Aug 30, 2012

Medical Food Services in Japan

Involuntary internal radiation exposure from consumption of contaminated food

The Japanese government has been trying very hard to “promote” food products from disaster-affected regions.  It’s called, “Tabete Ouen Shiyou!” or “Let’s Eat and Help!” campaign, which uses celebrities and politicians for “showing” that it is safe enough for them to eat.  Prime Minister Noda has been seen sampling sashimi from fish caught off the Fukushima coast and juicy peaches grown in Fukushima Prefecture.

It might be one thing for ignorant people to accept the government propaganda campaign, but it is inexcusable when the campaign is extended to school lunches and now medical food services which cater to hospitals, nursing homes, and welfare facilities.  Those already compromised by illnesses, aging, or disabilities are basically force-fed food, without any option, which might be contaminated with radioactive material such as cesium, strontium and possible more.

Below is complete translation of a letter sent from the Chief of Food Industry Affairs Bureau in the Ministry of Agriculture, Forestry and Fisheries, to the president of the Japan Medical Food Services Association.

   **

Original letter in Japanese is found here:
http://www.maff.go.jp/j/press/shokusan/ryutu/pdf/120822-04.pdf

   **

24 Shokusan No. 2511
August 22, 2012

To: President of Japan Medical Food Services Association, Public Interest Incorporated Foundation

From: Chief, Food Industry Affairs Bureau,  Ministry of Agriculture, Forestry and Fisheries

Regarding promotion of use of food produced in disaster-affected regions for the purpose of reconstruction of areas affected by Great East Japan Earthquake.

I hope this letter finds you well.

I would like to express my appreciation for various support and cooperation you have provided to disaster-affected regions since the Great East Japan Earthquake last March.

It has been about a year and a half since the earthquake happened.  Disaster-affected regions have begun recovery of major infrastructures in earnest, and attempts are in progress towards reconstruction of industries.  In addition, as of July 13, Basic Policy for the Reconstruction and Rebirth of Fukushima was approved by the Cabinet, based on the Special Measures for the Reconstruction and Rebirth of Fukushima.  The Government will continue to put full effort into recovery and reconstruction of the disaster-affected regions including Fukushima.

However, despite these efforts towards recovery and reconstruction, economic situations of disaster-affected regions are still grim.  In order to solve this, we think it is important that we erase the anxiety of consumers towards the agricultural, forest and fishery products produced and processed in disaster-affected regions and surrounding areas (called “food produced in disaster-affected regions” from hence on), in an attempt to expand their consumption.

For this purpose, Ministry of Agriculture, Forestry and Fisheries, in cooperation with other related ministries and agencies, have widely and accurately released to the public such information as the test results for radioactive material in food and shipment restrictions of products.  At the same time we have called for a campaign, “Let’s Eat And Help!,” to actively consume food produced in disaster-affected regions. Under approval of private business operators and others, we have taken initiatives to sell and use, with priority, food produced in disaster-affected regions all over the nation with, by holding sales fairs and encouraging their use in company cafeterias.

Promoting expansion of nationwide consumption of food produced in disaster-affected regions will bring a powerful aid to fast recovery and reconstruction of disaster-affected regions.  In addition, it will maintain and increase nationwide opportunities for supporting disaster-affected regions.

Therefore, even though some of you have already made efforts to help disaster-affected regions, I would like to ask you to encourage members of your association, who are offering food services at medical, nursing and welfare facilities, to promote the use of food produced in disaster-affected regions.  This will help with expansion of nationwide consumption of food produced in disaster-affected regions.

The Medical Act of Japan

Portion of the Medical Act of Japan that pertains to “duty to provide medical care” was excerpted and translated into English.

http://www.houko.com/00/01/S23/201.HTM (The entire Medical Act in Japanese)
Originally enacted on July 30, 1948, and most recently revised on June 27, 2007.


Article 19 
Section 1.  Practicing physicians may not refuse a request for medical examination or treatment, unless there is a just cause.
Section 2. Physicians who performed examination, autopsy or delivery may not refuse a request for an issuance of a medical, autopsy, birth, or stillbirth certificate, unless there is just cause.

    **

Duty to provide medical care
http://ja.wikipedia.org/wiki/%E5%BF%9C%E6%8B%9B%E7%BE%A9%E5%8B%99

“A duty to provide medical care” is a duty imposed upon physicians and medical care facilities to provide medical care to patients under Article 19 of the Medical Act.  There are no penalty provisions established.

However, Ministry of Health, Labour and Welfare states the following:

1. “Just cause” as described in the Medical Act Article 19 is limited to situations where medical care by a physician is practically impossible due to the absence or illnesses of the physician.  Refusal of repeated requests by the patient due to a mild case of fatigue will constitute violation of Article 19.

2. No penalty provisions are set for physicians who violate Article 19, but such conduct qualifies as “disgracing conduct as a physician” stated in the Medical Act Article 7.  In cases of repeated violations, revocation or suspension of medical license might be ordered under Article 7.

    **

Article 7
Section 2.  When a physician falls under any of Article 4 Sections, or when exhibiting a disgracing conduct as a physician, the Minister of Health, Labour and Welfare may apply one of the following punishments.
  1. Warning
  2. Suspension of medical license for less than three years
  3. Revocation of medical license

    **

Article 4  A person who falls under one of the following Sections may not be given a medical license.
  1. Those who are defined by the regulation of the Ministry of Health, Labour and Welfare to be incapable of performing proper work as a physician due to mental or physical disorders.
  2. Those addicted to narcotics, marijuana or opium.
  3. Those who have received a punishment of more than a fine.
  4. Those who committed a crime or dishonesty in medical practice.

******************************************************************************************************
医師法

http://www.houko.com/00/01/S23/201.HTM

第19条 診療に従事する医師は、診察治療の求があつた場合には、正当な事由がなければ、これを拒んではならない。
 診察若しくは検案をし、又は出産に立ち会つた医師は、診断書若しくは検案書又は出生証明書若しくは死産証書の交付の求があつた場合には、正当の事由がなければ、これを拒んではならない。

http://ja.wikipedia.org/wiki/%E5%BF%9C%E6%8B%9B%E7%BE%A9%E5%8B%99

応招義務とは、医師法第19条で「診療に従事する医師は、診察治療の求があった場合には、正当な事由がなければ、これを拒んではならない」と規定する、医師や医療機関に課せられた患者の診療義務のこと。罰則規定はない。

ただし、厚生労働省(当時の厚生省)は以下のように述べている。

1. 医師法第十九条にいう「正当な事由」のある場合とは、医師の不在又は病気等により事実上診療が不可能な場合に限られるのであって、患者の再三の求めにもかかわらず、単に軽度の疲労の程度をもってこれを拒絶することは、第十九条の義務違反を構成する。

2. 医師が第十九条の義務違反を行った場合には罰則の適用はないが、医師法第七条にいう「医師としての品位を損するような行為のあったとき」にあたるから、義務違反を反覆するが如き場合において同条の規定により医師免許の取消又は停止を命ずる場合もありうる[1]

第7条 医師が、第3条に該当するときは、厚生労働大臣は、その免許を取り消す。
 医師が第4条各号のいずれかに該当し、又は医師としての品位を損するような行為のあつたときは、厚生労働大臣は、次に掲げる処分をすることができる。
     1.戒告
     2.3年以内の医業の停止
     3.免許の取消し

第4条 次の各号のいずれかに該当する者には、免許を与えないことがある。
1.心身の障害により医師の業務を適正に行うことができない者として厚生労働省令で定めるもの 2.麻薬、大麻又はあへんの中毒者 
3.罰金以上の刑に処せられた者 
4.前号に該当する者を除くほか、医事に関し犯罪又は不正の行為のあつた者

法医学
http://tsstudio.s12.xrea.com/med/lmedduty.html

Aug 29, 2012

Consent Form for Thyroid Examination for Fukushima Prefecture Resident Health Management Survey

http://www.env.go.jp/jishin/rmp/conf-health/b02-mat07.pdf



The left side of this form is an announcement about the implementation of thyroid examination as part of Prefecture Resident Health Management Survey.

The box contains details of the examination such as the examinee’s name, date, place, and type (a free, 5-minute ultrasound examination of thyroid) of examination, and how to apply for it.  Under item 5, it states that “As a rule, the thyroid examination will not be performed without submission of the consent form.”

The right side of this form is the actual consent form.  The box contains personal information, such as name of the examinee and the legal guardian, address, phone number, height and weight of the examinee, and the method of transportation to get to the examination site.  The part above the box is translated as follows.

  **

Consent Form

To:  Fukushima Prefecture Governor and Municipal University Corporation Fukushima Medical University President

“This thyroid examination is intended to assess current thyroid conditions in order to implement health management of children.  You will be notified of the examination result, and the data will be stored by Municipal University Corporation Fukushima Medical University.  There is a possibility that part of the data, kept anonymous in consideration of privacy, might be publicized and utilized as basic material for statistical processing and continuous health management.”

Upon understanding the above statement, I give consent to Prefecture Resident Health Management Survey Thyroid Examination for the following examinee under my legal guardianship.

Moreover, I append that the consent was given under the following conditions.
 
