Change in and long-term investigation of neuro-otologic disorders in disaster-stricken Fukushima prefecture: Retrospective cohort study before and after the great east Japan earthquake

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Abstract

On March 11, 2011, Japan's northeast Pacific coast was hit by a gigantic earthquake and subsequent tsunami. Soma City in Fukushima Prefecture is situated approximately 44 km north of Fukushima Daiichi Nuclear Power Plant. Soma General Hospital is the only hospital in Soma City that provides full-time otolaryngological medical care. We investigated the changes in new patients from one year before to three years after the disaster. We investigated 18,167 new patients treated at our department during the four years from April 1, 2010 to March 31, 2014. Of the new patients, we categorized the diagnoses into Meniere's disease, acute low-tone sensorineural hearing loss, vertigo, sudden deafness, tinnitus, and facial palsy as neuro-otologic symptoms. We also investigated the changes in the numbers of patients whom we examined at that time concerning other otolaryngological disorders, including epistaxis, infectious diseases of the laryngopharynx, and allergic rhinitis. The total number of new patients did not change remarkably on a year-to-year basis. Conversely, cases of vertigo, Meniere's disease, and acute low-tone sensorineural hearing loss increased in number immediately after the disaster, reaching a plateau in the second year and slightly decreasing in the third year. Specifically, 4.8% of patients suffering from these neuro-otologic diseases had complications from depression and other mental diseases. With regard to new patients in our department, there was no apparent increase in the number of patients suffering from diseases other than neuro-otologic diseases, including epistaxis, and allergic rhinitis. Patients suffering from vertigo and/or dizziness increased during the first few years after the disaster. These results are attributed to the continuing stress and tension of the inhabitants. This investigation of those living in the disaster area highlights the need for long-term support.

Figures

  • Fig 1. A map of the area around SomaGeneral Hospital. Soma City is located 44 km north of Fukushima Daiichi Nuclear Power Plant. Soma General Hospital and a clinic in Minami-Soma City are the only two places that employ a full-time ENT doctor. In other hospitals, part-time doctors see patients in outpatient settings once or twice a week. Approximately one-third of the southern side of Minami-Soma City is part of the evacuation area. People in the other two-thirds of the city are suffering from a great deal of anxiety and stress. Railways were damaged by the disaster. The railway north of Soma City was washed away by the tsunami, and train service along the railway south of Minami-Soma City has been suspended for three years because of the accident at the nuclear power plant.
  • Fig 2. Demographic transition in Soma City, Minami-Soma City, and Shinchi Town (excerpt from Fukushima Prefectural Home Page: http://www. pref.fukushima.lg.jp/). After the disaster, many people voluntarily evacuated to other places without changing their residence registry. The exact number of
  • Fig 3. Number of outpatients from all the departments at Soma General Hospital, and the number of new patients and revisiting patients of the ENT department. Those patients who had not visited us for more than 6 months were regarded as new patients. After the disaster, the number of new patients increased 7.7% in the first year, 4.8% in the second year, but decreased 0.8% in the third year. Thus, the differences were small.
  • Fig 4. Investigation of the new ENT patients from April to the following March by living area. (a) For all new patients, the number from Soma City decreased, but that fromMinami-Soma City and other evacuation areas increased. (b) Those with vertigo, MD, and ALHL increased in each area. In Soma City and Shinchi Town, the number peaked in the second year and showed a slight decrease in the third year. On the other hand, the number of new patients in Minami-Soma City and the evacuation areas remained about the same.
  • Fig 5. Diseases of the new patients in the ENT department of Soma General Hospital. There was an increase in the number of cases of vertigo, MD, ALHL, and laryngopharynx inflammation. However, we found no change in the number of cases of epistaxis, acute tonsillitis, peritonsillitis, parapharyngeal abscess, tinnitus, sudden deafness, facial nerve paralysis, and allergic rhinitis, conjunctivitis, or pharyngitis.
  • Fig 6. Diseases complicated with vertigo, MD, and ALHL.Depression and depressive type were the two diseases with the largest number of patients (27 cases). Other frequently seen diseases were anxiety disorder, neurosis, somatoform disorder, anxiety neurosis, adjustment disorder, and post-traumatic stress disorder (PTSD).

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APA

Hasegawa, J., Hidaka, H., Kuriyama, S., Obara, T., Hashimoto, K., Tateda, Y., … Katori, Y. (2015). Change in and long-term investigation of neuro-otologic disorders in disaster-stricken Fukushima prefecture: Retrospective cohort study before and after the great east Japan earthquake. PLoS ONE, 10(4). https://doi.org/10.1371/journal.pone.0122631

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