The PANW’s protest letter to the statements of Japan Nuclear Regulation
Authority, Japan Atomic Energy Commission and Nuclear Emergency
Response Headquarters
February 28 t h , 2014
Physic ians against N uc lear Weapons(PANW)

2 -5-5 Yoyogi, Sh ibuya-ku

Tokyo

151 -0053 Japan

Tel 81-3-3375 -5121, Fax 81 -3-3375 -1885
Med ical do ctors and s cho lars who gathered in Tokyo, launche d th e
medical p rofe ss ions ’ gr oup, Phys ic ian s against Nu clear Weapon s(PANW) in A ugust 1987 . Since then, PA NW members have pa rti ci pate din activit ies against nuc lear war and nuclea r weapons, together withother NGOs. Afte r the acc i dent at th e Fukush ima Daiic hi nu c lear
power p lant in Mar ch 2011 , recogni zi ng that nuclear weapo ns an dnuclear power p lants s hare a common histo ry and are based on thesame techno logy , we d ec ide d to ex pand our a ctiv itie s to in clu de th e
problem s of nu clear power p lants. A s a medi cal p rofe ss ions ’ grou p, wehave collecte d a large quantity o f data on the hea lth r is ks of rad iatio n
exposur e and have summarize d th is dat a on our web site. Duri ng thelast four month s, the government of Japan and some governmental
authorit ies have release d statements o n the Fukushima acci dent andaccele rated the retu rn of evacuees to the contaminated areas. The
under stand ing of the health ri sks of low level rad iation expo sur ementione d in these statements i s far re moved from the under stand ing
which ha s been obtaine d through s ome mega medical ep i demio logi ca lstud ies on radiat ion exposu re. We prote st the recent statements fro mJapan
Nuclear Regu lation
Autho r i ty,
Japan
Atomic Energy
Commis sion and Nu clear Emergency Respon se Headquarte rs, andprote st moves by the government to a cce lerate the retu rn ofevacu ees t o
the contaminated areas witho ut suf fi cie nt parti ci pation of c ommunit ymembers as stakeho lde rs.

1 Problems of risk esti mation for l ow level radiation exposure inth e Fukushima a ccident

App roximately
150,000people
evacuate dtonon-rad iatio n-c ontaminated area s after the acc ident at the Fuku sh ima
Daiich i n uc lear power p lant. On 20 t h N ovember, 2013 Japan Nuc lear
Regulation Autho rity p rovided a statement of pri nc ipal s for the retu r nof evacuee s to th eir contaminated home towns (Statement A) 1). Base don this statement, the Government of Japan deci ded to acce l e rate thereturn of evacuee s. Japan Atomic Energy Commiss ion and Nuc lea r
Emergency Resp onse Headquarter s prov ide d another statement on 20 t hDecember, 2013 (Statement B) 2). In add i tion to these co re statements,
the Government an d some gove rnment al author itie s have pub li she dmany documents an d memorand ums on the Fukush ima acc ident. The yhave desc r ibed the health r is k of low l evel ra diatio n expo sur e belo w
100 mSv as an uncerta in h ealth ri sk. Bu t they have co ndu cted very few
dis cu ssions on t he sto chast ic hea lth e ffect s of long te rm low leve lradiation expos ure in these doc uments.
Some re cent mega e pidemio logi cal stud i es have de sc ribe d the healt heffe cts of low level radiat ion exposu re more cl early 3),4). The in crease o fcancer r is k after CT scans is con fi rmed f or medi cal rad iation exposu r eof les s than 100 mSv. Some epidemio logi cal stu die s of atomic bombin gsurvivo rs or indu str ial work ers s how c ausal lin ks between long -te rm
exposur e to low doses of rad iation an d the incr eased in c iden ce ofcancer 5),6). The Wo rld Health O rgani zation(W HO) repo rt on t heFukush ima acc ident est imated that radiatio n ef fect ive doses fo r th e
first year ranged from 12 to 25 mSv in t he two most af fecte d locatio n sof Fukush ima Prefe cture. The re port estimated a 4~7% addit iona llifetime r is k for leukem ia and some s oli d cance rs i n these areas 7).
Furthermo re, the repo rt d id not negl ect the p oss ibi lity o f exce s slifetime can cer risk among resi dents wh o had receive d rad iation do se s
in the range of 3~5 mSv. Radiation doses o f 3~5 m Sv/year w ere
estimated in Fukush ima and some ot her pref ectu res after t he ac ci dent .
JapanNuclear Regu lation
Autho r i ty,
Japan
Atomic Energy
Commis sion and Nuc lear Emergen cy Res ponse Headquarte rs, however,
did not ment ion all the c onc lus ion s and suggestion s of th ese nume rou s
medical re port s in Statement s A & B.

