Many disasters directly damage workplaces and affect business activities, such as production and sales. In such workplaces, the employees are affected physically and mentally: to maintain their health following a disaster, occupational health should respond to their various needs. In ordinary occupational health, the occurrence of adverse health effects is prevented by assessing health risks in the workplace environment and for workers and by reducing the risks acceptable levels. Such an approach is based on the assumption that there are no significant changes in the workplace during the process from risk assessment to risk reduction. However, in the event of disasters, occupational health staff have to predict day‐to‐day changes in employees’ conditions and the occurrence of occupational health needs; subsequently, they take appropriate action. To do so, occupational health staff should learn from experience with past disasters. However, there have been few reports about occupational health activities in the workplace following a disaster. One reason for this is that companies may be reluctant to disclose information about health issues following a disaster if the cause of the disaster is attributable to errors on the part of the company. In the case of the Great East Japan Earthquake, which was an unprecedented disaster that occurred on March 11, 2011, many valuable scientific articles and reports on occupational health have been published through the efforts and cooperation of many stakeholders. Among them, many articles are related to the accident at Fukushima Daiichi Nuclear Power Plant (NPP) of Tokyo Electric Power Company, which occurred as a result of the tsunami that followed the earthquake. Workers affected by the nuclear accident have been categorized as follows: those engaged in stabilization and decommissioning work in the NPP; those involved in evacuation guidance for residents; those engaged in work related to the direct impact of the accident, such as decontamination work of radioactive materials generated by the disaster; and those employed in workplaces affected by the accident, such as evacuation or change in business activities. Some examples of the findings are as follows. Following the disaster, in which a company was found to have been at fault and which affect the lives of many residents, the mental condition of company employees deteriorated as a result of discrimination or slurs.1 The health and safety measures for staff working in municipal offices may have been inadequate compared with those at public institutions under central government control.2 Where many employees are engaged as subcontractors and face multiple health risks, the original company and subcontracting company both need to play a role in maintaining subcontractor employees’ health beyond legal requirements. To fulfill that role, active guidance from government agencies and the involvement of occupational health experts are highly important.3 In this issue of The Journal of Occupational Health, Orui et al report that communication with superiors or managers and consultation with them were significantly associated with low psychological distress following the NPP accident. However, the authors found no significant association between low psychological distress and communication with workplace colleagues where there was forced evacuation following the nuclear accident.4 From their findings, it is evident that superiors or managers should take the initiative in engaging in open communication and active consultation in the event of a disaster. However, psychological distress among managers may not be small especially when they are also victims. Accordingly, occupational health staff should provide technical guidance to managers regarding their expected roles with subordinates; occupational health staff should support managers in being able to play those roles. To ensure that occupational health staff respond properly to needs following a disaster, it is essential that they be clearly positioned in the crisis management organization, not as external supporters; it is imperative that a trusting relationship be established with such staff in workplaces. It is also important to learn from previous disasters. However, it is difficult for individual