国の健康支援 福島住民の拡充要求に 安倍はあっち向いてホィ、と逆ギレ

7/22付東京新聞の会員サービス記事、海外でも大きく報道されている。管理人

原発事故後の健康支援で逆走　環境省の専門家会議:

福島原発事故後の健康支援を議論する環境省の専門家会議が、あらぬ方向に走り始めている。今月十六日の会合でも、外部から招いた研究者が健康診断の拡充を求めると、座長は「議論したくない」とそっぽを向いた。

健診拡充は子ども・被災者支援法も求めているが、座長自ら「成立時と現在は状況が違う」という声を上げている。被災者たちがこうした姿勢を到底、受け入れられるはずもない。

◆健診拡充に後ろ向き

「（福島原発事故で拡散している）放射性物質が福島県境でとどまるとは思わない。早く県外の住民の症例も把握すべきだ。放射線量の評価ばかりに、こだわるべきではない」

16日にあった環境省の専門家会議。ゲストで招かれた疫学者の津田敏秀・岡山大教授は、同県内外の住民がどれだけ被ばくしたかの議論に時間を費やす会議の現状に疑問を呈した。

しかし、座長の長滝重信・元放射線影響研究所理事長は「非常にユニークな方がおられる」と、津田教授の指摘を突き放した。

同県では事故直後から県民健康調査が実施され、事故当時18歳以下だった県民を対象に甲状腺検査などが進められている。ただ、現在は国費による健康調査は福島分のみ。このため、専門家会議では現在、他の地域でも健診などが必要か否かを議論している。

座長の長滝氏は、①同県内外の住民の被ばく線量を評価②線量に基づく健康影響を分析③必要な健康支援が何か考える─という方針を掲げており、6月26日の前回（第7回）会議で、ようやく線量評価の骨子がおおむねまとまった。

骨子には、独立行政法人・放射線医学総合研究所の推計や同県による住民の行動調査などから、甲状腺がんを引き起こす放射性ヨウ素の内部被ばくは「大半が50ミリシーベルト以下」、外部被ばくは「『福島県でも99.8％が5ミリシーベルト以下』という調査結果は全体の傾向を見る上で妥当」と記された。

だが、この評価結果は不確かな部分が大きい。

ヨウ素被ばくを分析しようにも、実測したのはわずか1000人程度。同県による甲状腺検査対象の0.3％だ。放射性ヨウ素は半減期が8日と短く、現在からは実測し難い。外部被ばくの行動調査も、回答率は25.9％と低迷している。

津田教授は会議の席上、「病気とその原因の因果関係を考える際、原因側のデータが少なくなりがちだ。病気の側から考えるのが、国際的な疫学分析の基本になっている。原因から考えるのは、実験室のやり方にすぎない」と主張した。

さらに「線量評価にこだわると対策を先送りし、被害を広げる」と続け、同県内外で甲状腺がんやその他の病気の症例把握のため、早急に健診し、事故を境に病気が増えたか、地域によって差があるかなどを分析すべきだと強調した。

会議に招いたにもかかわらず、座長の長滝氏はこの意見をほぼ無視した。

この対応に対し、津田教授は「私はオックスフォード大出版局の教科書に基づいて発言している。先生の方がユニークですね」と応酬したが、長滝氏は「先生と議論するつもりはありません。線量に基づいて議論する」と述べ、一方的に話を打ち切った。

◆住民の期待に応えず

国の放射線の健康影響に対する消極評価は、今に始まったことではない。

内閣府の有識者会議「低線量被ばくのリスク管理に関するワーキンググループ（ＷＧ）」は2011年12月に報告書をまとめ、「発がんリスクの増加は100ミリシーベルト以下の被ばくでは他の要因の影響に隠れるほど小さく、明らかな増加の証明は難しい」と断じた。

内閣府のＷＧも、長滝氏が議長を務めた。環境省の専門家会議で委員を務める丹羽太貫・福島県立医科大特命教授や、遠藤啓吾・京都医療科大学長もメンバーだった。

専門家会議は現在のところ、同県内外の被ばく線量は100ミリシーベルトをかなり下回ると見込んでいるため、「放射線による健康影響は証明できない」「影響が証明できない以上、福島県内の健診すら不要」という方向に傾き始めている。

実際、専門家会議では、すでに健診拡充に後ろ向きな発言が出ている。

12年6月に成立した子ども・被災者支援法は健診拡充や医療費軽減などを求めているが、長滝氏は第7回会議で「法案ができた時と、今と非常に大きな違いがある」「線量の評価がどんどんでき、リスクについて科学的に物が言えるようになった」と、必要性に否定的になっている。

同様に専門家会議メンバーの祖父江友孝・大阪大教授は、同じ会議で「過剰診断」という言葉を使い、健診の不利益を説いた。

これは甲状腺がんのように進行が遅いがんでは、寿命まで発症せず、体に悪さをしない可能性がある。にもかかわらず、健診でがんを見つけることで、余計な不安を抱かせたり、手術による心身の負担を生じさせたりするという意味だ。

