Yuliya Lyamzina

The worst commercial nuclear accident and the first large‐scale voluntary evacuation due to a nuclear event in United States history took place at Three Mile Island (TMI) in 1979. Within a short time, there was a well‐recognized impact of the TMI accident by public health officials and academicians upon mental health of nearby residents—particularly pregnant women. Despite long‐term and detailed follow‐up of this population for cancer outcomes, community concerns continue. Herein, we conduct a scoping and process review of fetal/maternal/child health (MCH) and cancer health outcomes, and consider the findings in light of subsequent accidents. The process evaluation is enhanced by unpublished transcripts of the Pennsylvania Department of Health's (PA DOH) TMI Advisory Panel on Health Research Studies (APHRS), comprised of experts from prominent US research institutions. Research and process strengths included a rapid initial house‐to‐house health census of over 35,000 individuals, intense medical record reviews, in‐person interviews of pregnant women within a 10‐mile radius, and coordination of multiple parallel studies by PA DOH with APHRS collaboration. Major limitations include (1) errors in causal inference, (2) limited radiation exposure assessment, (3) failure to include TMI never‐exposed groups in risk estimates, (4) exclusion of vulnerable populations, (5) nonindexed/never published investigations, and (6) government‐stated need for long‐term MCH follow‐up that was never conducted. Lingering unaddressed actual and perceived risks were identified as major common themes among TMI, Chernobyl and Fukushima accidents. These findings underscore the need for the establishment of mechanisms to ensure long‐term follow‐up and preaccident protocols designed to address major health issues with inclusion of vulnerable populations and perceived risks.

Nuclear power remains one of the most accessible choices in addressing environmental and social concerns due to the continuously increasing energy needs around the world. While it remains an excellent source of energy due to its low price and low level of emissions, potential accidents remain a serious problem. An example of such is the most recent accident in the Fukushima Daiichi Nuclear Power Plant (2011), which reminded the world of the potential risks of nuclear energy and the consequences of which continue to have a lasting effect. There is no nuclear power plant in Serbia, but there are about 15 nuclear power stations scattered within its neighboring countries. Therefore, the Serbian Government decided to study how the Serbian public perceives the risks related to the potential construction of nuclear power stations in the country, nuclear energy in general, and its possible benefits and risks. The objective of this paper is to present the results of this assessment along with a literature overview on the (environmental) risk of nuclear power. A pilot study consisted of a series of 270 randomized face-to-face interviews that took place in the public square of Belgrade in March 2019. Logistic regression was used to examine the cumulative effects of the different risk factors. The results showed that the majority of the respondents are skeptical and do not support the construction of nuclear power stations in Serbia. Furthermore, this research identified several additional important correlations that have a significant impact on the public perception of risk.

The high levels of public worry and distrust of authorities, especially as associated with nuclear energy and radioactive waste, are well established in the literature and in the experience of risk communicators dealing with the general public. Though much of the experience with the heightened sense of worry that accompanies planned exposure situations associated with proposed radioactive/nuclear facilities (e.g., radioactive waste repositories, nuclear power plants, yet to be approved or built), there are also examples of existing exposure situations such as those following radiological accidents (e.g., Chernobyl or Fukushima). Some risk perception factors (e.g., trust, dread) are common to both planned and existing exposure situations, whereas others (e.g., volition, controllability) may be more prevalent in post‐accident exposure situations. Specific risk perceptions held by a given population and its various subgroups must be acknowledged and incorporated into successful risk communication and public engagement strategies. Post‐accident recovery programs and remediation projects, while in many countries requiring stakeholder and public acceptance to proceed, often fail to incorporate the specific risk perceptions held by the various affected groups in their risk communication and public involvement strategies. Such failures can foster a skeptical or angry public reaction, and hamper recovery in terms of both primary measures (radiological risk reduction interventions) and secondary measures (aiming at “return to normal life,” removal of stigmatization, health and well‐being, etc.). Existing exposure situations and the corresponding mitigations are often approached as local or national scale issues, but by their nature of following radiological emergencies or nuclear accidents, issues of multinational risk perceptions may also arise. Confronting risk perceptions featuring high levels of uncertainty, issue complexity, distrust, information asymmetry, and so forth, requires more interactive forms of governance and adaptive approaches to securing public acceptance. A suggestion is made to deploy an iterative continuous improvement model for incorporating specific risk perceptions into risk communication programs in concert with mutual‐gains‐based public engagement mechanisms.

Long-term recovery after any serious nuclear accident is a multi-faceted, complex process, different from non-nuclear disasters. Difficulties in recovering from a nuclear accident include not only the immediate direct health impacts on people and damaged infrastructure but also on technical, environmental and financial problems that extend to psychological, societal and ethical challenges. Results of the Fukushima Health Management Survey (FHMS) indicate severe mental health issues especially among different vulnerable groups, including senior citizens and mothers with small children. Complex psycho-social consequences related to well-being and mental health have noticeably emerged in the post-accident phase of the nuclear accident. These health problems tend to be connected with sudden and prolonged evacuation, and with perceived high risk and anxiety regarding radiation in the affected area. It is essential to continue monitoring both direct and indirect health effects and mitigate the overall health risks in order to improve the health and living conditions of the affected population while simultaneously helping with revitalization and recovery. This chapter provides an overview of indirect health consequences in the Fukushima Prefecture area resulting from the nuclear accident of 11 March 2011. Learning from this experience will better prepare the world for similar possible accidents in the future.

Since the 2011 Fukushima nuclear accident, tremendous resources have been devoted to recovery, and the Japanese Government is gradually lifting evacuation orders. However, public concerns remain prevalent, affecting some people’s return to a normal life and threatening their well-being. This study reviews government reports, academic papers, newspaper articles and conference presentations with the aim of obtaining a better understanding of issues which relate to radiation concerns in the recovery process in the aftermath of the accident. It looks extensively at: (1) the current status of the post-accident operations and existing radiation issues in Fukushima, and (2) approaches taken to engage the public during recovery from five previous comparable nuclear and radiological events: Three Mile Island, Buenos Aires (RA-2 facility), Chernobyl, Goiânia and Tokai-mura. The findings indicate that the limitations and emerging challenges of the current recovery operations cause concerns about radiation exposure in various aspects of day-to-day life. Past experiences suggest that long-term management that take a holistic and cohesive approach is critical for restoration of sustainable livelihoods and for social re-integration. Not only actual risks but also public perceptions of risks should be carefully assessed and addressed in the process of environmental remediation.

The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.

This chapter recognizes that all types of violence and different kinds of security threat are not only external, but also internal. It covers all aspects of our lives. In comparison to civil war, genocide or ethnic cleansing, most non-state terrorism has not been a major killer. The chapter talks about political violence and war that has been identified as a major public health problem, not only because of the deaths and disability they cause, but also because of their longer term and more indirect effects on the health, well-being, livelihoods of individuals, families, and communities. The wars and political violence shift large amounts of scarce resources from social and health services to the military. The high levels of psychological distress increases the burden of non-communicable diseases. The chapter explains ongoing scholarly efforts which focusses on collecting data on war, only limited data have been collected regarding violence against civilians. Wars cause malnutrition by increasing food prices, which reduces food accessibility.