Consent conditions:

1. I (or the examinee once becoming a legal adult) may be able to revoke this consent at my (or examinee’s) convenience.

2. I and the examinee will not receive any disadvantage from the consent being revoked.

3. I (or the examinee once becoming a legal adult), may obtain information related to the examinee himself/herself anytime I or the examinee should wish.

4. Any personal information provided for this survey will be strictly confidential.

Yamashita will be too dead to take responsibility


“I won’t be able to take responsibility … I will be dead
before the consequence are known.”





(This is a screenshot from a television program.  Captions are translated below.)

What is going on in Fukushima schools?
Uncertain radiation safety standards

Nagasaki University Professor
Fukushima Prefecture Radiation Health Risk Management Adviser
Shunichi Yamashita

When the government set the radiation limit of 20 mSv per year:

“By the time I die, I won’t be able to take responsibility for all of your lives.
However, we have an obligation to obey the standard set by the government.  I will be dead before the consequence are known.”

Aug 28, 2012

〈Thyroid Examination〉 The Cabinet Office policy to compare with children outside Fukushima Prefecture

http://www.excite.co.jp/News/society_g/20120826/Mainichi_20120826k0000e040108000c.html?_p=1
This is a complete translation of a Mainichi Shimbun article linked above and published online on August 26, 2012.


In relation to the thyroid examination of children started by Fukushima Prefecture after the Fukushima Dai-ichi nuclear accident, the Japanese government decided to implement a similar examination outside Fukushima Prefecture in order to assess the effect of radiation on children.  Comparative data will be obtained by the end of the current fiscal year (the end of March, 2013).  In Fukushima Prefecture, about 35% of children examined had thyroid abnormalities such as nodules.  Even though Fukushima Prefecture explains that “Small, benign cysts and nodules are not unusual,” parents are anxious and worried as there is no good comparison data of normal prevalence.  The government official says, “We would like to collect data that can be used for comparison to relieve anxiety of Fukushima residents.”

Because pediatric thyroid cancer increased after the Chernobyl nuclear accident, Fukushima Prefecture began thyroid ultrasound examination in approximately 360,000 children who were between the ages of 0 and 18 at the time of the accident.  Of 38,114 children who were examined by the end of March, 2012, 35.8% or 13, 646 children had either nodules (lumps) or cysts (fluid-filled sac); 186 children went on to receive secondary examinations.  No cases of cancer have been found.

For details about the thyroid examination by Fukushima Prefecture, please refer to this article:
http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html

Professor Shinichi Suzuki from Fukushima Medical University, which is implementing the examination, says that “There should be no effect of radiation seen at this point of time.” as pediatric thyroid cancer cases began to increase 4 to 5 years after the Chernobyl accident.  On the other hand, radiation specialists have pointed out that “There is no way to judge the presence or absence of the effect of radiation exposure unless the results are compared to prevalence of thyroid nodules/cysts in an average population of children.”

According to the Team in Charge of Assisting the Lives of Disaster Victims in the Cabinet Office, the project will be commissioned to an organization which wins an open competitive bidding.  A free examination will be performed on a total of over 4,500 children under age 18 in more than three locations in Japan.  The examination will be performed by specialists belonging to the Japan Thyroid Association, just as in Fukushima Prefecture, and the quality of ultrasound equipments and the result assessment guidelines will be standardized.  Professor Toshihide Tsuda of Okayama University (environmental epidemiology) says, “This is a meaningful investigation, as the current situation is too insufficient for residents to accept explanation by Fukushima Prefecture.”

Data from examination will be compiled into a report by the end of March 2013.  Before the start of the examination, an investigation committee consisting of specialists, such as epidemiologists, will be established to make concrete plans.  Selection of areas to be examined will most likely require agreements by the Board of Education, schools, and parents/guardians.

Examination results will be sent to those examined.  The government will provide counseling and advice as needed and hold information sessions when most results come out.


Insufficient explanation causing anxiety

The thyroid examination for children under age 18, offered free of charge by Fukushima Prefecture, in order to “watch over children’s health to bring a sense of relief,” is increasing anxiety of parents/guardians.  Many are taking their children to hospitals outside Fukushima Prefecture, looking for a second opinion.  The reason for that is the insufficient explanation about the result from the prefecture.

A sixty-year-old woman from Kawamata-machi, Fukushima, took her four-year-old grandchild to Nakadori General Hospital in Akita-city, Akita Prefecture, in June.  It took them three hours each way by car and Shinkansen bullet train.  They stayed there the night before in order for the grandchild to undergo palpatory and ultrasound examinations of thyroid gland as well as blood test for thyroid function.  As the visit was considered a health check-up, insurance could not be applied.  They paid about 14,000 yen ($178) for the visit, in addition to about 40,000 yen ($509) for travel expenses.

The family received the prefectural examination result from Fukushima Medical University in February.  All it said was, “There are small nodules and cysts (fluid-filled sacs), but there is no need for secondary examination.”  They grew anxious about having to wait until the next examination two years later.  They were upset when multiple cysts were confirmed at the Akita hospital.  The doctor recommended a follow-up examination six months later and told them, “Now that there is a diagnosis, you will be able to use insurance next time.”

This hospital has seen 65 children from Fukushima Prefecture in the last five months since March 14, 2012.  Similar visits are seen in Niigata, Hokkaido, and Tokyo Metropolitan region.  The prefecture examination implemented by Fukushima Medical University restricts examining physicians to specialists belonging to one of seven specialty associations, such as the Japan Thyroid Association, but an examination can be done at any medical facility with the right equipment and experience.

However, there are quite a few cases of people traveling far for the examination after being denied medical care in Fukushima Prefecture.  A 38-year-old mother of two who evacuated to Aizu wakamatsu-city called five hospitals in the city, yet nobody agreed to examine them.  She resented that “It is just not right that we can’t be seen by a doctor when we want to be seen.”

We asked physicians the reason for refusal to provide medical care and received the following responses.

A pediatrician in Fukushima-city:  “It will be confusing if our result is different from the result by Fukushima Medical University.”

A hospital in Aizu district:  “It’s not a duty of a private hospital to relieve the anxiety of parents/guardians.”

One of the physicians involved with the prefectural examination:  “This examination by Fukushima Medical University is an unprecedented epidemiological study in the world to follow up on health effects by radiation.  If some undergo examinations at another hospital instead of the prefectural examination, it will interfere with the study. 

Some point out the influence by a letter sent in January by Fukushima Medical University vice president Shunichi Yamashita to seven specialty associations including the Japan Thyroid Association. The letter tells members of those specialty associations to “Please explain to them well to make sure they understand that any further testing is not necessary before the next examination unless symptoms appear,” in case they receive inquiries or consultations from parents regarding the results of the prefectural examination.  One of the physicians belonging to the Japan Thyroid Association said, “If I follow what’s in this letter, I will be going against the Medical Act which says physicians cannot refuse to provide medical care.”

For the letter sent by Shunichi Yamashita, please refer to this article.
http://fukushimavoice-eng.blogspot.com/2012/05/fukushima-childrens-thyroid-examination.html

Regarding this letter, Yamashita explained, “It tells them to explain to parents/guardian the fact the prefecture is conducting an extremely accurate examination.  It does not tell them not to give a second opinion.”

As the anxiety of parents/guardians spreads, Namie-machi began an independent project in July:  Town clinic will provide thyroid examination in the year it’s not provided by the prefecture.

Norio Konno, the chief for health insurance section, said, “The prefecture does not understand how parents/guardians and children feel.  They need to provide more detailed support and offer the data.


Request for information disclosure needed for detailed results

Results of the thyroid examination by Fukushima Prefecture are divided into four assessment categories [A1], [A2], [B] and [C], based on the presence or absence of nodules and/or cysts and their sizes.  Those in categories [B] and [C] will undergo secondary examination.

For details about the thyroid examination by Fukushima Prefecture, please refer to this article:
http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html

The category that attracts the most anxiety from parents/guardians is [A2].  Thyroid nodules and/or cysts found are too small to qualify for secondary examination.  Moreover, the notification does not have detailed information about the number, location, and size of the nodules and/or cysts.  Fukushima Medical University began improving the process after receiving over 250 phone calls.  From now on they plan on informational meetings to explain the results to the residents.

However, there are other issues.  Consent forms signed by parents/guardians prior to the examination clearly states that the result “can be released any time upon request (by parents/guardians or examinees themselves),” yet request for information disclosure must be filed according to the prefecture regulations in order to obtain physician’s diagnosis or see ultrasound images.

There have been six requests for information disclosure.  Three of them had information disclosed three weeks later, but the still image of ultrasound was printed on a regular copy paper, and the actual digital image data which is more clear was not given to them “for fear of alteration” (per Fukushima Medical University).  Professor Shiro Matsui, Fukushima Medical University Public Relations Officer, explains, “We have to be extremely careful in handling information relating to physical body. In order to confirm that it’s actually the person the information belongs to, the best way is for them to file a request for information disclosure.

To this, an attorney Tsutomu Shimizu, a chairman of the Japan Federation of Bar Association Information Issue Countermeasure Committee, states, “This is meant to be an examination to protect children, and they have their priorities wrong.  Information like test results which is compelling to both children and parents/guardians should be promptly disclosed to them once it is being given out to the right person.”  Even if the image given out might be altered, “All they have to do is keep track of the original data, and it is no excuse for nondisclosure,” he says.


