The reality of Ultrasonic Thyroid Examinations
Since December 2011, Fukushima Prefecture has conducted ultrasonic thyroid examinations among children under the age of 18. However, those who were subjected to the examinations are only given the results marked by the letters A to D, and even if the results indicate discovery of pustules or nodules, there are no explanations about the details of the echo results, nor about the size of the nodules, unless the individual submits a request that those findings be disclosed. In response to this demeaning procedure, Fukushima citizens have demanded that each person undertaking the examination should be provided with a copy of the ultrasound image immediately after the examination is complete.
These citizens are not only concerned with thyroid cancer, but other illnesses such as heart disease, stroke, neuropathy, weakened immune system and genetic effects. The group have asked the prefecture to conduct blood examinations in addition to the ultrasonic tests.
So far, some 80,000 children living in the evacuation zone and in Fukushima city have undergone the examination. However, there are cases where the examinations of children from certain regions with high iodine contamination will be delayed, after other areas and towns have been examined. In Iwaki city, for example, although a huge amount of iodine fell on the ground immediately after the nuclear explosion, the tests will not take place until 2013. Due to this delay, many families there have voluntarily had similar tests carried out at hospitals outside Fukushima.
Shunichi Yamashita and Shinichi Suzuki, medical doctors from Fukushima Medical University, who are responsible for the health monitoring of Fukushima people, have sent an email to Japan's Thyroid Association requesting that their doctors refrain from providing parents with their second opinions or conducting additional tests.
Results of the tests on the second group of about 42,000 children conducted between April and summer of this year, show that more than 43% of the children were found to be A2. This means they had nodules of less than 5 mm and pustules smaller than 2 cm. Among the children who received the tests from December last year through March, the percentage was only about 37%. Parents are concerned and wondering how they should interpret these results.
Upon handing over the proposal, the citizens' group asked Dr. Yamashita to be present at the meeting, however, he did not appear at either of the two meetings.
Sachiko Sato, the leader of Fukushima Network for Saving Children from Radiation, said "In order to protect our children from the risk of developing diseases, we need to keep calling for examinations conducted from the standpoint of preventive medicine as well as for the disclosure of abnormalities".
Fukushima citizens require the prefecture’s Medical school to improve their thyroid tests
In July 2012, nine groups of citizens including “Fukushima Network for Saving Children from Radiation”, submitted a proposal to the Fukushima Medical University and the governor of Fukushima to improve the standard of ultrasonic thyroid examination for children. Such tests form part of the health monitoring survey on residents of Fukushima, which is conducted by the government after the Fukushima Daiichi nuclear accident.
Although the Medical University responded on August 9, the citizens groups were not convinced by their answer, and the groups submitted their proposal once more on September 13.
This renewed request is based on the suspicion and doubts among the citizens regarding the reliability of such tests. After the accident the Fukushima prefectural government failed to distribute iodine tablets (except for one town) or evacuate the residents to prevent thyroid cancer, although the levels of radiation were very high. Even though the government did not see the necessity of distributing iodine tablets, the parents have a huge issue why the government are investigating the condition of the children’s thyroids and whether they will conduct the examinations with an adequate standard of medical condition.
Parents are concerned with the fact that the results of the examinations are not disclosed to the public. Another source of worry is that those who have a small amount of pustules have been told to wait two years for a follow up test. This casts a big question if it is safe for the children to wait for such a long period of time.
The proposals the citizen submitted and the responses from the Fukushima Medical University
1. Prompt disclosure of the examination results to those who undertook the tests.
Response: We expect to do so.
2. Simplify and disclose the procedures.
Response: We are in the process of simplifying the procedure.
3. Create a map that indicates the relationship between soil contamination and the degree of thyroid abnormality.
Response: We are planning to do so, but not able yet to say when it will be.
4. Co-operate with other prefectures to complete the primary thyroid examinations as early as possible.
Response: We are presently making requests to other prefectures to send us ultrasound technicians. We assume it will be less than two years before the tests are done on all children.
5. Conduct both blood and urine examinations.
Response: No plans to conduct both at the same time.
6. Start the examinations from Iwaki where considerably high iodine contamination was detected.
Response: We do not have an accurate map of iodine contamination shortly after the accident, therefore we will not alter the current plan. We have not yet decided when the examinations in Iwaki city will be conducted.
7. Since Fukushima prefecture is not the only region that shows the high rate of the children with A2 results, conduct an epidemiological study on children outside Fukushima. (A2 : group of children who were found to have nodules smaller than 5 mm, or pustules smaller than 2 cm)
Response: We will not request other prefectures for their cooperation. (A few days after this proposal was submitted, the Japanese government announced that they would conduct an epidemiological examination on some 4,500 children).
8. Conduct the thyroid examinations on adults too.
Response: No plan to examine adults.
9. Allow the other medical institutions to give their second opinions. (It was suspected that Dr. Shinichi Yamashita, Vice President of Fukushima Medical University, sent an email to "Japan Radiology Society" to forbid their doctors to provide the parents with their second opinions about the thyroid examination results.)
Response: The thyroid examination is merely screening test, not medical practice, therefore the idea of second opinion itself does not apply. We do not forbid other medical institutions to conduct similar tests.
"Tangara", October 2012, magazine of Fukushima Network for Saving Children from Radiation