2 Problems with the return to conta minated areas withou tnece ssa ry protective measures
For radiatio n exposu re after the Fukush ima accide nt, the governmentof Japan re lied on recommen datio ns f rom the Internat iona lCommis sion s on Radio log ical P rotect i on (ICRP). Based on som e
general recommen dation s p rovi ded in 20 07 and 2009, ICRP indi cated arefe rence level rad iation do se of above 20 mSv/year for evacuationand a refe ren ce level dose of 1 mSv/year to 20 mSv/year for peop l e
liv ing in contaminate d areas , with the long-term goal of redu c ing
refe rence levels to 1 mSv/year 8)-10). ICRP conf irme d that it i s the ro le o fauthorit ies t o im pleme nt all ne cessa ry prote ctive meas ures fo r p eop le
who elect to live there rathe r than abandoning the contami nated areas,
when the radiat ion sou rc e is unde r cont rol 8), 10).
To decide the re feren ce leve l of radiati o n exposur e to the publ ic afte r
the Fukush ima ac cident, the author it ie s have est imated the leve l o fradiation expo sur e, based on measurement of e nviro nmenta lradioact ivity. But Statement s A & B r ec ommended measu ri ng the rea llevel of externa l radiat ion expos ure fo r each perso n. For the purpo se o fjustif icat ion and o ptim izatio n fo r each indu str ial o r med ica l worker,
measuring pe rsona l external ra d iatio n exposure i s neces sary toprevent ex ces sive o cc upatio nal radiat io n exposu res. For the genera lpublic, however, centra l and local governments and con cern e dauthorit ies sho uld first im plement al l neces sary prote ctive measur e s

to redu ce the radiat ion expo sure o f the publ ic. Witho ut str ong
measures and su ppo rt, a system based on personal measu rement o fone’s own radiation expo sure coul d easi ly
resu lt in res pons ibi lit ybeing sh ifte d to the in divi dual fo r h is o r he r pe rsona l rad iatio nprote ction. Furthe rmore, the me ntal cond itio n o f pe op le facing ahigher leve l of rad iation ex posu re may become worse i f they have totake per sonal res pon sibility fo r the ir e xposure . Es pec ial ly fo r youn gpeop le, their phys ica l activit y may be reduce d if they have topers onal ly measure and prot ect t hems elves from external rad iatio nexposur e.

