*Radiation Emergency Medical Assistance Team (REMAT), National Institution of Radiological Sciences (NIRS), Chiba, Japan.
Health Phys. 2014 Jun;106(6):630-7. doi: 10.1097/HP.0000000000000093.
A huge earthquake struck the northeast coast of the main island of Japan on 11 March 2011, triggering a tsunami with more than 10-m-high waves hitting the area. The earthquake was followed by numerous sustained aftershocks. The earthquake and aftershocks left almost 16,000 people dead and more than 2,800 missing (as of 11 March 2014). The earthquake affected the Fukushima Daiichi Nuclear Power Plant (NPP) of Tokyo Electric Power Company (TEPCO), causing serious damage to the NPP and resulting in large amounts of radioactive materials being released into not only controlled areas but also the environment. Damage was caused to the cooling systems of the NPP, although they automatically shut down after the earthquake. The trouble with the cooling systems led to hydrogen explosions and core meltdown. The major nuclides released on land were ¹³¹I, ¹³⁴Cs, and ¹³⁷Cs. The release of these radioactive materials resulted in contamination of first responders and workers and also a high ambient dose of radiation around the NPP. The local hospital system, including that for radiation emergency medicine, was dysfunctional. Hospitals that had been designated as radiation emergency facilities were not able to function because the earthquake and tsunami had caused damage to their facilities; some of these were located within a 20-km radius of the NPP and in the evacuation areas. Local fire department personnel were also ordered to evacuate. Fukushima prefecture changed the screening level required for decontamination from 13,000 to 100,000 cpm, with decontamination by wiping being performed for over 13,000 cpm. However, as hospitals and fire departments had to abide by lower levels than that of the prefecture for receiving or transporting contaminated patients, these personnel could not accept or transport contaminated people from the NPPs. In addition, hospitals not designated as radiation emergency facilities would not receive patients from the NPPs because of concerns about the health effects of radiation. From this disaster, it was learned that basic knowledge of radiation and its effects is extremely important for health care providers.
2011 年 3 月 11 日,日本主岛东北海岸发生强烈地震,引发超过 10 米高的海啸袭击该地区。地震后发生了多次持续余震。截至 2014 年 3 月 11 日,地震和余震造成近 16000 人死亡,2800 多人失踪。地震影响了东京电力公司(TEPCO)的福岛第一核电站(NPP),导致 NPP 严重受损,大量放射性物质不仅释放到控制区域,而且释放到环境中。尽管地震后 NPP 的冷却系统自动关闭,但仍对其造成了损坏。冷却系统出现故障导致氢气爆炸和堆芯熔毁。陆地上释放的主要核素是 ¹³¹I、¹³⁴Cs 和 ¹³⁷Cs。这些放射性物质的释放导致了第一反应者和工作人员的污染,以及 NPP 周围环境的高辐射剂量。当地医院系统,包括放射应急医学系统,都无法正常运行。被指定为放射应急设施的医院由于地震和海啸对其设施造成的破坏而无法正常运行;其中一些医院位于 NPP 半径 20 公里范围内,以及疏散区域内。当地消防部门人员也被命令撤离。福岛县将去污所需的筛选水平从 13000 调整到 100000 cpm,对超过 13000 cpm 的地区进行擦拭去污。然而,由于医院和消防部门在接收或运送受污染患者方面必须遵守比县更低的水平,这些人员无法接收或运送来自 NPP 的受污染人员。此外,由于担心辐射对健康的影响,未被指定为放射应急设施的医院不会接收来自 NPP 的患者。从这场灾难中,我们了解到,医护人员对辐射及其影响的基本知识极为重要。