Listening to parents’ voices humbly

We asked Fukushima Medical University vice president Shunichi Yamashita, who is in charge of the thyroid examination, about his challenges.

Reporter:: What is the objective of the examination?

Yamashita:  It is a medical service to promote the health of prefectural residents.  It is by no means a research study.  WHO dose estimation study says radiation exposure dose of Fukushima residents is at most 100 mSv.  International consensus by scientists says that the health risk under 100 mSv has either been not clearly shown or extremely small.

Reporter:  What do you think about more and more parents/guardians seeking second opinions outside Fukushima Prefecture?

Yamashita:  We must figure out a better way of dealing with it.  There is a gap between physician’s opinions and mothers’ understandings.  We need to listen to them humbly to establish a trusting relationship.  

Reporter:  What do you think about the effect of radiation?

Yamashita:  We might find small cancer, but thyroid cancer can occur at a certain frequency under normal circumstances.  We won’t know the conclusive trend until over 10 years later.  We cannot get into oppositional relationships with the prefectural residents.  I would like to guide them so that Japan as a country will not fall apart.  After the Chernobyl accident, many lawsuits happened regarding health effects, with compensatory expenses cut into the national budget.  When that happens, the ultimate victims are people of the country.

 

Aug 27, 2012

Radiation Effects Research Foundation (RERF) “alters” a Japanese summary of their research paper

RERF published a research paper earlier this year, “Studies of the Mortality of Atomic Bomb Survivors, Report 14, 1950–2003: An Overview of Cancer and Noncancer Diseases.”
http://www.rrjournal.org/doi/pdf/10.1667/RR2629.1

RERF released a 4-page Japanese summary of the study in the spring.  It was recently revealed that the content of the Japanese summary has been tampered with.

Concerns of tampering are in regards to the following phrase in the first paragraph before Introduction:

“The estimated lowest dose range with a significant ERR (Excess Relative Risk)  for all solid cancer was 0 to 0.20 Gy, and a formal dose-threshold analysis indicated no threshold; i.e., zero dose was the best estimate of the threshold.”

      **

In the Japanese summary that was released in the spring and happened to be printed by this author, the following phrase was used (translated into English):

ERR for all solid cancer deaths showed a linear dose-response relationship to radiation dose in all dose ranges, indicating no threshold, and the estimated lowest dose range with a significant ERR was 0 to 0.20 Gy

The Japanese summary currently available online, apparently altered in July, shows the following:

ERR for all solid cancer deaths showed a linear dose-response relationship to radiation dose, and a threshold for the most compatible linear model is zero, but the estimated dose range with a significant ERR was over 0.20 Gy.

      **

This information was originally published by a blogger in this blog:   http://ameblo.jp/megumi-jk/entry-11238511139.html  
In an addendum dated July 31, 2012, the blogger stated that a phone conversation with RERF representative revealed that RERF “changed it because the previous expression was largely misunderstood by the general public.  The content remains the same.”
       **

The significance of this difference of expression relates to the fact that dose ranges below 0.20 Gy (200 mSv) are being ignored.

  **

By the way, this study was covered brilliantly by Ian Goddard in one of his videos.

☢ Low-Dose Radiation ☢ NEW A-Bomb Study





 **

Japanese summary (see lines 2 through 4 in the first paragraph):

May 2012 (original version)
https://docs.google.com/document/d/1ODzgGge5Vnp5ngxDwyN0M789AtPadD4qbO1hNjwHqmQ/edit

July 2012 (current version)
http://www.rerf.or.jp/news/pdf/lss14.pdf

Aug 17, 2012

Analysis: Radiation Health Risk Management Adviser Shunichi Yamashita


This analysis was based on the videotape of the following press conference.

From the Foreign Correspondents’ Club of Japan website:
URGENT: Shunichi Yamashita, Understanding Nuclear Power and Radiation Exposure
http://www.fccj.or.jp/node/6488
Time: 2011 Mar 22 15:00 - 16:00
Summary:
URGENT PRESS CONFERENCE
Shunichi Yamashita, Professor,
Graduate School of Biomedical Sciences, Nagasaki University
Department of Molecular Medicine and Department of International Health and Radiation Research, Atomic Bomb Disease Institute,
Newly Appointed Adviser to Fukushima Prefecture on Health-risk Management from Nuclear Radiation
Language:
The speech and Q&A will be in English
Description:
Understanding Nuclear Power and Radiation Exposure
Professor Shunichi Yamashita will address the issue of radiation exposure from the Fukushima Daiichi nuclear plant accident to correct misconceptions of the people of Japan and abroad.  Yamashita is an authority on the subject with lengthy experience caring for patients suffering from radiation exposure from the atomic bombs and Chernobyl nuclear power plant disaster.
Fukushima Prefecture on March 19 named Yamashita as an adviser on health-risk management from nuclear radiation.
Yamashita is the dean of the Graduate School of Biomedical Sciences at Nagasaki University and professor and chairman of the Department of Molecular Medicine and Department of International Health and Radiation Research at the Atomic Bomb Disease Institute of Nagasaki University School of Medicine. He also works as a director of the WHO Collaboration Center for Research on Radiation Emergency Medicine

http://www.ustream.tv/recorded/13489249#utm_campaigne=synclickback&source=http://www.videonews.com/press-club/0804/001775.php&medium=13489249

******************************************************************************************************

The speaker at this presentation, Shunichi Yamashita, M.D., has been Fukushima Prefecture's "Radiation Health Risk Management Adviser” since the Fukushima nuclear accident in March 2011.

If the video of the press conference had been seen live on March 22, 2011, instead of over one year after the accident, the information may have seemed appropriate and legitimate.  Possibly.  Most people did not possess much knowledge about nuclear reactors and radiation at the time of the accident. Even physicians have very little training in radiation exposure other than basic knowledge about acute external radiation exposure that might result from nuclear accidents or bombs.

Shortly after the 2011 Tohoku earthquake, it became apparent that Fukushima Daiichi nuclear power plant was in trouble.  There were Ustream videos of informative and well-documented press conferences at the Foreign Correspondents’ Club of Japan available, presented by members of Citizen’s Nuclear Information Center and Mr. Masashi Goto, a former Toshiba nuclear power plant designer.  Compared to these, Yamashita’s press conference was scattered and difficult to follow due to the absence of a professional interpreter.  Yamashita spoke in English which was at times too unclear to provide more in-depth information and detail.

Notice this line in the program description of this event from Foreign Correspondents’ Club of Japan’s website: “Professor Shunichi Yamashita will address the issue of radiation exposure from the Fukushima Daiichi nuclear plant accident to correct misconceptions of the people of Japan and abroad.”  Did he perhaps think he did an excellent job of “correcting” misconceptions of the people of Japan and abroad at this press conference?  Regardless, any sane individual would recognize these “misconceptions” as being correct and sound knowledge about potential harmful effects of any dose of radiation.  In reality, his views that he seemed to believe to be the absolute truth were misconceptions, yet he didn’t even seem to know it.

             ***************************************************************************
Note: This analysis consists of brief descriptions of the content of his speech, actual transcripts of his speech in quotation marks with special “verbatim” parts in blue color.  Analytical sections are in italics.

In the beginning of the press conference, Yamashita went over the basics of “radiation protection guidelines” established by “international societies.”  According to him, these guidelines are “scientific” and are “exactly based on risk estimation.”  By now many recognize these international societies including ICRP (International Commission on Radiological Protection), IAEA (International Atomic Energy Agency), WHO (World Health Organization), and UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation), as entities whose clear purposes are to promote nuclear use, regardless of cost to all life forms, especially children and other vulnerable populations.  Understanding this provides an interesting insight into what Yamashita was saying.

                                                         * * *

In regards to Yamashita’s claim of these guidelines being “scientific” and “exactly based on risk estimation,” the second draft of Position Paper on Radiation Risk by Scientists Concerned About Radiation Risk (SCARR Statement) questions the validity of ICRP’s methodology of risk estimation.http://www.scarr.eu/files/shortstatementv2.pdf (short form)
http://www.scarr.eu/files/draftscientificstatementv2afinal.pdf (complete draft)

“On the basis of radiobiological theory and epidemiological evidence, we believe that
ICRP's current dose/risk estimates are significantly in error for some types of exposure.”

                                               * * *

Yamashita kept repeating that the radiation dose between 10 to 100 millisievert (mSv) was an “uncertain” level, whereas the dose over 100 mSv was associated with a dose-dependent cancer risk throughout life.  He also said the natural background level was about 1 to 2 mSv, and microsieverts were very, very small numbers.  He didn’t seem concerned about the 2 to 10 mSv range.

He boasted that Nagasaki University had a wealth of data on external radiation health effects due to the atomic bombs in Hiroshima and Nagasaki, and that he also had data from Chernobyl, through Sasakawa Project, which offered internal radiation exposure data due to “radioactive iodine” in contaminated milk.  

                                                                 * * *

Ian Goddard, a long-time archival medical-study researcher, offered this insight: "After around 8:30 in the video Yamashita appears to confabulate that the A-bomb data shows a threshold effect. I've never seen a statement from the Radiation Effects Research Foundation (RERF) overseeing the A-bomb cohort to that effect, and to the contrary the RERF explicitly says the dose response is linear with no threshold. How he gets away with such outlandish misleading statements while maintaining professional standing is disturbing."

