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ObjectiveAssess the level of radiation-related knowledge (RRK) and nuclear energy-related knowledge (NERK) among residents near the Sanmen Nuclear Power Plant, the first project adopted the Advanced Passive Pressurized Water Reactor (AP1000) technology.MethodsIn this study, respondents were selected using stratified multi-stage random sampling for residents aged 18 years and above living within 30 kilometers of the Sanmen Nuclear Power Station. Respondents were surveyed face-to-face by investigators who received standardized training. The results of the survey were collated and analysed to assess the RRK and NERK levels of the respondents from both subjective and objective perspectives, and the anxiety levels were assessed using the Likert Scale. Factors affecting RRK, NERK and anxiety levels of residents were analysed using multiple linear regression analysis.ResultsThe study interviewed 751 individuals. Participants correctly answered an average of 2.76 out of 7 objective radiation knowledge questions, yielding a 39.4% RRK cognition rate. For nuclear energy knowledge, the average was 2.14 out of 7, resulting in a 30.5% NERK cognition rate. Spearman’s correlation and multiple linear regression analyses revealed that higher education and younger age were positively correlated with RRK and NERK. Gender significantly influenced NERK, with males scoring higher than females. Anxiety levels were inversely related to age and directly related to education. Regression analyses also indicated that occupation affected nuclear-related anxiety, and married and unmarried individuals exhibited higher anxiety levels than widowed individuals.ConclusionResidents near the Sanmen Nuclear Power Station showed improvements in RRK and NERK, but levels remained low. Both RRK and NERK correlated with age and education, while NERK was also linked to gender. Anxiety among residents was associated with age, education, occupation, and marital status. These findings highlight the need for improved public education on RRK and NERK, effective engagement strategies, and measures to address residents’ anxiety to enhance decision-making and social trust regarding nuclear safety.

IntroductionSanmen nuclear power plant (SNPP) operates the first advanced passive (AP1000) nuclear power unit in China.MethodsTo assess the radiological impacts of SNPP operation on the surrounding environment and the public health, annual effective dose (AED) and excess risk (ER) were estimated based on continuous radioactivity monitoring in drinking water and ambient dose before and after its operation during 2014–2021. In addition, the residents' cancer incidence was further analyzed through authorized health data collection.ResultsThe results showed that the gross α and gross β radioactivity in all types of drinking water were ranged from 0.008 to 0.017 Bq/L and 0.032 to 0.112 Bq/L, respectively. The cumulative ambient dose in Sanmen county ranged from 0.254 to 0.460 mSv/y, with an average of 0.354 ± 0.075 mSv/y. There is no statistical difference in drinking water radioactivity and ambient dose before and after the operation of SNPP according to Mann–Whitney U test. The Mann-Kendall test also indicates there is neither increasing nor decreasing trend during the period from 2014 to 2021. The age-dependent annual effective doses due to the ingestion of drinking water or exposure to the outdoor ambient environment are lower than the recommended threshold of 0.1 mSv/y. The incidence of cancer (include leukemia and thyroid cancer) in the population around SNPP is slightly higher than that in other areas, while it is still in a stable state characterized by annual percentage changes.DiscussionThe current comprehensive results show that the operation of SNPP has so far no evident radiological impact on the surrounding environment and public health, but continued monitoring is still needed in the future.