Review of health issues of workers engaged in operations related to the accident at the Fukushima Daiichi Nuclear Power Plant.

A nuclear accident occurred in northern Japan at the Fukushima Daiichi Nuclear Power Plant of the Tokyo Electric Power Company (TEPCO) following a mega-earthquake and subsequent tsunami in March 2011. A large number of workers were engaged in the related works, which has shifted from emergency response to cooling of the fuel bars, stabilization of nuclear reactors by establishing cooling systems, and decommissioning of the nuclear reactors. In addition, a lot of workers were also engaged in rehabilitation of contaminated areas. Various health issues occurred among the workers. An emergency-care system for workers, including transportation to hospitals, has been one of the highest concerns, and an occupational health system did not function well. It took a few months to establish the systems. The workers were exposed to multiple health hazards, such as radiation, heat stress and psychological stress, and there were trade-offs among the hazards. Outbreak of infectious diseases and fitness for duties of temporary workers were also significant concerns from expert viewpoints. Experts in occupational health, emergency medicine, and other specialties did their best to manage the situations in cooperate with the Japanese government and TEPCO. There are several lessons learned from the experiences. Emergency response plans at national, local, and company levels should be reviewed and be improved for disasters in the future.