                                                                 * * *

Yamashita described different types of radiation exposure such as external/internal, local/general, and contamination such as fallout as was experienced in evacuation zones and even in the Kanto region at the time.  After describing different sources of radiation such as natural and artificial, he said there was radioactivity in many things, including human bodies due to naturally occurring radioactive potassium.  Of course, this statement is a well-known point because those who want to make radiation exposure look minimal always compare the exposure to bananas, naturally high in potassium.  Yamashita said, “This is very clear.  Everybody has radioactivity within your body from the food chain.”  

                                                              * * *

Natural background radiation doesn’t seem to be as harmless as widely believed, according to this study by Lene H.S. Veiga, Sérgio Koifman, Pattern of cancer mortality in some Brazilian HBRAs.  http://www.sciencedirect.com/science/article/pii/S0531513104016863

Among residents of Brazilian High Background Radiation Areas, there is great concern about radiation-related health effects and there is also a common certitude that cancer incidence is higher in those areas than in other Brazilian areas with normal background radiation. This paper aims to present an overview of Brazilian High Background Radiation Areas and evaluate whether cancer mortality among residents from Poços de Caldas, Araxá, and Guarapari is higher than would be expected when applying mortality rate of their respective States. Results show that cancer mortality from the Brazilian HBRAs, Poços de Caldas, and Guarapari is higher than would be expected for their respective reference population. On the other hand, cancer mortality for the Araxá population is lower than would be expected.”

This study was part of the following publication:
International Congress Series, Volume 1276, Pages 3-468 (February 2005)
High Levels of Natural Radiation and Radon Areas: Radiation Dose and Health Effects, Proceedings of the 6th International Conference on High Levels of Natural Radiation and Radon Areas
Osaka, Japan
6–10 September 2004
Edited by T. Sugahara, H. Morishima, M. Sohrabi, Y. Sasaki, I. Hayata and S. Akiba
http://www.sciencedirect.com/science/journal/05315131/1276

                                                               * * *

One of the points Yamashita kept emphasizing was, of course, the now famous 100 mSv theory:

He said, “Radiation more than 100 mSv causes risk of cancer.  Less than 100 mSv we just don’t know the effect of radiation on the body.  Generally speaking it’s a safe level, but we don’t know.  It’s difficult to prove low dose effects in human body at less than 100 mSv.”

                                                              * * *

Yamashita kept repeating, “it’s clear,” “this is scientific,” without really giving any details about why or how or by citing any scientific sources.  Was it the time constraint due to scheduling, or was he not able to explain fully in English, or did he think the audience did not need to know?  What IS clear is that it is not clear why he chose to do this press conference in his own English.  The consequence was that the whole presentation was perceived as unsophisticated, full of incorrect and incoherent grammar and pronunciation and lack of sentence structure to the point that he was sometimes saying the opposite of what he probably meant to say without any self knowledge.  It was so bad that some critical remarks he made were transcribed, word for word, and these phrases are shown in blue.  Some phrases were loosely transcribed and are shown in black in quotation marks.

                                                               * * *

“Fukushima is completely different from Chernobyl.  Internal exposure is a very important point for local residents who received radiation fallout.”  

                                                               * * *

As of March 22, 2011, when this press conference was held, the fact that there were three meltdowns at Fukushima Dai-ichi was not yet known.  However, this statement doesn’t make sense since he said, erroneously, local residents only had internal exposure after Chernobyl, and he also seemed to be saying internal exposure was important for Fukushima residents even though “Fukushima is completely different from Chernobyl.”  

This 1999 report by Edwin S. Lyman, PhD, Scientific Director of the Nuclear Control Institute on MOX fuel use in Japan may shed light on critical health issues surrounding Fukushima's impacts: http://www.nci.org/j/japanmox.htm

                                                               * * *

“This is a kind of the radiation risk proven by radiation health science based on Hiroshima/Nagasaki data.  Radiation never immediately causes any symptoms if it’s less than 1,000 mSv. Ten to forty years later some kind of diseases occur due to DNA damage. It has latency, and dose responsiveness, and age of exposure is very crucial.”

                                                               * * *

Acute radiation sickness symptoms are not supposed to occur until the exposure over 1,000 mSv or 1 sievert (Sv)?

However, a faxed TEPCO Abnormal Incident Report 21 (Article 15, Report 20) from Fukushima Daiichi NPP at 11:39 on March 12, 2011, stated a TEPCO employee involved in drywell venting procedure in Unit 1 registered a dosimeter reading of 106.30 mSv.  (The radiation level at the front gate was 6.69 microsievert per hour (μSv/h) at 11:00, although it appears that it was 162.9 μSv/h at 10:40.)  According to Abnormal Incident Report 26 (Article 15, Report 25) at 17:59 on March 12, 2011, this employee began to complain of headaches and feverish sensation and was taken to Ono Hospital in a company car.  This person certainly hadn’t experienced 1,000 mSv.
http://www.nisa.meti.go.jp/earthquake/plant/1/230617-1-2.pdf

(Abnormal Incident Reports are Article 15 reports, based on the Act on Special Measures Concerning Nuclear Emergency Preparedness, Article 10, paragraph 1.  They include location, date, time, specific events and possible causes, radiation levels detected in reactor buildings, circumstances in affected areas, presence/absence of exposed individuals, and radiation levels from monitoring posts on the property.
http://www.nisa.meti.go.jp/earthquake/plant/1/plant-1.pdf

Additionally, anecdotal stories of evacuees suggest many had symptoms such as metallic taste, eye discomfort, headache, nausea, diarrhea, bloody nose, fatigue, and mental confusion like this family which evacuated from a 10-km zone.
http://fukushimavoice-eng.blogspot.com/2012/01/symptoms-in-family-who-lived-in-namie.html

Perhaps these symptoms were never associated with and documented for radiation exposure levels lower than 1,000 mSv.  However, unlike after the Chernobyl accident, the Fukushima nuclear accident has occurred during the information age in which people’s experiences could be shared with others almost instantly through Twitter and blogs.  Fukushima evacuees’ testimonials might provide valuable information in understanding the effect of radiation on human bodies.

Interestingly, on page 21 of Preliminary Dose Estimation From the Nuclear Accident After the 2011 Great East Japan Earthquake and Tsunami published by World Health Organization in 2012, the following statement is made: http://whqlibdoc.who.int/publications/2012/9789241503662_eng.pdf

“Evacuation – Most people within 20 kilometres of the nuclear power plant were rapidly
evacuated. Therefore, the panel chose not to estimate doses in this area. Some dose may have been received prior to evacuation but the assessment of this required more precise data than were available to the panel at the time of the assessment, including detailed information about the implementation of protective actions (see Box 3).”

The truth is, however, the evacuation from the 20 kilometer zone wasn’t as rapid as assumed.  There was confusion about which direction to go to, and some evacuees even went in the direction of the radioactive plume.  Nevertheless, the fact the WHO report did not include residents from the 20 kilometer zone in the preliminary dose estimation brings up some interesting points.

1. Was it because the residents had hardly any radiation exposure?
2. Was it because their radiation exposure would be too high to be included in the report, giving rise to “undesirable” results?
3. What are evacuees’ symptoms attributed to?  Stress of evacuation?  Does stress cause metallic taste, eye discomfort and bloody nose?

On a different note, Alexey Yablokov from Russian Academy of Science, a biologist and ecologist who is the co-author of Chernobyl: Consequences of the Catastrophe for People and the Environment, stated that beginning about 1-5 mSv per year there was a statistically significant increase in the number of chromosomal aberrations and lens opacities.  This might not be considered “immediate symptoms,” yet it is a significant piece of information that suggests radiation affects the body at a much lower dose than 1,000 mSv.

Moreover, consider this paragraph from the abstract of the SCARR statement as previously introduced: .

“The mechanisms of harm are subject to ongoing investigation and are, as yet, poorly understood but there is strong evidence that radioactive contamination causes many more diseases than are accommodated within ICRP advice.”

                                                               * * *

Yamashita does admit that, based on radiation biology, individual susceptibility has been recognized.  

“International regulation of radiation safety depends on linear, non-threshold models. This is a model.  It’s not a real finding on how to give the safety levels.  There are a lot of the gray zones.  But we know more than 100 mSv, especially internal and external, cause the risk of radiation cancer. What happened around Chernobyl?  Radiation caused the dose responsive damages at chromosomal levels, DNA levels, and cell levels.  Even low dose.  But it’s very difficult to prove the human levels, especially health levels.  We cannot detect such kind of low dose effect for the human bodies for long life lives.  Less than 100 mSv, it’s we don’t know if it’s linear threshold or such kind of the different curve.”

He declares that due to “ limitation of low dose studies,” the data at Nagasaki University and also from Chernobyl Sasakawa Project are the only data all over the world.

                                                               * * *

This statement on page 12 of the SCARR statement might partially explain the perceived scarcity of data.

“The authors of one overview regard the language barrier as a considerable obstacle in the search for truth. ‘ […]  serious analyses from scientists in Russia, Ukraine and Belarus, which have been published in Russian and discussed at congresses in Russian […] are almost completely ignored in the Western world because, in the West, Russian is a very foreign language and good translations are expensive.’”

