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Background: Since the Fukushima Daiichi nuclear power plant (FDNPP) accident in 2011, measures have been taken to address occupational health risks, such as heat illness and infectious diseases, and ensure fitness for duty with the Tokyo Electric Power Company and its contractors. However, with the decommissioning operations set to span several decades and an aging workforce, there arose a need for proactive occupational health strategies that not only addressed these risks but also promoted employee health and created a comfortable work environment. With the Japanese government's promotion of health and productivity management (HPM) for corporations, an HPM-based initiative was launched at the FDNPP in 2019., Case: We designed an HPM questionnaire tailored to the unique conditions at the FDNPP for contractors in 2019. Subsequently, we adjusted the questionnaire annually in light of evolving societal contexts and insights derived from contractors' feedback. This initiative also involved the annual recognition of outstanding contractors. These efforts have led to a steady increase in the number of contractors participating in the HPM survey, with respondents' scores continually improving. We also emphasized dissemination of HPM practices from contractors to their subcontractors due to the complex subcontracting structure at FDNPP, and our results showed that more contractors have been extending these efforts to their subcontractors., Conclusions: Our findings suggest that individual contractors are steadily enhancing their HPM efforts. We are committed to continually offering support to advance HPM throughout the FDNPP., (© The Author(s) [2024]. Published by Oxford University Press on behalf of Journal of Occupational Health.)

We evaluated the correlation between radiation dose and the medical examination data of Tokyo Electric Power Company Holdings, Inc (TEPCO) employees working during the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011. This study included 2164 male TEPCO workers who received periodic medical examinations from March 2006 to January 2013. First, we conducted log-linear regression analyses using the haematological data of 585 emergency workers and confounding factors to examine the effect of internal radiation exposure in March 2011. Since external radiation exposure was a major influence, we then evaluated the correlation between both internal and external radiation dose and the haematological data of 1801 emergency workers and confounding factors before and after the accident. Among 585 workers, internal radiation exposure in March 2011 alone was mainly due to thyroid doses (0.1-10 Gy) but not to bone marrow (BM) doses (0.01-1 mGy). Compared to before and after the accident, we found that the levels of monocytes, eosinophils (Eos) and basophils increased slightly, whereas the frequency of smoking and alcohol consumption decreased substantially. External dose exposure was positively correlated with haemoglobin (Hb), red blood cell and Eos but negatively correlated with age, haematocrit and frequency of alcohol consumption. Among these variables, Hb exhibited the strongest correlation with external dose. Regarding the correlation with Hb, although there is a possibility that confounding factors other than exposure were not evaluated, our findings on emergency workers can serve as a reference for the evaluation of health conditions during the emergency period of future nuclear-related accidents., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.)

Objectives: To follow up arising occupational health (OH) issues, measures taken, and their performances in the Fukushima Daiichi Nuclear Power Plant since 2014, and thus share experiences and extend the contribution of OH to long-term decommissioning work and preparation for future disasters., Methods: Necessary information from official reports and through the OH-related activities involved was collected and analyzed., Results: The issues were categorized into establishment of the OH management system, three individual issues, and others. During the 6 years until end 2019, the OH management system has been strengthened and OH measures have been enriched gradually by visualizing the broader picture, even though some resistance and problems have been encountered., Conclusions: Improvement in the autonomy of contractors and their ability to respond to environmental changes is necessary.

The results of a survey of radiation workers suggest that they are worried about the effects of radiation exposure on health, and approximately 30% of Fukushima Daiichi Nuclear Power Plant (FDNPP) workers have anxiety. This questionnaire survey reveals that the higher the frequency of radiation education, the higher the knowledge of radiation the workers will have, and that the higher the level of knowledge, the lower the anxiety. To reduce anxiety, it is important to increase knowledge about radiation through radiation education. However, even those workers who had radiation education several times still had anxiety. According to the Ordinance on the Prevention of Ionizing Radiation Hazards, the time spent on education about the effects of radiation on the human body is only about 30 minutes. This education is not enough to reduce anxiety. FDNPP workers needed more effective education to increase their knowledge and to reduce their anxiety.