同じくメンバーの鈴木元・国際医療福祉大クリニック院長も「住民の健康不安に対し、健診をすることが本当にベストアンサーなのか、十分議論しないといけない」と主張する。

ただ、党の住民側からは逆に健診の拡充を求める声がわき上がっている。

今月13日には原発事故後の生活について、福島県内外の母親らが語り合う会合が東京都内であった。

参加した栃木、茨城、千葉、埼玉の4県で甲状腺検査をする市民団体「関東子ども健康調査支援基金」の稲垣芳さん（42）は「検査の募集では、すぐに申し込みが殺到する」と話した。

出席者の一人で、福島県大玉村から小学2年の娘と神奈川県内へ避難している鹿目久美さん（46）は「原発事故で子どもの病気の不安が増えた。それを調べてもらいたいと思うのは当たり前。福島県内であろうと県外であろうと、母親ならそう考える」と訴えた。

会合を主宰したＮＰＯ法人「子ども全国ネット」の伊藤恵美子代表（51）も「専門家会議は子ども・被災者支援法をないがしろにしている。住民の不安解消につながるわけがなく、不信感しか生まない」と語る。

専門家会議の委員でも、異論を抱く人がいる。その一人、日本医師会の石川広己常任理事は「現在の専門家会議は、住民の意見を反映していない。不安を抱く人に、一方的に『大丈夫』と言わんとする人の気がしれない」と批判する。

「低線量被ばくの影響は誰にも分からない」という立場から「放射線により、何らかの病気が生じていないか、生じた場合、どう対処するかを早く検討しなければならない。そうした備えがあって、初めて不安は解消できる」と語る。

「健診の利益や不利益は専門家を称する人たちが、一律に決められるものではない。健診の体制を整えたうえ、当事者である住民に判断を委ねるべきだ」

［デスクメモ］
専門家会議を長滝さんが仕切っている。この事実だけで、政府が福島原発事故をどう総括したかは明白だ。放射線影響研究所の前身は「治療せず、原爆の効果を調査」した米国の原爆傷害調査委員会（ABCC）だ。そこに連なる人脈が「安全神話」に関与した。いまは「安心神話」の流布に奔走している。

  

Running Backwards on Health Support After the Nuclear Accident: Ministry of Environment Expert Meeting

The Ministry of the Environment (MOE) Expert Meeting Discussing Health Support After the Fukushima Nuclear Accident is taking an unthinkable twist. At the July 16th meeting, an outside researcher asked for the expansion of health checkups, but the committee chair looked the other way, stating “I don’t want to discuss the issue.” The expansion of health checkup is part of the Act Concerning Support for Children and Disaster Victims, but the committee chair himself voiced an opinion, “We now have different circumstances from when the Act was first approved.” There is no way disaster victims can accept such attitudes.

◆ Hesitant on the Expansion of Health Checkups

“Radioactive materials [being disseminated due to the Fukushima nuclear accident] are not thought to remain within borders of Fukushima Prefecture. We need to urgently figure out if there are any cases in non-Fukushima residents. We should not be fixated only on dose assessments.”

It was the Ministry of the Environment Expert Meeting held on July 16th. An invited guest speaker Toshihide Tsuda, an epidemiologist and an Okayama University professor, challenged the current state of the meeting spending time on discussing what the exposure dose was for residents within and out of Fukushima Prefecture.

However, Shigenobu Nagataki, the committee chair and a former chairman of Radiation Effects Research Foundation, pushed aside what Professor Tsuda pointed out, stating,“You are extremely unique.”

Fukushima Prefecture began the Prefectural Resident Health Survey immediately after the accident, including thyroid examination for those who were under age 18 at the time of the accident. However, the central government currently pays for health examination only for Fukushima residents. Therefore, the Expert Meeting is presently discussing whether other areas might need health checkups.

Chairman Nagataki has set a policy to: 1) Assess the exposure dose for residents within and out of Fukushima Prefecture; 2) Analyze health effects based on the dose; and 3) Consider which health support might be necessary. At the last meeting (the seventh session) on June 26th, the rough outline of dose assessment was finally put together.

The outline, based on the dose estimates by an Independent Administrative Institution, National Institute of Radiological Sciences, as well as the behavior questionnaire of residents by Fukushima Prefecture, stated that the internal exposure dose from radioactive iodine that can cause thyroid cancer was “mostly under 50 mSv.” In regards to the external exposure dose, it noted that “The survey finding, ’99.8% was under 5 mSv in Fukushima Prefecture,’ could be reasonably applied to see the overall tendency.”

However, there are large uncertainties in this assessment result.

Only about 1,000 had direct measurements of exposure from radioactive iodine taken, which is 0.3% of residents eligible for thyroid examination by Fukushima Prefecture. Radioactive iodine has a short half-life of 8 days and cannot be measured now. Behavior questionnaires for external dose assessment had a low response rate of only 25.9%.

During the meeting, Professor Tsuda claimed, “When considering a causal relationship between an illness and a cause, data for the cause often tends to be scant. It is a principle of international epidemiological analysis to see it from the side of the illness. Considering the cause first is merely a laboratory method.”