Moreover, this video on the DOE low-dose study by Ian Goddard illustrates limitations of the DOE, in-vitro study:
http://www.youtube.com/watch?v=oe2fMMaVE7Q&feature=player_embedded

This video, “Fukushima Radiation NOT SAFE!” by Ian Goddard illustrates important low-dose studies listed below:
http://www.youtube.com/watch?v=ywKv0dj3UuY&feature=player_embedded#!

These were the studies referred to in the above video:

The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: estimates of radiation-related cancer risks.
http://www.ncbi.nlm.nih.gov/pubmed/17388693

Is cancer risk of radiation workers larger than expected?
http://oem.bmj.com/content/66/12/789.full

Diagnostic X-ray examinations and increased chromosome translocations: evidence from three studies.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075914/?tool=pubmed

Also there is a wealth of Chernobyl data available in Chernobyl: Consequences of the Catastrophe for People and the Environment.
http://www.strahlentelex.de/Yablokov%20Chernobyl%20book.pdf

There is an extensive list of literature regarding low-dose radiation exposure available here.
http://www.nuclearreader.info/chapter5.html

In addition, according to scientists at the annual meeting of the American Society of Clinical Oncologists, or ASCO in Chicago, children that received radiation treatments for childhood cancers have a higher risk of developing breast cancer later in life, even if the radiation dose was low.
http://enformable.com/2012/06/adults-at-higher-risk-for-developing-cancer-later-in-life-after-childhood-exposures/

                                                               * * *

“Radiation induces cancer.  But nobody can diagnose because there is no radiation signature. Limitation of science is very clear.  Less than 100 mSv, generally speaking it’s a safe level, but we don’t know.  We cannot prove scientifically if it’s dangerous or not.  So therefore we give the more safety range, less than 50 mSv.  This is kind of the philosophy of a concept to make the radiation safety regulation.”

                                                               * * *

If the limitation of science is clear and if the safety is unknown below 100 mSv, would it not be a reasonable thing to assume less than 100 mSv is not safe?  After all, you are talking about human lives here.  Why take risks?

In fact, former WHO director, Margaret Chan stated “There is no safe low level of radiation.”
http://concernforhealth.org/radiation-is-always-dangerous-says-world-health-organization-director-general/

                                                               * * *

“Please remember latency, dose response and age dependence.  Because of this age dependence, nobody in this room has to worry about it at all.  Only children and pregnant women.  Also, please remember observatory period is very long.  In 10 to 30 years down the road other risk factors come into play.  Radiation is only one of the risk factors that cause health impact.  Of course there is genetic susceptibility, but this is complex and combined.  It’s difficult to prove radiation-induced diseases below 100 mSv.”

                                                               * * *

Essentially, Yamashita was saying adults in the room would not have to worry about being affected by radiation exposure because radiation was only one of the risk factors which would give rise to illnesses.  However, he does admit that radiation is known to cause damage at chromosomal, DNA and cellular levels.  What about the synergistic effects of radiation with other risk factors such as cigarette smoking and obesity?  How about the contribution of chromosomal, DNA, and cellular damages from radiation to the development of so-called “age-related illnesses” such as hypertension, diabetes, atherosclerosis, cerebrovascular diseases, and cardiac diseases?  Does a human body respond to each risk factor so independently as it is often depicted?

                                                   * * *

He goes on to explain the following (sic):
“Chernobyl on April 26, 1986.  On May 1, people walked around without any prohibition.  People ate radio-contaminated food and drank radio-contaminated milk without any specific regulation by the former Soviet Union. Cause of radiation cancer is really increased by such activities.  I-131 has disappeared, but Cs-137 is still there. Even 30-km zone is still prohibited to live even after 25 years.  Chernobyl Sasakawa Program was established at five centers and has screened more than 200,000 children who were 0 to 10 years of age at the time of the accident.  We collected many data.  So we only have health effect of radiation fallout during these time periods. Very unfortunate, but Hiroshima/Nagasaki provided external radiation data and Chernobyl internal radiation data in local residents.  Source of the radiation in Chernobyl is from the food chain, which has high correlations to what is occurring in Fukushima.”  

“On the childhood cancer it increased 5 to 10 years after Chernobyl, peaking at different times depending on the age group.  Currently there is no more childhood cancers, but adolescent cancers are still at high level because of critical age, especially 0 to 10 years at the time of Chernobyl accident. This is due to age factors and also the consumption of contaminated milk with radioactive iodine hitting thyroid gland.  It is not atmospheric or environmental such kind of ‘radionucleotide’ (I think he meant to say  ‘radionuclide’ but throughout this press conference his English was not professionally presented, constituting unclear communication) but from food consumption.”

                                                               * * *

In regards to “no more childhood cancers,” Alexey Yablokov from Russia stated, “That statement is not correct.  There are childhood cancers, of course, in the Chernobyl-contaminated territories.  Our current data, however, will not be published for several years.”

Yamashita claims local residents only had internal radiation exposure from contaminated food and especially, milk.  

In fact, the local residents were exposed to radiation through multiple vectors.  

Immediately after the accident, the route of exposure would have been through inhalation and direct exposure to the radioactive cloud, called “cloudshine,” and exposure to the radioactive particles falling on the ground and emitting large amounts of gamma radiation, called “groundshine.”  Beyond the first week, their exposure would have been from groundshine; inhalation of resuspended particles from the ground; and consumption of contaminated food and water.  Thus the local residents had both internal and external radiation exposure over time.

Thus Yamashita’s statement that “It is not atmospheric or environmental such kind of radionucleotide” obviously does not hold true.

In addition to radioactive iodine which Yamashita refers to, there were numerous, supposedly over 200, radionuclides released from Chernobyl in the form of gases, aerosols, and “hot particles.”  The true extent of the release is said to be difficult to assess due to the inadequacy of available data.
Table 1.5 on page 19 of Chernobyl: Consequences of the Catastrophe for People and the Environment by Yablokov, et al., published in 2009 by New York Academy of Sciences, shows the following primary radionuclides emitted from April 26 to May 20, 1986: I-135, La-140, Np-239, Mo-99, Te-132, Xe-133, I-131, Ba-140, Cs-136, Ce-141, Ru-103, Sr-89, Zr-95, Cm-242, Ru-106, Cs-134, kr-85, Pu-241, Sr-90, Cs-137, Pu-238, Pu-240, and Pu-239.

                                                               * * *

“Internal radiation dose estimation is very, very difficult, almost impossible.  But we tried different scientific approaches and then we showed internal exposure, as similar to external exposure, of radioactive iodine can cause childhood cancers.  So therefore this is really evident we should stop to give the contaminated milk to the children in this kind of Fukushima areas.”

                                                               * * *

This is an interesting statement in that if he thought giving children contaminated milk would be bad, why are Fukushima children getting Fukushima-produced food in their school lunches, including milk, mushrooms and fish?  Japan’s school lunch industry, we have discovered, is full of corruption where suppliers and schools have cozy relationships.  Neither party seems to be purely interested in true well-beings of children by keeping contaminated food out of the system.  Rather they will use the food items as long as their contamination level is below stated government guidelines, which are still unacceptably high.  It appears, they would rather keep doing their business as usual, at the expense of children’s lives.

                                                               * * *

“At the standard point of nuclear safety governance of mechanism in Japan, this is exactly unpredictable.  Even in Japan we prepared for this kind of accident, but it completely destroyed our such kind of scenario.  What they are received inside of the peoples, the highest may be 400 mSv or the highest may be 1000 mSv.  I told you the radiation effect is very clearly seen more than 100 mSv, but less than 100 mSv we don’t know what really happen.”

                                                               * * *

“Exactly unpredictable” is an interesting expression.  The whole sentence doesn’t even make any sense.  Was it that they simply weren’t prepared for nuclear disaster even though they thought they were?

                                                               * * *

“Too much worry is not good.  To disturb with your life, even to destroy spiritual mentality.”

                                                               * * *

This is the now famous statement that got on so many people’s nerves.  Yamashita told Fukushima people that they needed to laugh instead of worrying.  Later, in this interview by Der Spiegel, http://www.spiegel.de/spiegel/print/d-79974035.html, he said he was rather upset himself immediately after the events surrounding the 311 earthquake/tsunami, and he apparently thought people in Fukushima looked very worried and thought that would not be good for their immune system.

It might be true that stress suppresses immune function and laughter helps boost immune system.  However, Yamashita’s statement is simply his value judgement and lends no credibility to his position as the Radiation Health Risk Management Adviser.  In the midst of a nuclear emergency, especially with the lack of sufficient information, it would have been completely natural for people to worry.

Instead of brushing aside their “worries” and telling them to “laugh,” he could have simply been honest with them about known and unknown factors, shared their concerns, and taken any known appropriate measures to protect Fukushima people from slightest possibilities of danger, evacuating them farther away.  However, this wasn’t going to happen, judging from what he said next about the then current situation.

