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Current Environmental Health Reports

, Volume 3, Issue 4, pp 348–359 | Cite as

Risk Communication Strategies: Lessons Learned from Previous Disasters with a Focus on the Fukushima Radiation Accident

  • Erik R. Svendsen
  • Ichiro Yamaguchi
  • Toshihide Tsuda
  • Jean Remy Davee Guimaraes
  • Martin Tondel
Global Environmental Health and Sustainability (W Al-Delaimy, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Global Environmental Health and Sustainability

Abstract

Purpose of the Review

It has been difficult to both mitigate the health consequences and effectively provide health risk information to the public affected by the Fukushima radiological disaster. Often, there are contrasting public health ethics within these activities which complicate risk communication. Although no risk communication strategy is perfect in such disasters, the ethical principles of risk communication provide good practical guidance.

Findings

These discussions will be made in the context of similar lessons learned after radiation exposures in Goiania, Brazil, in 1987; the Chernobyl nuclear power plant accident, Ukraine, in 1986; and the attack at the World Trade Center, New York, USA, in 2001. Neither of the two strategies is perfect nor fatally flawed.

Summary

Yet, this discussion and lessons from prior events should assist decision makers with navigating difficult risk communication strategies in similar environmental health disasters.

Keywords

Risk communication Ethics Radiation Management Fukushima accident 

Notes

Acknowledgments

Ichiro Yamaguchi reports grants from the Japanese Ministry of Health, Labor, and Welfare.

Compliance with Ethical Standards

Ethical Guidelines

The International Society for Environmental Epidemiology (ISEE) Ethics and Philosophy Committee has taken an active role in supporting ethical conduct and formulating ethics guidelines. The second revision to the Ethics Guidelines for Environmental Epidemiologists was adopted by the Governing Council of the ISEE in 2012 [93].

Conflict of Interest

Erik R. Svendsen, Ichiro Yamaguchi, Toshihide Tsuda, Jean Remy Davee Guimaraes, Martin Tondel declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •Of importance ••Of major importance

