Establishment of Nuclear Disaster Health Assistance Team (NuHAT) for nurse-led radiation risk management after the Fukushima nuclear accident

Abstract

After the accident at the Fukushima Daiichi Nuclear Power Plant in 2011, a gap emerged between residents, government officials, and experts in terms of understanding and accepting radiation risks, and this gap remains unresolved. Therefore, the Radiological Nursing Society of Japan hopes that nurses, who possess the most information on residents’ daily lives and health conditions and are physically and psychologically close to residents, can play a role in helping residents understand and accept radiation risks via the Nuclear Disaster Health Assistance Team (NuHAT) that it has established. The NuHAT aims to provide radiation risk management for the population during normal times and in the early, intermediate, and long term following a radiation or nuclear accident. The members of the NuHAT are those who have completed a Certified Nurse Specialist in Radiological Nursing (CNS) course and a graduate course in public health nursing. Going forward, we will continue our activities to raise awareness of the NuHAT among local residents, government officials, and nuclear power operators and to improve the quality of the NuHAT.

1. BACKGROUND

Since the Fukushima Daiichi Nuclear Power Plant accident in 2011, government officials and experts in radiological protection have frequently explained the health effects and risks to the residents, based on scientific data. However, the gap between residents and experts regarding the acceptance of the health effects and risks has not been bridged. The Radiological Nursing Society of Japan (RNSJ) believes that registered nurses and public health nurses are closest to residents through routine communication and community diagnosis. Therefore, the RNSJ established a Nuclear Disaster Health Assistance Team (NuHAT) composed of advanced nursing professionals to manage radiation risks for residents in the event of a nuclear disaster.

2. RESEARCH STUDIES FOR THE ESTABLISHMENT OF NuHAT

To obtain the information necessary for the organisation and operation of the NuHAT, we conducted interviews with three groups: the disaster medical support organisation, the radiation exposure medical support network, and administrative staff in the prefecture where the nuclear power plant was located. In addition, a questionnaire survey was administered to prospect the NuHAT participants to determine whether they would participate in the team.

Based on the results of interviews with the two medical groups, three important points for the NuHAT management were suggested. The first was to keep members motivated to deal with nuclear disasters, the second was to ensure the members’ ability to respond appropriately to nuclear disasters, and the last was to ensure administrative functions. Interviews with the administrative staff revealed that they had never considered the contribution of the nursing profession to nuclear disasters. However, they expected registered public health nurses and other nurses to play active roles in nuclear disasters, such as eliminating residents’ anxiety about radiation. The results of the interviews with the three groups revealed that the NuHAT’s activities during the nuclear disaster were expected and that it was important for the nursing profession to improve its knowledge to meet the community’s expectations.

According to a survey of 35 prospective NuHAT participants, almost all of them wanted to be members of the NuHAT and were willing to assist the community in understanding and accepting radiation risks during nuclear disasters (Fig. 1).

Fig 1.

Survey of prospective members’ intention to participate or not in NuHAT.

3. OUTLINE OF NuHAT

A summary of the NuHAT constructed by the RNSJ is shown in Table 1. The objectives of the NuHAT are to provide radiation risk management for the population during normal times (planned exposure situations) and in the early, intermediate, and long terms following a radiation or nuclear accident (emergency and existing exposure situations). We consider risk management for residents in this context to be a series of activities that lead to their understanding and acceptance of radiation risks.

Table 1.

Outline of the NuHAT.

Role	To provide radiation risk management for the population
Members	Certified Nurse Specialists in Radiological Nursing (CNS) Registered public health nurses who have completed a master’s course at a graduate school
Time of activity	Normal times and early mid-term and long-term post radiation or nuclear accident
Activities	Normal times: The NuHAT members provide educational training sessions for local residents, nurses at hospitals and health facilities, and nursing students to deepen their understanding of radiation exposure and radiation risks. At the time of disaster: The members will meet directly with residents to discuss and respond to their concerns at the disaster site. The members will work in pairs at the disaster site

The NuHAT’s constituent members were Certified Nurse Specialists in Radiological Nursing (CNS) and registered public health nurses who had completed a master’s course at a graduate school. The specific activities of the NuHAT are as follows. In normal situations (planned exposure situations), they will conduct education for local residents. Additionally, the NuHAT members will take leadership in conducting educational training for nurses at hospitals and health centres and nursing students to deepen their understanding of radiation exposure and radiation risks while working at their regular workplaces including medical facilities and health centres. In the event of a nuclear disaster, members will travel from their workplaces to the affected area(s) to communicate directly with residents and address their concerns. We believe that approximately 30 members could fulfil this role.

4. TRAINING PROGRAMME FOR NuHAT MEMBERS

A training programme for the NuHAT members was developed and will be conducted regularly in the future. The training programme consists of lectures, group work, and practical exercises. The specifics of the training sessions conducted to date are listed in Table 2. Training sessions included a lecture on ‘Anxieties of residents after the Fukushima nuclear accident’, given by an expert with experience on dealing with Fukushima residents following the disaster; a lecture on ‘Actual nuclear disaster countermeasures and expectations of the nursing profession’, presented by a local government official responsible for disaster response planning; group work on how to respond to examples of specific cases and enquiries that could be raised by residents; and practical exercises such as body surface contamination monitoring and thyroid monitoring. Many participants expressed the desire for more frequent training sessions. In the future, the NuHAT members plan to participate in comprehensive nuclear disaster management drills, conducted jointly with the central government, local government, and nuclear operators in areas where nuclear power plants are located.

Table 2.

Training programme for the NuHAT members.

Day 1 PM
Lecture 1	Anxieties of residents after the Fukushima nuclear accident
Lecture 2	Basic knowledge of individual dose monitoring
Practice 1	Measuring natural radiation
Practice 2	How to protect from radiation (with a mobile x-ray device)
Practice 3	Body surface contamination monitoring
Day 2 AM
Lecture 3	Radiation risk management
Practice 4	Thyroid monitoring
Group work	How to respond to examples of specific cases and queries that are raised by residents

5. CONCLUSION

The Radiological Nursing Society of Japan established the NuHAT, which consists of nurses with advanced education in risk management for residents in the event of a nuclear disaster. We will continue the activities to raise awareness of NuHAT among local residents, government officials, and nuclear power operators, and to improve the quality of NuHAT’s services.