                                                               * * *

“People who evacuated from 20 km, local residents are completely safe.  We don’t need to worry about their health impact at all.  Very sadly, foreign journalist, even Japanese, announced or make misunderstandable information to the public.  That’s the one important point is the effect of radioactive iodine.  Radioactive iodines accumulate selectively into the  thyroid gland, because iodine is the source of thyroid hormone.  So therefore the thyroid should be avoided to be exposed to the radioactive iodine.  So therefore IAEA or WHO or international radiation safety network give a recommendation to block thyroid before expose to radioactive iodine.  It’s true.  It’s true.  So therefore, we prepared, already, this kind of the stable iodine to block when some level of the radiation enters into the bodies.  But what is the dangerous dose?  This is very important.  I told you 100 mSv is, less than 100 mSv we cannot say anything about the dangers.  So concerning to this kind of the regulations in Japan, we took 50 mSv may be dangerous for childrens or neonates.  So we should avoid exposure to more than 50 mSv.  So once we predict the people were, may exposed to more than 50 mSv, the government order to give stable iodine.  But it’s not properly correct.  As I told you this times of evacuation mechanism is completely destroyed.  People at far evacuated from 3 km to 10 km and then 20 km.  It means the people evacuated to the safe areas.  However, after that, government said please stay to people who evacuated, to a stay within between 20 to 30 km.  It’s kind of the strain.  If that area is still some dangerous they should go out 30 km.  But the government the past one week people still inside.  What message from this?  I would have to ask the Japanese government.  But anyway I guess probably they thought 20 to 30 km’s local residents are still safe.”

                                                               * * *

He seemed to be saying that the evacuation was sufficient because the government said so, and those who evacuated are out of the harm’s way and thus didn’t need the stable iodine tablets.  As the Radiation Health Risk Management Adviser for Fukushima Prefecture, wasn’t he in a position to recommend further evacuations if necessary?  A physician should value human lives more than government procedure or possible financial strain for the government.  He could have used his role as the Radiation Health Risk Management Adviser to advocate for people’s safety and health.

If Fukushima people had been told of the true danger of the situation, they might have just run away as fast as they could.  Instead, lukewarm information and advice such as “don’t worry, laugh” has given people a false sense of security.  Yes, they were relieved temporarily of worries, but they continued to be exposed to high levels of radiation.

                                                               * * *

“Their predicted thyroid dose are really maybe less than 50 mSv.  So far no order of stable iodine administration are very important.  It means other area of people they don’t need to take stable iodine.  No peer (sic) is essentially needed so far. This is important.  Depend on the countries regulation levels are different.  Some country took 100 mSv of the guideline to safe areas.  In Japan I recommend the 50 mSv.  But I don’t know this type of approaches still very importantly show us safety level is highly regulated. Very safe.  Safely regulated.  And also secondly the administration of stable iodine is very important.  The timing just before receiving radioactive iodine the stable iodine can block or compete to enter the radioactive iodine into the thyroid gland.  So therefore such kind of the chronic stage of the radiation exposure including radioactive iodine it is very difficult to judge when we give the stable iodine.  Because very low.  Low dose of the radioactive iodines cannot influence the thyroid gland directly because the effect of radiation in the cell damages is very, very low.  So just before the exposure to be predicted into thyroid gland, if we received some certain amount of the stable iodine, 90% of the inhibition occurred.  Even the 8 hours after exposures 40% are inhibited.  But one days after it already exposed, no effect at all.  So it is very crucial, very important to administer stable iodine immediately after exposures.  So we already missed such kind of the timings, because people already evacuated within 20 km to the 30 km. And also there are no such kind of the safetyness(sic) for the using the such kind of the stable iodine to block the thyroid gland.  Of course any other radioactivities cannot be blocked by stable iodine.

General people, local residents, they don’t need to take such kind of stable iodine because of side effect problems and Japan is a high rich area of iodine intake.

Stable iodine is the kind of the complementary approaches to block the thyroid.  If we predict we will be exposed coming in 2 or 3 hours, they should evacuate out of that area.  So it means the people who are already evacuated to the 20 to 30 km they don’t need to take such kind of the stable iodine.  If necessary, if needed, they should go away, and away from the 30 km.

So this is the kind of the important point to recognize what about the stable iodine effect.  So Japan Nuclear Safety Commission already made the special guideline in 2002 of April.  This is called the Disaster Countermeasure Office.  So they said the person who will be evacuated to receive more than 100 mSv of projected thyroid dose at the site of evacuation they are target to be administered the stable iodine.  So therefore in Japan we don’t do distribution of stable iodine.”  

Yamashita went on to explain why iodine tablets were not distributed to people in Fukushima, due to unpredictability of the disasters and the miscommunication at the level of national and local governments and municipalities.  He expressed his “sadness” over mix-up that led to some communities having already distributed iodine, and he blamed media for not providing the public with correct information, saying “If the media “interviews (sic)” the correct information to the public.”  He went on to say Fukushima Prefecture had no good communication tool or lifeline even then due to the disaster, which was actually true and one of the few true things he said during the press conference.  He claimed people’s primary responsibility would be to support Fukushima.

                                                               * * *

He might not have known this at the time of the press conference, but an instruction proposal had been released at 9:30 am on March 13, 2011, from the local headquarter of the Nuclear Emergency Response Headquarter in the Cabinet Office, actually ordering  stable iodine administration.  It was addressed to the governor of Fukushima Prefecture and mayors of Okuma-machi, Futaba-machi, Tomioka-machi, and Namie-machi.
http://www.nsc.go.jp/senmon/shidai/bousin/bousin2011_03/shijian.pdf

It is a little difficult to read due to poor resolution of the scanned document, but the following is the approximate translation:

“In terms of radiation screening of persons, because iodine 131 and cesium 137 are the main radionuclides causing radiation levels, decontamination should be performed and stable iodine tablets administered when a radiation level of 6,000 to 10,000 cpm is detected by the gamma survey meter.  
Moreover, in terms of iodine tablet intake for children, refer to the disaster manual and administer iodine syrup.  Also, for individuals over age 40, administer stable iodine tablets only if they want to.”


Based on TEPCO Abnormal Incident Reports 33 and 34, Unit 3 drywell vent was begun at 08:41 on March 13, 2011, 49 minutes before the order was faxed.  At 09:01, “Abnormal Increase of Property Border Radiation Level” had been determined. http://www.nisa.meti.go.jp/earthquake/plant/1/230617-1-3.pdf
Unfortunately, the Governor of Fukushima Prefecture, Yuhei Sato, seemed to have failed to follow this order from the government.

                                                               * * *

The following was actually Yamashita’s concluding statement.

“This is a couple of the important topics I explain but the level of radiation I today explained to you is mSv.  Millisievert is kind of the concern information.  But microsievert per hour, we don’t need to worry about.  This is a clear message.  Even background 0.002 microsievert, here in Tokyo 1 microsievert, Fukushima it’s 20 microsievert per hour, it’s still safe because millisievert is a very dangerous zone.  You are talking about microsievert.  It’s a nonsense.  So please remember, concerning the health effect, health impact, the dose are very crucial.  From zero to the 10,000 times a day, always appear but the health impact is unusual.  So this is really my message as an adviser to Fukushima government.  Maybe my comment is, Japanese government they don’t like me, my government, my comment, but anyway, we need to, it’s very happy, today, in front of you, to introduce how we can approach to the health conditions of Fukushima people based on science.”

                                                               * * *

Amazingly, he seemed to truly believe radiation levels in microsievert were “nothing” and “nonsense.”  This explains why Fukushima Prefecture keeps children in places where ambient radiation levels could be 0.2, 0.5, and even over 1.0 μSv/h.  In fact, schools insist on having outdoor swim classes this year (2012) as long as the ambient radiation level is less than 1.0 μSv/h.  Recently, a Fukushima school had officials cleaning the pool area in protective suit so that the children’s radiation exposure would be reduced and parents’ anxiety would be soothed.  It seems counterintuitive to put children in bathing suits where adults must wear protective suits as precaution just to clean it.
https://twitter.com/s_hiroki24/status/214217227908554752/photo/1

                                                               * * *

During the questions and answers session, more surprises ensued, not only regarding the actual content of his answers but also his demeanor and lack of coherence.

First questioner stated firmly that half of what Yamashita told them was useless because he did not clarify the units of radiation measurement with the time factor, such as μSv or mSv per hour, per day, per year, or if he meant a one-time dose.  

Regarding the Tokyo radiation levels and effect of rain, he said,

“If radioactive particles exist, worry about rain.  For the amount of radioactivity in Tokyo area, rain is important to wash out such kind of fallout in this area.   You don’t need to worry about staying in Tokyo for one month or even a whole year.  It’s μSv.  Yeah, very clear.”

When the next questioner asked if damage would be done after reaching 100 mSv annually, he explained as follows:

“I always mention about the 1 mSv give the 1 DNA damage, and 10 mSv give 10 damages.”

                                                               * * *

This statement makes no sense on many levels.

Again, referring to the abstract of the SCARR statement might be helpful.
http://www.scarr.eu/files/shortstatementv2.htm

“the fundamental quantity used in radiation protection is ‘absorbed dose’ which
ignores direct measurements of individual irradiation, and is an average of energy
transfer which therefore is unable to describe the impact of short-range radiations at
the cellular and molecular level; that the ‘absorbed dose’ approach was developed and adopted before such discoveries as the double helix structure of DNA, the DNA repair process, the chemical affinity of certain radionuclides for DNA, the Secondary Photoelectron effect, and non-targeted effects (genomic instability and bystander or secondary effects) and before biodosimetric methods for assessing actual exposures became available.”