3 Necessi ty of free total health managemen t system in theconta minated area s- Urgen t necessa ry actions before
accelera ting the return to conta minated a reas -The importan ce of a med ica l con s ultation system after th e
Fukush ima accident was ment ioned in S tatement A. The main ro le o f
medical consu ltation was de sc ribed as ex pla in ing that th ere was no o rvery limite d healt h r is k f rom low level radiati on expo sur e after th e
Fukush ima accident. The role and syst em of medical con sultat ion s
were des cr ibed more c lear ly in Statem ent B, as the provis ion of apublic nur se to explain that there was very limite d health r isk f rom
the Fukush ima acc ident fo r the p ur pose of d imin is hing the rad iatio nphobia among members of the community. The Fukushima Healt hSurvey to detect t hyroid can cer in th e young generation wi l l bepromote d throughout this plann ing s ystem, but other laboratory
examinations and t reatments wi ll n ot be inc lude d i n thi s p lanning.
Before the Fu kush ima acc id ent , we had a ser ious rad iation acc iden t
at the JCO nu clear fue l pr oces si ng fac i lity in Ibaraki Pre fect ure i n
1999. Two nuclear p lant worke rs die d and app roximately 700 peop l e
had exces sive radiat ion expo sure s as a resu lt of th is a cc ident. F ree
medical examinatio ns s upp orte d f inan cial ly by Ibaraki Prefe ctu rehave been con ducte d on the res ide nts o f all af fecte d area s with leve l sof rad iatio n expo sure above 1 mSv/year 11),12). Free me di ca l
examinations inc lu ded chec ki ng non- co mmunicable di seases suc h as
cancer s and vascu lar d isease s. Japan Nuc lear Regu lation Aut hor ity
mentione d the post-JCO health che ck system as an example forconst ruct ing a health che ck system afte r the Fukush ima acc i dent in adocument pub lished in Mar ch 2013 12). However, thethe JCO accident was
not mentioned in Statements A & B. In regard to the Fukus him aaccident, the spe cia l rappo rteu r of the U nited Nat ions Human Right s
Counc il recomme nde d total health ma nagement , inc lud ing med ica lconsu ltation and tr eatment for the re si d ents of all areas with level s ofradiation expos ure h igher than 1 mSv/year 13).
The system of f ree med ica l examinati ons has been su stained i nIbaraki Prefect ure s in ce the JCO radi ation acc ident, and for th i shealth management system f ree and ea sy acces s i s es sent ial fo r th epeop le living in the contaminate d areas. However, the Vict im s
Protection Law for the Fuku shima acc ident di d not dete rmi ne th elevel of ra diation exposu re requ ire d for health management suppo rt

to be provide d. Furthe rmore, exce pt for ultrason ic examinat ions fo r
thyroi d diseases in the young generati on, medica l examinations t odetect othe r non- commun icable d iseas es were exclu ded from th e
supp ort sy stem of the Fuku shima Pre fec ture Health survey.
The Nuc lear Emergen cy Res pons e Hea dquarters p lans to a llo cate
900,000 yen for early r eturn to the conta minated areas. When member sof the commun ity elect to live in the se contaminate d areas un de r
cond itio ns o f low level radiat ion expo sure rather than abandonin gtheir home town, they cannot have a good quality of l ife with out stron g
supp ort fo r perso nal prote cti on from r adiation expos ure and a free
total health management system.
We, PANW members strongly p rotest the moves to accelerate thereturn o f evacuees to the contamina ted areas without suf fi c ientsupp ort ing system s an d pr ovid e re commendation s as fo llows:
1 The Government of Japan and conce rn e d author itie s must summar iz e
the res ults of rece nt mega epi dem iolo gical stud ies on the h ealt heffe cts of low leve l ra diatio n expos ure and prov ide them to peop l eaffecte d by the Fukush ima a cci dent.
・ Some stud ies r epo rted the hea lth r is ks fr om low leve l rad iatio nexposur e, which is p red ict ed in the co ntaminated areas wher eevacuees will retur n in the nea r futu re.
・Without unde rstand ing rec ent medi cal data on long-term exposu re
to low level rad iation, member s o f the commun ity cannot
participate as stakehol der s in the d is c uss ion about whethe r o r
not to elect to live in the ir contaminate d home town .
2 For the contro l o f o ccu pationa l ra dia tion exp osu re, measu ring t helevel of externa l radiat ion is impo rtant and usefu l at a personal leve l.
But pe rsona l measu rement o f ra diati on e xposure i s not acce ptable a s
a means of contro l ling ra diati on expos ur e at a public level.
・ The government and con ce rn ed author it ies shou ld im plement al lneces sary prote ctive measure s for me mbers of the community
with the long -te rm goal of redu c ing refe ren ce levels to 1
mSv/year.
・ Measur ing rad iation ex posu re at a pers onal leve l shou ld be use dfor ju stification and o ptim ization fo r ea ch p erso n, based o n eac hpers on unde rstan ding the s cie nti fi c dat a on low level rad iatio nexposur e.
3 Easy and fr ee acc ess t o total hea lth management is nec essary fo r
members of the commun ity if they ar e to cont inue liv ing in th econtaminated areas.
・ As the spe cia l rap porteu r of the Un it ed Nation s Human Right s
Counc il recommen de d, total health management , inclu din g
medical consu ltatio n and t reatment , s ho uld be available for t heres ident s of all affe cte d areas with leve ls of rad iation expo su rehigher than 1 mSv/year.
・ As with the sup port system p rovi ded by Ibaraki Prefectu re afte r
the JCO acc ident in 1999, health management shou ld cover a l lradiation- relate d d isease s, and 1 mSv/year shou ld b eestablish ed as the do se leve l for s up port un der the Vict im s
Protection Law for the Fuku shima acc id ent.