  1. 1.
    Lippmann M, Cohen MD, Chen LC. Health effects of world trade center (WTC) dust: an unprecedented disaster’s inadequate risk management. Crit Rev Toxicol. 2015;45(6):492–530.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    •Oughton DH. Ethical foundations of environmental radiological protection. Ann ICRP. 2016;45(1 Suppl):345–57 This is the fundamental document on which radiological protection is built on worldwide.CrossRefPubMedGoogle Scholar
  3. 3.
    Jaworska A. Types of radiation mass casualties and their management. Annali dell’Istituto superiore di sanita. 2009;45(3):246–50.PubMedGoogle Scholar
  4. 4.
    Kamiya K, Ishikawa T, Yasumura S, et al. External and internal exposure to Fukushima residents. Radiation Protection Dosimetry. 2016.Google Scholar
  5. 5.
    Kamiya K, Ozasa K, Akiba S, et al. Long-term effects of radiation exposure on health. Lancet. 2015;386(9992):469–78.CrossRefPubMedGoogle Scholar
  6. 6.
    •Shimura T, Yamaguchi I, Terada H, Robert Svendsen E, Kunugita N. Public health activities for mitigation of radiation exposures and risk communication challenges after the Fukushima nuclear accident. J Radiat Res. 2015;56(3):422–9 This is a fundamental document detailing the public health activities after the Fukushima disaster.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Miyazaki M, Tanigawa K, Murakami M. After Fukushima: creating a dialogue. Science. 2016;352(6286):666.CrossRefPubMedGoogle Scholar
  8. 8.
    Takamura N, Taira Y, Yoshida K, Nakashima-Hashiguchi K, Orita M, Yamashita S. Communicating radiation risk to the population of Fukushima. Radiation Protection Dosimetry. 2016.Google Scholar
  9. 9.
    Tomkiv Y, Perko T, Oughton DH, Prezelj I, Cantone MC, Gallego E. How did media present the radiation risks after the Fukushima accident: a content analysis of newspapers in Europe. J Radiol Protect: Off J Soc Radiol Prot. 2016;36(2):S64–81.CrossRefGoogle Scholar
  10. 10.
    Hayano RS. Engaging with local stakeholders: some lessons from Fukushima for recovery. Ann ICRP. 2015;44(1 Suppl):144–52.CrossRefPubMedGoogle Scholar
  11. 11.
    Iimoto T, Nunokawa J, Fujii H, et al. Collaboration of local government and experts responding to increase in environmental radiation level due to the nuclear disaster: focusing on their activities and latest radiological discussion. Radiat Prot Dosim. 2015;167(1–3):358–64.CrossRefGoogle Scholar
  12. 12.
    Ohno K, Endo K. Lessons learned from Fukushima Daiichi nuclear power plant accident: efficient education items of radiation safety for general public. Radiat Prot Dosim. 2015;165(1–4):510–2.CrossRefGoogle Scholar
  13. 13.
    Ohtsuru A, Tanigawa K, Kumagai A, et al. Nuclear disasters and health: lessons learned, challenges, and proposals. Lancet. 2015;386(9992):489–97.CrossRefPubMedGoogle Scholar
  14. 14.
    ••Tsuda T, Tokinobu A, Yamamoto E, Suzuki E. Thyroid cancer detection by ultrasound among residents ages 18 years and younger in Fukushima, Japan: 2011 to 2014. Epidemiology. 2016;27(3):316–22 This is the fundamental paper which has initiated the public debate regarding whether there is an increase in pediatric thyroid cancer in Fukushima.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    ••Davis S. Commentary: screening for thyroid cancer after the Fukushima disaster: what do we learn from such an effort? Epidemiology. 2016;27(3):323–5 Editorial commentary on the Tsuda paper which has started this public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  16. 16.
    ••Suzuki S. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e19 .A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    ••Takahashi H, Ohira T, Yasumura S, et al. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e21 .A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    ••Takamura N. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e18 .A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima CrossRefPubMedGoogle Scholar
  19. 19.
    ••Shibata Y. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e19–20 A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  20. 20.
    ••Jorgensen TJ. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e17 .A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima CrossRefPubMedGoogle Scholar
  21. 21.
    ••Wakeford R, Auvinen A, Gent RN, et al. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e20–1 A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  22. 22.
    ••Korblein A. Re: thyroid cancer among young people in Fukushima. Epidemiology. 2016;27(3):e18–9 A published letter illustrating the public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  23. 23.
    ••Tsuda T, Tokinobu A, Yamamoto E, Suzuki E. The authors respond. Epidemiology. 2016;27(3):e21–3 Response to the published letters illustrating the public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  24. 24.
    ••Normile D. Epidemic of fear. Science. 2016;351(6277):1022–3 An illustration of the public debate on pediatric thyroid cancer in Fukushima.CrossRefPubMedGoogle Scholar
  25. 25.
