1 Nagoya City University Graduate School of Natural Sciences Nagoya Japan.
2 Goshawk Protection Fund Utsunomiya Japan.
J Am Heart Assoc. 2019 Mar 19;8(6):e009486. doi: 10.1161/JAHA.118.009486.
Background After the Chernobyl nuclear accident in 1986, an increase in the incidence of congenital heart disease ( CHD s) in the neighboring countries was reported. In 2011, Japan experienced the Great East Japan Earthquake and the nuclear accidents at Fukushima. However, a nationwide study of their effects has not been conducted yet. Methods and Results We used data covering the period between 2007 and 2014 from the annual surveys conducted by the Japanese Association for Thoracic Surgery, which included almost all of the operations pertaining to 46 types of CHD s in Japan. CHD s were divided into 2 groups based on complexity, the time of occurrence during heart development, and age at operation. We estimated the change in the number of the operations per 100 000 live births between pre- and postdisaster using a negative binomial generalized linear mixed model. Overall, a significant 14.2% (95% CI, 9.3-19.4) increase in the number of operations for complex CHD s in neonates and infants per 100 000 live births was found, whereas those performed for patients of 1 to 17 years old showed no significant change during the study period. Conclusions The number of operations for complex CHD s in neonates and infants in Japan significantly increased after the massive disaster, and its level was maintained thereafter. The number of operations for complex CHD was not equal but closely correlated to the live birth prevalence of complex CHD s. Therefore, some meaningful increase in the live birth prevalence can be assumed; however, the precise cause of the increase is unknown.
1986 年切尔诺贝利核事故后,邻国报道先天性心脏病(CHD)发病率增加。2011 年,日本经历了东日本大地震和福岛核事故。然而,尚未对其影响进行全国性研究。
我们使用了日本胸外科学会在 2007 年至 2014 年期间进行的年度调查的数据,这些数据涵盖了日本几乎所有 46 种 CHD 手术。根据复杂性、心脏发育过程中的发生时间和手术时的年龄,将 CHD 分为 2 组。我们使用负二项广义线性混合模型估计了灾难前后每 10 万活产儿手术数量的变化。总体而言,新生儿和婴儿中复杂 CHD 的手术数量每 10 万活产儿增加了 14.2%(95%CI,9.3-19.4),而 1 至 17 岁患者的手术数量在研究期间没有显著变化。
日本新生儿和婴儿中复杂 CHD 的手术数量在大规模灾害后显著增加,此后一直保持在这一水平。复杂 CHD 的手术数量与复杂 CHD 的活产患病率并不相等,但密切相关。因此,可以假设活产患病率有一定程度的增加;然而,增加的准确原因尚不清楚。