Mortality risk associated with nuclear disasters depends on the time during and following evacuation of hospitals near nuclear power plants: An observational and qualitative study

This study aimed to examine the factors correlated with emergency evacuations on patients' prognosis in hospitals severely affected by the Fukushima Daiichi nuclear power plant (FDNPP) accident in March 2011, and to recommend measures mitigating potential health risks among them in future disasters. Seven hospitals within a 20-km radius of the FDNPP were designated as the evacuation zone, of which three hospitals located within a 5-km radius were examined. In-formation regarding hospital emergency evacuation among the three hospitals from previous literature and official reports were integrated and interview outcomes of staff at each hospital were qualitatively analyzed using thematic analysis. Our thematic analysis identified four themes: insufficient preparedness for disaster, difficulty of patient evacuation, insufficient materials, and insufficient information. Comparison of the three hospitals located within a 5-km radius of the FDNPP revealed that hospitals with several patients or those with a high proportion of bedridden or critically ill patients faced more difficulty in emergency evacuation and experienced higher fatalities. In addition to individual evacuation plans, for future preparedness, external and public organizations should prepare disaster responses such as procedures to integrate information on the status of each medical facility and measures to support them individually.