In addition, the effect of radiation on the body varies depending on if it’s alpha, beta, or gamma radiation.

For instance, alpha particles, although stopped by a sheet of paper due to its relatively great size and weight, are very energetic.  “If it’s moving fast enough when it comes in contact with a living body cell, it can burst through the cell wall and do serious damage to the interior.  In fact, for the same amount of total energy delivered, alpha radiation has greater biological effects than any other form of radiation.  Recent studies show the alpha impact on chromosomes to be one thousand times greater than gamma radiation.” (excerpted from Nuclear Madness by Helen Caldicott).

Also, the effects of radiation are cumulative.  Yamashita did admit that accumulated doses of 100 mSv was “hypothesized” to be equivalent to one-time doses of 100 mSv.

                                                               * * *

Dennis Normile from Science Magazine asked about any justification for the 50-mile (80-km) evacuation zone recommended by the chairman of the US Nuclear Regulatory Commission.  He asked what effect it had on situations in Japan if recommendation issued by the head of the nuclear regulatory agency in another country was in conflict with recommendations issued by the Japanese government.

Yamashita answered that “harmonization” of different radiation recommendations was important, but he personally couldn’t understand why Americans would evacuate beyond 80 km because there was no correct information at all and also the Japanese government never guaranteed foreign people’s safety.  He went on to emotionally state:

“So therefore Japanese should stay here in Japan.  It’s a small island.  It’s our country. We love the Japan.  So people anyway to save and support Fukushima Prefectures (sic).  Yeah? “

                                                               * * *

This statement seems another one of his “value judgement.”  It simply isn’t an appropriate or professional statement for someone who is the Radiation “Health Risk” Management Adviser for Fukushima Prefecture whose best interest should have been people’s safety and health.
                        
                                                   * * *

He then said that scientifically the radiation fallout level was not dangerous beyond 20 km, and if it were they would evacuate people beyond 20 km.  He complained that even though he understood American recommendation, they were misleading, worrying Japanese people too much.

                                                                * * *

Interestingly, it became apparent recently that the United States government had radiation contamination data which they shared with the Japanese Foreign Ministry through their Tokyo Embassy on March 18, 2011.  It was never utilized appropriately to evacuate people.  Perhaps Yamashita actually was not given this radiation contamination data, since apparently then Prime Minister Kan didn’t even know about it.   But did he not wonder why the United States government made their recommendations?  Did he think they were made out of blue or from some uncertain information?  For fear of “worrying” the people of Japan too much,  did he neglect to “check out” all the options?
http://www.nytimes.com/2012/06/20/world/asia/japan-did-not-use-us-radiation-data.html

                                                               * * *

On questions about safety of food, water, and seafood, he admitted that Japan didn’t have real regulation safety standards for food but stressed his trust in the Ministry of Agriculture controlling any contaminated food to leave the area for distribution to the rest of the country.  Production of food was stopped, locally produced food was no longer distributed outside Fukushima or even from Ibaraki.  Interestingly, what seemed to be of more concern to him than actual contamination of food and water was the fact some food from the area was perfectly “safe” but needlessly avoided.  “People worry TOO MUCH.”  He stated “it was important for the Ministry of Agriculture to address how to give, endorse or guarantee the ‘safeness’ of the food to protect the local product.”  As for seafood, he said such radioactivity had half-lives, which he was not sufficiently able to clarify, but the radioactivity would eventually go below the regulation limits.

                                                               * * *

Distribution of food was indeed halted during the acute stage, but over time this protocol was relaxed, with rice grown in contaminated areas being sold to wholesalers or mixed in with uncontaminated rice for distribution to food industry, destined for hospital food and school lunches.  So-called fuhyo higai, or baseless rumor, refers to damage to reputation suffered from “baseless” fear, as in everything near Fukushima might be contaminated.  People keep using the term “fuhyo higai” when it is indeed “actual” damage due to actual contamination.  Indeed, strong infatuation with this term within Fukushima Prefecture has originated from the very mouth of the Radiation Health Risk Management Adviser who kept mitigating actual dangers to “relieve the anxiety” of Fukushima people.  

                                                                * * *

Steven Harmen from Voice of America, who spent the week after the earthquake in Fukushima, mentioned places such as Date and Namie consistently reported radiation levels over 100 μSv/hr for over a week and wondered when Yamashita thought the cumulative level would reach what he considered hazardous.  

Yamashita said he was aware that some small towns had radiation levels over 100 μSv/hr due to heterogeneous spread of the radiation fallout due to wind, climate, temperature and geography of areas.  Even though there might be some hot spots, most of the area in Fukushima was safe.  He recommended to evacuate if possible or stop eating locally produced food or drinking water.  Fukushima Prefecture was already doing such recommendations, he was sure, and that was his recommendation.  

                                                               * * *

Did he really answer the question? In addition, he seemed to be presuming a lot, such as logistics of evacuating when gasoline was scarce.  

Also, such recommendations from agencies can only be effective if food policy follows suit.  For example, import rules, tariffs, etc. would need review and amendment to ensure the affected populations can gain access to “safe” consumables.

                                                               * * *

A French correspondent from Science Magazine asked if the French government would have asked the French people living in Japan to leave if there hadn’t been any danger.  The correspondent also asked what Yamashita thought of the smoke coming out of the reactor that morning, as in what might have been going on inside.  Yamashita said the very important point was that “even the people didn’t believe their government announcements sometimes.  So reliability was very important.”  He could not tell him what happened inside.  His job was radiation risk control.  Risk was to consider the dose.  He could say past accumulation was safe but he had no answer about future prediction and he was sorry about not having an answer to the question.

                                                               * * *

It didn’t seem like he actually answered what he thought of the French government’s recommendation.  He even seemed irritated by further questions from the other members of the audience about what might have happened inside the reactors.

                                                               * * *

David McNeill from The Independent asked whether comparison of one year’s worth of ingesting contaminated  spinach and milk to CT scan, as mentioned by Yukio Edano, the top government spokesman at the time, was valid and if the government was being honest about the danger of radiation.  

Yamashita said: “Comparison to medical exposure was an explanation tool which I wasn’t sure if appropriate but it was easy for the Japanese to understand.  Scientifically it was not correct because medical exposure was completely beneficial over the risk.  In such cases of artificial nuclear disaster, it was totally unnecessary exposure.  If they kept eating contaminated food, more than 10 mSv of contamination would occur.  However, as all of them knew, in Japan, the public had strong watches over control of food safety, so he believed there would be no more distribution of radio-contaminated food. So please believe the government.”   

                                                               * * *

Japanese people would be intelligent enough to understand a more “appropriate” explanation tool.  Public attention on the situation has indeed brought to the surface a contamination issue in baby formula that was not previously disclosed, but the burden really should not be placed on the public.

                                                               * * *

“Information should be accurate and accurately transmitted by you, medias.”

                                                               * * *

This is true, but even the media cannot transmit accurate information unless accurate information is made available first.

                                                               * * *

Another correspondent asked if it was necessary to set different safety standards for women, children and infants.

He said that wasn’t necessary because the radiation safety regulation standards were based on children’s data--and that all the standards for adults were also applicable to children.

                                                               * * *

Radiation regulation standards had been established basically for nuclear workers and nuclear emergencies, and they were not based on children’s data.  

                                                   * * *

Leo Lewis from The Times asked a very pointed question, “One of the issues in Japan in crisis is who takes responsibility?  In your role as an adviser, which is a very broad title, are you actually taking responsibility for the health of the people in Fukushima?”  He also asked if someone living 31 km from Fukushima Daiichi had the exact same health risk as his mother living in London.

Yamashita appeared to smirk at the latter question and said he was very sorry not to be able to answer accurately about his mother and Fukushima. Then he went on to say(in verbatim), “But my situation is very clear. I can advise governors to do something and recommend and those  I can share the responsibility together with governors.  It’s very clear.  But most important thing is, seriously, the major respondent is Japanese government.  And also Tokyo, ah, eh, anyway, the nuclear reactor’s companies.  Very important.  They are the first responders, I am sure.  So now what is the problem now?  Local government Fukushima is doing their best, not only this nuclear disasters, the tsunami, earthquakes, but within 30 km, 20 km, they cannot return back.  Even dead bodies they cannot collect.  Because evacuation is ordered from the government.  So the government should take in charge of this kind of the very, very [inaudible ] even contradicted, miserable things occurred. I or our staff are trying to sacrificing by ourselves to support the Fukushima areas.  Yesterday or two days ago, we met to the local resident, more than 500 to 300.  And they discussed a lot.  They complained a lot.  The government people, they never listen to their direct voice.  I would like to ask all of you, to go Fukushima and to listen to their voice.  And what really they have the problems?  And what is there safe enough to support?  But very unfortunately, infrastructure of a life are still far behind the recoveries. This real problems.  So I would like to appeal to all of you, to pay special attention to Fukushima.  Not only to the nuclear disasters, but people who are residing 20 km, 30 km or all the contaminated areas.  This is a very important message from you as an adviser.”