    Nagataki S, Takamura N. Radioactive doses—predicted and actual—and likely health effects. Clin Oncol. 2016;28(4):245–54.CrossRefGoogle Scholar
  26. 26.
    Miura M, Ono K, Yamauchi M, Matsuda N. Perception of radiation risk by Japanese radiation specialists evaluated as a safe dose before the Fukushima nuclear accident. Health Phys. 2016;110(6):558–62.CrossRefPubMedGoogle Scholar
  27. 27.
    Commission JFS. The report by the working group on future direction of risk communication In: Commisssion JFS, ed 2015.Google Scholar
  28. 28.
    Higgins ET. Beyond pleasure and pain. Am Psychol. 1997;52(12):1280–300.CrossRefPubMedGoogle Scholar
  29. 29.
    Ishikawa K. What has been brought to residents and communities by the nuclear power plant accident? Special and serious disaster relief procedure modification after the 2011 Tohoku earthquake and tsunami in Fukushima. Nihon Ronen Igakkai zasshi Jpn J Geriatr. 2011;48(5):489–93.CrossRefGoogle Scholar
  30. 30.
    Becker SM. Risk communication and radiological/nuclear terrorism: a strategic view. Health Phys. 2011;101(5):551–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Bonte FJ. Chernobyl retrospective. Semin Nucl Med. 1988;18(1):16–24.CrossRefPubMedGoogle Scholar
  32. 32.
    Ministry of Health LaW. We created a brochure to answer to the worry of the radiation to the mother for in women and child care during pregnancy. 2011.Google Scholar
  33. 33.
    Health Ministry. Pregnant women, et al for the pamphlet created = a fear of radioactivity—the Ministry of Health and Welfare. In: Health Mo, ed 2011. Japan.Google Scholar
  34. 34.
    Oliveira AR, Hunt JG, Valverde NJ, Brandao-Mello CE, Farina R. Medical and related aspects of the Goiania accident: an overview. Health Phys. 1991;60(1):17–24.CrossRefPubMedGoogle Scholar
  35. 35.
    Steinhausler F. Chernobyl and Goiania lessons for responding to radiological terrorism. Health Phys. 2005;89(5):566–74.CrossRefPubMedGoogle Scholar
  36. 36.
    Farina R, Brandao-Mello CE, Oliveira AR. Medical aspects of 137Cs decorporation: the Goiania radiological accident. Health Phys. 1991;60(1):63–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Oliveira CA, Lourenco MC, Dantas BM, Lucena EA. Design and operation of a whole-body monitoring system for the Goiania radiation accident. Health Phys. 1991;60(1):51–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Natarajan AT, Santos SJ, Darroudi F, et al. 137Cesium-induced chromosome aberrations analyzed by fluorescence in situ hybridization: eight years follow up of the Goiania radiation accident victims. Mutat Res. 1998;400(1–2):299–312.CrossRefPubMedGoogle Scholar
  39. 39.
    Bauchinger M. Health impacts of large releases of radionuclides. Cytogenetic effects as quantitative indicators of radiation exposure. CIBA Found Symp. 1997;203:188–99 discussion 199-204, 232-184.PubMedGoogle Scholar
  40. 40.
    da Cruz AD, Curry J, Curado MP, Glickman BW. Monitoring hprt mutant frequency over time in T-lymphocytes of people accidentally exposed to high doses of ionizing radiation. Environ Mol Mutagen. 1996;27(3):165–75.CrossRefPubMedGoogle Scholar
  41. 41.
    Socie G, Medhi Sohrabi K, Carosella ED, et al. Hematopoiesis research in aplastic anaemia induced by accidental protracted radiation. C R Acad Sci III. 1996;319(8):711–6.PubMedGoogle Scholar
  42. 42.
    Bauchinger M. Cytogenetic research after accidental radiation exposure. Stem Cells. 1995;13 Suppl 1:182–90.PubMedGoogle Scholar
  43. 43.
    Flynn DF, Goans RE. Nuclear terrorism: triage and medical management of radiation and combined-injury casualties. Surg Clin North Am. 2006;86(3):601–36.CrossRefPubMedGoogle Scholar
  44. 44.
    Toohey RE. Internal dose assessment in radiation accidents. Radiat Prot Dosim. 2003;105(1–4):329–31.CrossRefGoogle Scholar
  45. 45.
    Melo DR, Lipsztein JL, de Oliveira CA, Bertelli L. 137Cs internal contamination involving a Brazilian accident, and the efficacy of Prussian blue treatment. Health Phys. 1994;66(3):245–52.CrossRefPubMedGoogle Scholar
  46. 46.
    Brandao-Mello CE, Oliveira AR, Valverde NJ, Farina R, Cordeiro JM. Clinical and hematological aspects of 137Cs: the Goiania radiation accident. Health Phys. 1991;60(1):31–9.CrossRefPubMedGoogle Scholar
  47. 47.
    Beyea J. Response to, “on the origins of the linear no-threshold (LNT) dogma by means of untruths, artful dodges and blind faith.” Environmental research. 2016.Google Scholar
  48. 48.
    Calabrese EJ. On the origins of the linear no-threshold (LNT) dogma by means of untruths, artful dodges and blind faith. Environ Res. 2015;142:432–42.CrossRefPubMedGoogle Scholar
  49. 49.
    Seong KM, Seo S, Lee D, et al. Is the linear no-threshold dose-response paradigm still necessary for the assessment of health effects of low dose radiation? J Korean Med Sci. 2016;31(Suppl 1):S10–23.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Nakashima E. Radiation dose response estimation with emphasis on low dose range using restricted cubic splines: application to all solid cancer mortality data, 1950-2003, in atomic bomb survivors. Health Phys. 2015;109(1):15–24.CrossRefPubMedGoogle Scholar
