Fukushima. Chernobyl. Three Mile Island. Each is immediately recognizable for the radiological accident that wreaked havoc on plant workers and nearby residents. And while it’s true that nuclear disasters can and do cause devastation, the surprising reality is that the psychosocial impacts can vastly outweigh the physiological effects.
“The sociological impacts can kill people,” says Ed Maher, Program Director of the Harvard T.H. Chan School of Public Health’s program, Radiological Emergency Management. He points to Fukushima Dai-ichi as a poignant example of this; the Japanese government advised residents up to 50 miles away from the plant to evacuate as a cautionary measure even though available data suggested a shelter-in-place strategy might have been more effective and safe in many cases.
“The doses from the plant eruption were small, but suicides, domestic abuse, depression and alcoholism all went up immediately after the event. In analysis of the death rates, as many as 1,600 people may have died as a direct or indirect result of the evacuation,” he says.
To understand the true danger of radiological accidents, researchers have analyzed the impacts from historical disasters. Their work has led to unexpected and nuanced conclusions about what happens during these disasters and how to minimize their effects.
The Physiological Impacts
The majority of research about nuclear plant accidents comes from Chernobyl, because it was the most severe of the four major nuclear accidents to date and thus affected the greatest number of people. In that incident, 134 plant and emergency response plan workers received high whole-body radiation doses; 28 died within four months. Thyroid cancer among children who drank contaminated milk drastically increased, and cleanup workers experienced higher incidence of leukemia and cataracts. Even with these outcomes, the results came in vastly underneath risk assessments.
“Risk estimates for radiation appear overestimated at low doses. The current standards are based on a linear no-threshold (LNT) association, which may very well be overly protective.” says Maher. This association posits a direct correlation between exposure and illness even at the smallest doses, which has not been borne out in existing data. This model drives regulators to recommend protective actions that can result in more social and physiological detriment than not taking any action.
According to the Chernobyl’s Legacy report, the mental health impact was the largest public health problem created by the incident.
At Fukushima, the Japanese government has taken proactive steps to protect its exposed citizens, including control of milk consumption among children, and thus the radiation dose estimates are substantially lower than Chernobyl. Various health programs are in progress to ensure the residents’ and workers’ well-being. Currently, of the 250,000 children examined, only 75 have suspected thyroid cancer and 32 have confirmed thyroid cancer.
The Sociological Impacts (and Misconceptions)
After an accident like this, psychological symptoms often include anxiety, depression, PTSD and medically unexplained physical symptoms. Evacuation can lead to loss of community, work, activity and continuing uncertainty about the future including a fatalistic outlook (i.e., that everything is hopeless and a person has no control over his or her life). Those who are connected to the disaster are often stigmatized or shunned throughout their entire lives as being “tainted,” well beyond the accident. These effects can be widespread and long-lasting. According to the Chernobyl’s Legacy report, the mental health impact was the largest public health problem created by the incident.
More than a dozen small communities surrounding Chernobyl became ghost towns overnight and its inhabitants were relocated, losing their sense of community pride and identity as well as many of their possessions. These communities will never exist again, and the stigmas and personal losses haunt the relocated residents for the rest of their lives. Many suffer mental illnesses and a sense of lifelong dread and unwittingly pass that dread on to their children in subtle ways.
Emergency and training plans for this type of crisis must include a strong psychosocial element: who might be affected, how to help them, and how to reduce the long-term societal impact.
The media can extend these myths, through both reporting and fiction. There are more than 300 movies that portray some kind of radiological experiment or exposure that results in a defect, mutation in the exposed person(s) or superpower, which Maher says is not only misleading but also dangerous and flat out wrong. In the age of superhero movies, many have an origin story that at least touches on a radiological accident (from Godzilla to Spiderman to the Teenage Mutant Ninja Turtles and many others).
Communicating the Truth
Helping the public understand that the risks of radiation exposure, especially during a disaster, can be tricky. One of the most important lessons is the need for authorities to be more proactive in addressing people’s concerns and presenting them with accurate, up-to-date information. In the case of Fukushima, because information wasn’t given to evacuees about the radioactive plume’s dispersion, some actually evacuated from less to more contaminated areas.
Another key insight is that an emergency preparedness plan for this type of crisis must include a strong psychosocial element: who might be affected, how to help them, and how to reduce the long-term societal impact. Emergency planners and scientists are quick to point out that they are skilled at managing and containing the damaging effects of radiological accidents, but too many lack the risk communication skills that the public needs to put the emergency in perspective and avoid sociological and physiological injuries.
The greatest promise for change may lie in the regulatory community—particularly in revising their current linear no-threshold dose response curve between radiological exposure and cancer and hereditary effects. The extreme caution over very small doses may not be warranted and can do more harm than good.
By way of example, the United States Environmental Protection Agency (USEPA) has set the Protective Action Guide (PAG) threshold dose for recommending evacuation and permanent relocation following a radiological release at less than the dose that many patients receive following just one whole body CAT scan. It’s critical to help the public understand that, though direct exposure to high doses of radiation can cause disease, small doses of radiation are normal and may very well be harmless or represent an acceptable risk.
Maher also believes that “excessive regulation of extremely low radiation doses increases the public fears of nuclear technology, increases the costs borne by society and can deprive society of the full benefit of that technology.”
For example, the National Council on Radiation Protection and Measurements (NCRP) has studied and reported the background radiation doses to the average member of the U.S. population, not including occupational doses. The report, published in 2006, listed the typical doses from cosmic, environmental, indoor radon, medical procedures and food ingestion.
“Radioactive potassium 40 is in your body in minute amounts, through eating plants and animal tissue. On average, humans get twice as much radiation dose a year from natural background radiation than the average occupational dose that workers at nuclear plants,” says Maher. “Radiation is a part of our lives and a force of nature.”
Harvard T.H. Chan School of Public Health offers Radiological Emergency Management, which focuses on effectively planning for and responding to radiological emergencies. To learn more about this opportunity, click here.