In addition, he continued, “Fixating on dose assessments will delay countermeasures, worsening the damage.” He emphasized that health checkups should be immediately carried out within and out of Fukushima Prefecture, in order to identify cases of thyroid cancer and other illnesses and to analyze whether the number of cases increased after the accident or whether there are regional differences.

Despite inviting Professor Tsuda to the meeting, Chairman Nagataki practically ignored his opinion.

To this response [by Nagataki calling him unique], Professor Tsuda retorted, “My opinions are based on a textbook published by Oxford University Press. Chairman, you are the one that is unique.” However, Chairman Nagataki unilaterally cut off the conversation, stating, “I have no intention of arguing with you. We are going to carry on discussion based on exposure dose.”

◆ Not Meeting the Expectations by Residents

Passive assessments of radiation health effects by the Japanese government predate this meeting.

The Cabinet Office expert meeting,“Working Group (WG) on Risk Management of Low-dose Radiation Exposure,” put together a report in December 2011, concluding,“…increased risk of cancer from low-dose radiation exposures at 100 mSv or less is so small as to be concealed by carcinogenic effects from other factors, making verification of any clear cancer risk from radiation exceedingly challenging.”　

The Cabinet Office WG was also headed by Nagataki. It also included other members of the MOE expert meeting, such as Ostura Niwa, a special professor at Fukushima Medical University, and Keigo Endo, president of Kyoto College of Medical Science.

The expert meeting, at this point of time, is leaning in the direction of “Radiation health effects cannot be proven,” and “As the effects cannot be proven, even health checkups within Fukushima Prefecture are unnecessary,” since the exposure dose within and out of Fukushima Prefecture is expected to be significantly lower than 100 mSv.

In fact, the expert meeting already has some opinions hesitant on expanding health checkups.

The Act Concerning Support for Children and Disaster Victims [English translation here], approved in June 2012, asks for expansion of health checkups as well as reduction of medical expenses, but Chairman Nagataki cast doubt on the need for it at the seventh session, stating “Circumstances are quite different now compared to the time when the act was approved,” and, “As the dose assessment has progressed, we can now make scientific statements in regards to the risk.”

Likewise, during the same session, a member of the expert meeting and a professor at Osaka University, Tomotaka Sobue, explained disadvantages of health checkups using the term, “overdiagnosis.”

This means that since a slow-growing cancer, such as thyroid cancer, has a possibility of never becoming symptomatic in lifetime and causing damages to the body, discovery of cancer during health checkups could cause excessive anxiety and a psychological and physical burden due to surgery.

Another member and the clinic director at International University of Health and Welfare, Gen Suzuki, claimed “An adequate debate needs to be carried out as to whether the best answer is to conduct health checkups as a response to anxiety by residents regarding their health.”

However, requests for expansion of health checkups are swelling from the side of the parties involved, the residents.

On July 13th, there was an event in Metropolitan Tokyo for mothers from within and out of Fukushima Prefecture to talk about life after the nuclear accident.

One of the participants, Kaoru Inagaki (age 42), a member of citizen’s group, Kanto Children Health Survey Support Fund, which conducts thyroid examination in four prefectures including Tochigi, Ibaraki, Chiba and Saitama, said, “When we announce openings for the examination, they are immediately taken up.”

Another participant, Kumi Kanome (age 46), a mother who evacuated with a second-grade daughter to Kanagawa Prefecture from Otama Village, Fukushima Prefecture, appealed, “The nuclear accident increased our worries about children’s illnesses. It is natural for us to want to have them checked out. Regardless of whether living in or outside Fukushima Prefecture, any mother would feel that way.”

Emiko Ito (age 51), director of the event organizer, non-profit organization “National Parents Network to Protect Children from Radiation,” said, “The expert meeting is ignoring the Act Concerning Support for Children and Disaster Victims. That won’t be conducive to resolving residents’ anxiety. It only leads to mistrust.”

Some of the members of the expert meeting have different views. One of them, Hiromi Ishikawa, Executive Director of Japan Medical Association, criticizes, “The present expert meeting does not reflect opinions of the residents. I don’t know why anybody would just one-sidedly tell worried people, ‘It’s okay.’”

From a stand point of “nobody knows the effect of low-dose radiation exposure,” he says, “We need to quickly consider whether there are any illnesses due to radiation and how to deal with them if there are any. Worries can be only resolved when we are prepared that way.”

“Advantages and disadvantages of health checkups are not something that can be uniformly decided by those who are called experts. We need to establish the system for health checkups and let the residents, who are the parties involved, decide.”

 

Memo from the editing desk:

Mr. Nagataki is running the expert meeting. This fact alone makes it clear how the government has summed up the Fukushima nuclear accident. The predecessor of Radiation Effects Research Foundation was the United States Atomic Bomb Casualty Commission (ABCC), which “investigated the effects of atomic bombs without treatment.” A network originating there was involved in developing the “Myth of Infallible Safety.” Now they are working hard to spread the “Myth of Reassurance.”