Impacts of the 2011 Fukushima nuclear disaster on healthcare facilities: A systematic literature review

Understanding how a disaster impact functions of healthcare facilities is important future disaster risk reduction. This study aims to synthesise the impact of the 2011 Fukushima nuclear disaster, one of the largest chemical, biological, radiation, nuclear, or explosive (CRBNE) events in world history, on the functional status of healthcare facilities. Two data sources, Medline and Nursing databases, were searched for peer-reviewed papers written in English or Japanese. CiNii and Ichi-shi Web were searched for papers in Japanese. Articles written in English or Japanese and published from March 2011 to April 2019 were included. For further information within the month of the disaster, newspaper articles from Asahi Shimbun and Yomiuri Shimbun were also searched, as well as an inquiry report published by the National Diet of Japan. After screening, 66 articles and a book were included. In the acute phase of the disaster, problems around logistics and human resources resulted in the most severe damage to healthcare facilities, despite the relatively limited structural damage. Hospital evacuation posed a large problem, and ill-planned evacuations resulted in increased mortality among evacuated patients. No literature described direct impacts of radiation exposure, or radiation screenings, to the functioning of healthcare facilities. In the chronic phase, issues around human resources including staff shortages and mental health deterioration among healthcare staff remained as major problems. In conclusion, after the Fukushima nuclear disaster and subsequent social disruption, there was prominent damage to the infrastructure and logistics of healthcare facilities, and staff shortages at local healthcare facilities continued long-term.