  51. 51.
    Government JN. Basic information on radiation risk. In: The Cabinet Office tCAA, the Reconstruction Agency, the, Ministry of Foreign Affairs tMoE, Culture, Sports, Science and, Technology tMoH, Labour and Welfare, the Ministry of Agriculture,, Forestry and Fisheries tMoE, Trade and Industry, the Ministry of, the Environment tSotNRA, eds. Tokyo, Japan: Federal Government Report; 2016: 44.Google Scholar
  52. 52.
    Agency IAE. TM on Best Practices in Media and Public Communication for Nuclear Power Programmes. 2015; https://www.iaea.org/NuclearPower/Meetings/2015/2015-10-05-10-08-NIDS.html.
  53. 53.
    Hangai T. How to overcome the difficulties from the nuclear disaster by empowering local community. TM on Best Practices in Media and Public Communication for Nuclear Power Programmes 2015; https://www.iaea.org/NuclearPower/Downloadable/Meetings/2015/2015-10-05-10-08-NIDS/Session3/Session_3-2-1_IAEA_hangai2.pdf.
  54. 54.
    Yasumura S, Hosoya M, Yamashita S, et al. Study protocol for the Fukushima health management survey. J Epidemiol/ Jpn Epidemiol Assoc. 2012;22(5):375–83.CrossRefGoogle Scholar
  55. 55.
    Shimura H, Ohana N. Current situation and the role of department of clinical laboratory medicine on the Fukushima health management survey project for risk of thyroid cancer. Rinsho Byori Jpn J Clin Pathol. 2013;61(12):1166–71.Google Scholar
  56. 56.
    Watanobe H, Furutani T, Nihei M, et al. The thyroid status of children and adolescents in Fukushima prefecture examined during 20–30 months after the Fukushima nuclear power plant disaster: a cross-sectional, observational study. PLoS One. 2014;9(12):e113804.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Ludolph R, Schulz PJ. Does regulatory fit lead to more effective health communication? A systematic review. Soc Sci Med. 2015;128:142–50.CrossRefPubMedGoogle Scholar
  58. 58.
    Lin CY. Promote health or prevent disease? The effects of health-related advertising on eating behavior intention. Int J Environ Res Public Health. 2015;12(4):3517–34.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Cancer IARo. IARC monographs on the evaluation of carcinogenic risks to humans, vol. 100D. IARC: Lyon, France; 2012.Google Scholar
  60. 60.
    Cancer IARo. IARC monographs on the evaluation of carcinogenic risks to humans, vol. 78. IARC: Lyon, France; 2001.Google Scholar
  61. 61.
    Cancer IARo. IARC monographs on the evaluation of carcinogenic risks to humans, vol. 75. IARC: Lyon, France; 2000.Google Scholar
  62. 62.
    •ATSDR-CDC. A primer on health risk communication. Principles and practices. Atlanta, GA, USA: Agency for Toxic Substances & Disease Registry, Centers Disease Control and Prevention.; 2016. A fundamental document on the guidelines to public health risk communication Google Scholar
  63. 63.
    Figueroa PM. Risk communication surrounding the Fukushima nuclear disaster: an anthropological approach. Asia Eur J. 2013;11(1):53–64.CrossRefGoogle Scholar
  64. 64.
    Kanda R, Tsuji S, Yonehara H. Perceived risk of nuclear power and other risks during the last 25 years in Japan. Health Phys. 2012;102(4):384–90.CrossRefPubMedGoogle Scholar
  65. 65.
    Vyncke B, Perko T, Van Gorp B. Information sources as explanatory variables for the Belgian health-related risk perception of the Fukushima nuclear accident. risk analysis: an official publication of the Society for Risk Analysis. 2016.Google Scholar
  66. 66.
    Perko T. Radiation risk perception: a discrepancy between the experts and the general population. J Environ Radioact. 2014;133:86–91.CrossRefPubMedGoogle Scholar
  67. 67.
    Perko T, Turcanu C, Carle B. media Reporting of nuclear emergencies: the effects of transparent communication in a minor nuclear event. J Conting Crisis. Man. 2012;20(1):52–63.Google Scholar
  68. 68.
    Perko T. Importance of risk communication during and after a nuclear accident. Integr Environ Assess Manag. 2011;7(3):388–92.CrossRefPubMedGoogle Scholar
  69. 69.
    Giles D, Hewitt D, Stewart A, Webb J. Malignant disease in childhood and diagnostic irradiation in utero. Lancet. 1956;271(6940):447.PubMedGoogle Scholar
  70. 70.
    Doll R, Wakeford R. Risk of childhood cancer from fetal irradiation. Br J Radiol. 1997;70:130–9.CrossRefPubMedGoogle Scholar
  71. 71.
    Bartley K, Metayer C, Selvin S, Ducore J, Buffler P. Diagnostic X-rays and risk of childhood leukaemia. Int J Epidemiol. 2010;39(6):1628–37.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Brenner DJ. What we know and what we don’t know about cancer risks associated with radiation doses from radiological imaging. Br J Radiol. 2014;87(1035):20130629.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Infante-Rivard C. Diagnostic x rays, DNA repair genes and childhood acute lymphoblastic leukemia. Health Phys. 2003;85(1):60–4.CrossRefPubMedGoogle Scholar
  74. 74.
    Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380(9840):499–505.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Preston DL, Ron E, Tokuoka S, et al. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat Res. 2007;168(1):1–64.CrossRefPubMedGoogle Scholar
  76. 76.
    Furukawa K, Preston D, Funamoto S, et al. Long-term trend of thyroid cancer risk among Japanese atomic-bomb survivors: 60 years after exposure. Int J Cancer. 2013;132(5):1222–6.CrossRefPubMedGoogle Scholar
  77. 77.
    Ozasa K, Shimizu Y, Suyama A, et al. Studies of the mortality of atomic bomb survivors, report 14, 1950–2003: an overview of cancer and noncancer diseases. Radiat Res. 2012;177(3):229–43.CrossRefPubMedGoogle Scholar
  78. 78.
    Cardis E, Vrijheid M, Blettner M, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ. 2005;331(7508):77.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Muirhead CR, O’Hagan JA, Haylock RG, et al. Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for radiation workers. Br J Cancer. 2009;100(1):206–12.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Hoffmann W, Terschueren C, Richardson DB. Childhood leukemia in the vicinity of the Geesthacht nuclear establishments near Hamburg, Germany. Environ Health Perspect. 2007;115(6):947–52.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Leuraud K, Richardson DB, Cardis E, et al. Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study. Lancet Haematol. 2015;2(7):e276–81.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Richardson DB, Cardis E, Daniels RD, et al. Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS). BMJ. 2015;351:h5359.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Band PR, Le ND, Fang R, et al. Cohort study of Air Canada pilots: mortality, cancer incidence, and leukemia risk. Am J Epidemiol. 1996;143(2):137–43.Google Scholar
  84. 84.
    Darby S, Hill D, Auvinen A, et al. Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies. BMJ. 2005;330(7485):223.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Kendall GM, Little MP, Wakeford R, et al. A record-based case-control study of natural background radiation and the incidence of childhood leukaemia and other cancers in Great Britain during 1980-2006. Leukemia. 2013;27(1):3–9.CrossRefPubMedGoogle Scholar
  86. 86.
    Krewski D, Lubin JH, Zielinski JM, et al. Residential radon and risk of lung cancer: a combined analysis of 7 north American case-control studies. Epidemiology. 2005;16(2):137–45.CrossRefPubMedGoogle Scholar
  87. 87.
    Spycher BD, Lupatsch JE, Zwahlen M, et al. Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study. Environ Health Perspect. 2015;123(6):622–8.CrossRefPubMedPubMedCentralGoogle Scholar
  88. 88.
    Eisenberg MJ, Afialo J, Lawler PR, Abrahamowicz M, Richard H, Pilote L. Cancer risk related to low-dose ionizing radiation from cardiac imaging in patients after acute myocardial infarction. CMAJ. 2011;183(4):430–6.CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Mathews JD, Forsythe AV, Brady Z, et al. Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ. 2013;346:f2360.CrossRefPubMedPubMedCentralGoogle Scholar
  90. 90.
    Preston-Martin S, Thomas DC, White SC, Cohen D. Prior exposure to medical and dental X-rays related to tumors of the parotid gland. J Natl Cancer Inst. 1988;80:943–9.CrossRefPubMedGoogle Scholar
  91. 91.
    Gulland A. Global cancer risk from Fukushima is low, says WHO. BMJ. 2013;346:f1390.CrossRefPubMedGoogle Scholar
  92. 92.
    •International Society for Environmental Epidemiology EaPC. Ethics guidelines for environmental epidemiologists 2012; http://www.iseepi.org/About/documents/ethics_guidelines_adopted_april_25_2012_001.pdf. These are the ethical guidelines which can help frame the public dialogue regarding pediatric thyroid cancer in Fukushima.
  93. 93.
    Kramer S, Soskolne C, Mustapha B, Al-Delaimy W. Revised ethics guidelines for environmental epidemiologists. Environ Health Perspect. 2012;120(8):a299–301.PubMedPubMedCentralGoogle Scholar
  94. 94.
    •ICRP. 1990 Recommendations of the International Commission on Radiological Protection. Vol 60: ICRP; 1991. Fundamental paper showing the international guidelines in radiological protection.Google Scholar
  95. 95.
    •Lochard J. Application of the Commission’s recommendations: the activities of ICRP committee 4. Ann ICRP. 2012;41(3–4):32–44 Fundamental paper showing the international guidelines in radiological protection.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2016

Authors and Affiliations

  • Erik R. Svendsen
    • 1
  • Ichiro Yamaguchi
    • 2
  • Toshihide Tsuda
    • 3
  • Jean Remy Davee Guimaraes
    • 4
  • Martin Tondel
    • 5
  1. 1.Medical University of South CarolinaCharlestonUSA
  2. 2.Department of Environmental HealthNational Institute of Public HealthWako CityJapan
  3. 3.Okayama UniversityOkayama CityJapan
  4. 4.Inst. de Biofisica Carlos Chagas Filho, Lab. de Tracadores, Bloco G, CCSUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  5. 5.Occupational and Environmental Medicine, Department of Medical SciencesUppsala UniversityUppsalaSweden

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