Objectives: At the Fukushima Daiichi Nuclear Power Plant, run by the Tokyo Electric Power Company, new procedures were introduced as part of the fitness for duty program in July 2016. These were designed to ensure that treatment and further investigations identified as necessary during health examinations were carried out. This study aimed to assess the effectiveness of the initiative by testing whether workers who needed further health examinations obtained them promptly, and whether the number with unmet health needs decreased and the number of workers being treated increased., Methods: The primary contractors reported aggregated quarterly results of health examinations of both their own and their subcontractors' employees, and follow-up visits to medical institutions were also reported over the next two quarters. The study used data for the period from July 2016 to December 2018. Incident rate ratios were estimated using a multilevel Poisson regression model, including the logarithm of the number of workers who took health examination for each primary contractor company as offset. The linear trend was assessed by treating the number of periods as a continuous variable., Results: The incident rate ratio for workers who needed treatment having a follow-up examination promptly showed a significant decrease over time. The incident rate ratio for those with unmet needs decreased, and those being treated increased over time., Conclusions: The findings showed that the initiative was effective, with the number of early visits for further health examinations increasing and a decrease in the number of people with unmet health needs., (© 2020 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Background: Numerous workers have participated in recovery efforts following the accident that occurred at the Tokyo Electric Power Company (TEPCO) Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake. These workers, belonging to various companies, have been engaged in various tasks since the accident. Given the hazards and stress involved in these tasks and the relatively long time required to transport sick or injured workers to medical institutions, it became necessary to quickly implement a more stringent management program for fitness for duty than in ordinary work environments., Case: It took considerable time to introduce and improve a fitness-for-duty program because of several concerns. Various efforts were conducted, sometimes triggered by guidance from the Ministry of Health, Labour and Welfare (MHLW), but the implementation of the program was insufficient. In April 2016, a new program was initiated in which all primary contractors confirmed that their subcontractors had achieved five conditions for workers' fitness for duty on the basis of guidance from the MHLW and occupational health experts. TEPCO confirmed that all primary contractors had implemented the program successfully as of the end of November 2016., Conclusion: Following a disaster, even though the parties concerned understand the necessity of fitness-for-duty programs and that companies in high positions have responsibilities beyond their legal requirements, it is highly possible that they may hesitate to introduce such programs without guidance from the government. It is necessary to prepare a governmental framework and professional resources that introduce these stringent management programs quickly.

Objectives: The aim of this review was to summarize the lessons learned from the experience in protecting the health of workers engaged in operations following the accident at the Fukushima Daiichi Nuclear Power Plant (NPP)., Methods: We reviewed all types of scientific papers examining workers' health found in Medline and Web of Sciences as well as some official reports published by the Ministry of Health, Labour and Welfare of Japan and other governmental institutes., Results: The papers and reports were classified into those investigating workers at the Fukushima Daiichi and Daini NPPs, workers engaged in decontamination operations in designated areas, and other workers. Regarding workers at the NPPs, many efforts were made to establish an emergency-care and occupational health system. Risk management efforts were undertaken for radiation exposure, heat stress, psychological stress, outbreak of infectious diseases, and fitness for work. Only a few reports dealt with decontamination workers and others; however, the health management of these workers was clearly weaker than that for workers at the NPPs., Conclusions: Many lessons can be learned from what occurred. That knowledge can be applied to ongoing decommissioning work and to future disasters. In addition, it is necessary to study the long-term health effects of radiation exposure and to accumulate data about the health of workers engaged in decontamination work and other areas.

Objective: To clarify the occupational health (OH) issues that arose, what actions were taken, and the OH performances during the disaster involving the Fukushima Daiichi Nuclear Power Plant and thus improve the OH management system with respect to long-term decommissioning work and preparation for future disasters., Methods: We used information in advisory reports to the Tokyo Electric Power Company by an OH expert group, observation through support activities, and data officially released by the Tokyo Electric Power Company., Results: Occupational health issues transitioned as work progressed and seasons changed. They were categorized into OH management system establishment, radiation exposure control, heat illness prevention, infectious disease prevention and control, and fitness for workers' duties., Conclusions: Occupational health management systems involving OH experts should be implemented to manage multiple health risks with several conflicts and trade-offs after a disaster.

Background: A nuclear accident occurred at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company (TEPCO) as a result of a mega-earthquake and tsunami in March, 2011. A large number of workers were engaged in response and recovery operations under a complex structure of involved companies. They were exposed not only to radiation but also to other health hazards. TEPCO implemented programs to prevent radiation exposure, but had no effective systems for managing the other health risks and few occupational health (OH) professionals contributed to the health risk management., Activities: The University of Occupational and Environmental Health (UOEH), Japan, dispatched physicians to a quake-proof building at the plant to provide first-aid services from mid-May, 2011, and took a strategic approach to protecting workers from existing health risks. UOEH presented recommendations on OH systems and preventive measures against heat stress to the Government and TEPCO. The Ministry of Health, Labour, and Welfare issued guidelines to TEPCO and contractors. TEPCO implemented a comprehensive program against heat stress according to the guidelines and in cooperation with UOEH. As a result, we successfully prevented severe heat illness during summer 2011., Discussion: From our experiences, we believe that the following recommendations should be considered: (1) the role of OH and the participation of experts should be defined in emergency response plans; (2) regulations should allow the national government and main companies involved to lead safety and health initiatives for all workers at disaster sites; and (3) OH professionals, response manuals and drills should be organized at a national level.