Ref erences

The basic statement on return to contaminated home towns -Estimationof radiation exposure levels for people living in contaminated areas in thelong-term-. Japan Nuclear Regulation Authority ( Genshiryoku KiseiIinkai ) ( in Japanese )November 20, 2013.
www.nsr.go.jp/nra/kettei/data/20131120kikan.pdf
2) The basic statement to accelerate return to contaminated home towns.
Japan Atomic Energy Commission and Nuclear Emergency Response
Headquarter ( Genshiryuku Iinkai, Genshiryoku Saigai Taisaku Honbu )( in Japanese )December 20, 2013.
www.aec.go.jp/jicst/NC/iinkai/teirei/siryo2014/siryo02/siryo1-2.pdf
3) A Radiation exposure from CT scans in childhood and subsequent risk ofleukaemia and brain tumours: a retrospective cohort study.
Pearce MS et al, Lancet. 2012, 380(9840):499-505.
4) Cancer risk in 680,000 people exposed to computed tomography scans inchildhood or adolescence: data linkage study of 11 million Australians.
Mathews JD et al, British Medical Journal. 2013, 346: f2360.
5) Studies of the mortality of atomic bomb survivors, Report 14, 1950-2003: anoverview of cancer and non-cancer diseases.
Ozasa K et al, Radiat Res. 177:229-43, 2012.
6) Risk of cancer after low doses of ionising radiation: retrospective cohort study
in 15 countries. Cardis E et al, British Medical Journal ;331(7508):77. 2005.
7) Health risk assessment from the nuclear accident after the 2011 Great East
Japan earthquake and tsunami, based on a preliminary dose estimation,
WHO, 2013.
http://www.who.int/ionizing_radiation/pub_meet/fukushima_risk_assessment_2013/en/index.html
8)
Fukushima Nuclear Power Plant Accident, ICRPref:4847-5603-4313 ICRP,
2011. http://www.u-tokyo-rad.jp/data/fukueng.pdf
9) Application of the Commission's Recommendations for the Protection ofPeople in Emergency Exposure Situations. ICRP Publication 109, Ann
ICRP 39 (1). ICRP, 2009.
10) Application of the Commission's Recommendations to the Protection ofPeople Living in Long-term Contaminated Areas after a Nuclear Accident ora Radiation Emergency. ICRP Publication 111, Ann ICRP 39 (3). ICRP,
2009.
11) JCO accident in Tokai village, Ibaraki Prefecture. –Health management ofresidents- Mitsuhiko Yaginuma (in Japanese)- Law and investigation
338:131-144, 2013.
1)

http://www.sangiin.go.jp/japanese/annai/chousa/rippou_chousa/backnumber/2013pdf/20130308131.pdf
12) A proposal for health management after the Fukushima accident. Japan
Nuclear Regulation Authority ( Genshiryoku Kisei Iinkai )( in Japanese )March 6, 2013. http://www.nsr.go.jp/committee/kisei/h24fy/data/0032_06.pdf
13) Report of the Special Rapporteur on the Right of Everyone to the Enjoymentof the Highest Attainable Standard of Physical and Mental Health, Mission
to Japan ( 15-26 November 2012 ), Anand Grover Human Rights Council,
23rd session, 41/Add.3
United Nations, General Assembly. 2013.
http://daccess-dds-ny.un.org/doc/UNDOC/GEN/G13/160/74/PDF/G1316074.pdf