                                                   * * *

His English was becoming more and more incoherent at this stage, perhaps due to fatigue.  Apparently he was saying the burden of responsibility should be placed on the government and TEPCO.  He would “share” the responsibility with Fukushima governor.

As the Radiation Health Risk Management Adviser, all his attention could have been paid to the serious nuclear disaster that was endangering people, instead of making an emotional plea to “care for” people of Fukushima.

                                                               * * *

He appeared to smirk at the question from another person, “Which one is the safe food?”

Asked about different units of radiation measurements, he said people always misunderstood or sometimes ignored the unit, which he also seemed to be doing earlier in his talk.  Sometimes information in newspaper might be completely wrong due to lack of or inappropriate use of the unit.  He appeared to have no idea how to convert microrem to microsievert.  He said it was critically important to standardize units, but each country had their own standardization.

                                                               * * *

Incidentally, 1 microrem would be equal to 0.01 microsievert, easily accessed on the Internet.  http://en.wikipedia.org/wiki/Sievert

                                                               * * *

“I am also very happy this time, even very sad nuclear disasters, not only Japanese people foreign people now learning to the physics, chemist.  Yeah.  I received a lot of interview from the mass media.  But the journalist they don’t know at all about the nuclear physicist, even that, ah, radiation biologies.  So I really ask all of you to think, to learn together with us what really happened inside of Fukushima.”

                                                               * * *

“Happy” hardly seems like a good choice of word under the circumstance.  People were simply desperate to learn what they could for survival.  As a public figure representing a public cause, it might have been better for him to leave his personal opinions and preferences at home.  Such an inappropriate, insensitive use of word would ordinarily enrage the public, leading to resignation of a public official.  In that sense he was perhaps fortunate to be doing this press conference in English.

                                                               * * *

“If you learn physics, you can detect radioactivity even in dust.  Learn physics first.”

One journalist said he would go to Fukushima on his advice and asked him what to wear and how to act to avoid dangers of radiation

“Within 20 km, you don’t have to worry about anything. You can go like this (in regular clothes), without any mask.”  

                                                               * * *

He hopefully simply misused an English word ‘within.”  Surely he meant to say “outside” instead.

                                                               * * *

“If you are worried about such things carry a personal dosimeter.”  “If you worry, please measure.  Radioactivity is easy to measure.”
                                                               * * *

A more effective Radiation Health Risk Management Adviser might have listed “potential” dangers that might be there and presented appropriate measures to take, instead of simply telling them to “measure” it.

                                                               * * *

Tsukuba University researcher asked if he thought that around the evacuation zones people might have to be permanently evacuated due to cesium 137 and strontium 90 in the soil.

“I missed this time to introduce about the effect of cesium 137 into the bodies.  Nobody knows how much level is critically hazardous to the cesium to the bodies.  Only we have.  We already monitors nearly 120,000 childrens from 1991 to until now.  So their body also contaminated by cesium 137, very high level to low levels.  So far, that’s within 25 years far out, no specific disease occurred.  So we don’t need to worry about cesium 137.  This is very clear.”

                                                               * * *

When he said we didn’t have to worry about cesium 137, was he perhaps referring to this statement from Nuclear Energy Agency’s report?
http://www.oecd-nea.org/rp/chernobyl/c05.html
“No association between thyroid abnormalities and 137Cs activity in the body or soil contamination was seen in 115 000 children in the Sasakawa framework health and Medical cooperation project (Ya97).”      

If so, he might be considering only thyroid abnormalities caused by cesium 137.    

Perhaps he is not familiar with autopsy researches on Chernobyl victims by an exiled Belarusian pathologist, Yury Bandazhevsky.  Bandazhevsky found accumulation of cesium 137 in various organs.  
http://www.smw.ch/docs/pdf200x/2003/35/smw-10226.pdf

                                                   * * *

It is unusual to see this degree of lack of humility in a Japanese person.  This interview presented Yamashita as arrogant, opinionated, and dogmatic.  He sounds “concerned” but he is concerned about the wrong issues such as people’s feelings and Fukushima Prefecture’s survival at the height of an unprecedented national, ultimately an international nuclear emergency.

Possibly the only good thing he said during this press conference was this:

“We need openness of government to show different varieties of radionuclides.  Very important point.”

****************************************************************************

Ian Goddard brilliantly presented in this video how Yamashita’s “less-than-100-mSv-is-safe” theory fails:

☢ Low-Dose Radiation ☢ NEW A-Bomb Study   
http://www.youtube.com/watch?v=-VAncqK6bl0&feature=watch_response

“Let’s examine the data they cite to support their argument.  Here are the previously published solid cancer deaths in the atomic-bomb-survivor cohort which Professor Allison used in his talk.  The data table stratifies cancer deaths into dose ranges.  The two strata below 100 mSv are highlighted in green. And here are those data plotted.  The allegedly safe-dose range below 100 mSv is highlighted in green.  Now, the statistical significance is an arbitrarily chosen p value which under various circumstances may vary from 0.1 to 0.01.  For epidemiological research like this, 0.05 is usually chosen.  So in that case this value for the doses from 5 to 100 mSv is not statistically significant as Yamashita and Allison observed.  However, there are good reasons, too numerous to cover here, why this hasn’t swayed the scientific consensus for on radiation risk.  

For example, let’s consider what this p value means.  Two hypotheses are under consideration.  The null hypothesis, or H0, proposes that the risk value, or ERR, is equal to or below zero.  In other words, hypothesis H0 proposes that the doses from 5 to 100 mSv are harmless.  So the p value means that the probability that the hypothesis H0 is true is 10%.  Therefore, the p value also means that the alternative hypothesis, H1, which proposes the risk is greater than is zero has a 90% probability of being true.  In other words, the probability that doses from 5 to 100 mSv are harmful is 90%.  If the chance of rain was 90%, would you take your umbrella?   If you had a 10-round revolver with 9 bullets loaded, would you take aim at an innocent and pull the trigger?  

Just as the rational person takes her umbrella, ethical radiation-policy experts don’t play Russian roulette with public safety.  Two of the atomic-bomb-survivor scientists with the Radiation Effects Research Foundation expressed the consensus feeling that addressing the question of doses below 100 mSv, saying, “in the presence of available data, it is neither sound statistical interpretation nor prudent risk evaluation to take the view that the risk should be considered as zero in some low-dose range due to lack of statistical significance when restricting attention to that range.” (Pierre & Preston, 2000)”

**************************************************************************************

Recent developments:

Shunichi Yamashita, still holding the title of Fukushima Prefecture Radiation Health Risk Management Adviser, is currently the vice president of Fukushima Medical University where he is overseeing the Fukushima Prefectural Resident Health Management Survey.  Their motto is “We will protect your health.  We will watch over your health.”  This is ironic considering Yamashita has established guidelines for Fukushima children’s thyroid ultrasound results so that it would be exceedingly difficult for parents to obtain second opinions or further testing.  It is said that parents are not even shown the ultrasound images, citing privacy protection.
http://fukushimavoice-eng.blogspot.com/2012/05/fukushima-childrens-thyroid-examination.html

Yamashita’s policy is controversial.  When 36% of 38,114 children tested so far have thyroid ultrasound abnormalities, barely one year after the accident, one cannot help but wonder just how much radiation these children were exposed to.  Of these 2.5% had cysts larger than 5 mm, compared to 1% in Chernobyl children.  There are still over 310,000 children awaiting thyroid ultrasound examinations.
http://fukushimavoice-eng.blogspot.com/2012/07/thyroid-examination-by-fukushima.html

An Australian pediatrician, Helen Caldicott, who has been against the use of nuclear weapons and power as a way of practicing preventive medicine, stated that it was not normal at all for children to have thyroid nodules or cysts and that these children should be immediately biopsied rather than followed up in two years.  She also stated that an early appearance of thyroid abnormalities, less than one year, meant the children received a very high dose.

Yamashita, however, is confident that no Fukushima children will have any thyroid problems as quoted in this magazine interview (in Japanese).
http://www.cataloghouse.co.jp/2012spring/yomimono/yamashita/index.html

The latest review article that was co-authored by him, “Low-dose Radiation Exposure and Carcinogenesis” is essentially a documentation of his claims presented during this press conference in his poor English.  
https://docs.google.com/file/d/0B68f83tqq7QuZFBpSjI2dFItUlU/edit

Just as other pro-nuclear research papers, it seems biased and lacks depth, ignoring internal radiation exposure and only considering thyroid cancer as risks.  An interesting fact is seen in the Funding section.  The Ministry of Education, Culture, Sports, Science and Technology of Japan, which supported his research, also is responsible for radiation monitoring, “radiation education” and educational guidelines which are “inadvertently” exposing many children to radiation at school.  This appears to be a conflict of interest.  The Ministry also produced a radiation booklet as described in this article:
http://fukushimavoice-eng.blogspot.com/2012/05/japanese-governments-brainwashing.html

***********************************************************************************************
Postscript

On June 11, 2012, “Fukushima Nuclear Plant Legal Action Group,” consisting of over 1,300 Fukushima residents, filed charges with Fukushima District Public Prosecutor’s Office for professional negligence resulting in deaths and/or injuries, against a total of thirty-three individuals including TEPCO management, government officials, and radiation specialists.  Shunichi Yamashita was one of them.