GENERAL PUBLIC HEALTH IMPACTS OF NATURAL
CASE BOX 3.5 THE GREAT EAST JAPAN EARTHQUAKE IN 2011
By Carman Mark and Makiko Kato MacDermot
The devastating Great East Japan earthquake combined with a tsunami and nuclear explosion resulted in great mortality, massive destruction of health facilities, and release of radioactive material. Figure 3.10 shows the destruc-tion caused. It can be understood by identifying the five general public health consequences and the economic impact.
Background
A magnitude 9.0 earthquake occurred at 14:46 JST on 11 March 2011 off the north- east coast of Japan. It was an earthquake with the highest magnitude in the history of Japan and the fifth largest in the history of the world. The earthquake induced a 15- meter high tsunami that struck the land and caused widespread flooding and electricity failure about 40 minutes after the initial quake. The tsu-nami also triggered partial nuclear meltdowns and explosions at the Fukushima Daiichi Nuclear Power Plant located 150 km north- east of the epicentre. Radioac-tive material was released into the air, water and food, and a 20- kilometre ation zone was established where tens of thousands of people had to be evacu-ated. More than 24,000 people were killed or went missing in the catastrophe.
Unexpected mortality and morbidity
Most deaths were due to drowning, and the highest mortality was among the elderly. Hypertension, deep- vein thrombosis and respiratory problems were the most common reported illnesses among the victims. In addition, outbreaks of influenza and infectious gastroenteritis were identified in evacuation centres.
Destruction of health infrastructure
Health infrastructure and services were heavily disrupted. Unofficial sources reported that health facilities were damaged in 11 municipalities and at least 30 nursing facilities for the elderly were destroyed. After two weeks, the health facilities were still incapable of performing. In Iwate, Fukushima and Miyagi, 52% of health facilities were unable to accept new patients. Fourteen per cent of them were lacking health workers. In addition, electricity failure and lack of water supply disturbed the facilities’ operation.
Adverse effects on the environment and population
The tsunami washed away many of the coastal and river bank areas. The coastal ecosystems may have been destroyed, and reconstruction operations FIGURE 3.10 The aftermath of the Great East Japan earthquake
Source: Photo by Dylan McCord / Public Domain (https://en.wikipedia.org/wiki/
Aftermath_of_the_2011_T%C5%8Dhoku_earthquake_and_tsunami#/media/
File:2011TsunamiFireVehicles.jpg).
could cause environmental pollution. If seawater penetrates far inland, it may also affect the groundwater quality. The damage to the water supply and sewage networks could contaminate the water, leading to the risk of water- borne diseases.
Infl uence on social behaviour and psychological health Many people lost their loved ones, their homes and possessions. Unemploy-ment was prominent immediately after the disaster. Six months later, post- traumatic stress disorder cases were reported.
Undesirable long- term consequences
The accident was regarded as a “severe accident” or level 7 (the highest level) on the International Nuclear and Radiological Event Scale. WHO Report on the Health Risk Assessment from the nuclear accident indicated the increased lifetime risks for the development of leukaemia, breast cancer, thyroid cancer and all solid cancers. The emergency workers were also at a high risk of devel-oping cancer and non- cancer risks related to radiation. Five days after the acci-dent, Japan’s Nuclear Safety Commission recommended local authorities to instruct their citizens to ingest single- dose iodine as a precaution, and close to 2,000 workers were given stable iodine in the emergency response. The long- term consequences due to the released radioactive material are still unknown, requiring further monitoring.
Economic impact
The total loss and damage was estimated at US$309 billion (5.7% of GDP).
The damage was the sum calculation from triple disasters: earthquake, tsu-nami and nuclear explosion. Most severely affected areas were dependent on agriculture, fishing and manufacturing. These industries were heav-ily damaged. In addition, internationally, the United States Food and Drug Administration banned imports of spinach and kakina leafy vegetables from the affected region. All milk and dairy products manufactured in the affected prefectures were not allowed to enter the US market unless proved free from radioactive contamination (Asian Disaster Reduction Center [ADRC], 2011;
Nohara, 2011; United Nations Environment Programme [UNEP], 2011; WHO Regional Office for the Western Pacific, 2011).
Conclusion
Five general public health consequences of disasters are usually observed after natu-ral disasters (see Case Box 3.5). These include unexpected mortality and morbidity, destruction of health infrastructures and service provision, adverse impact on the
environment and population, adverse impact on the psychological and social well- being of the population, and other effects with long- term consequences, such as development setbacks in low- income countries resulting from the frequent eco-nomic losses related to disasters.
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The human health impact of natural disasters varies according to the risk fac-tors associated with the specifi c hazards, exposure and community vulnerabilities.
Health impact caused by earthquakes, tsunamis, volcanic eruptions, fl oods, extreme temperature events, cyclones, droughts and famines will be discussed in this chapter.
Geophysical hazards: earthquake and tsunami
An earthquake is a geophysical event caused by seismic waves which lead to the shaking and displacement of the ground. It is the result of a sudden release of energy stored in the earth’s crust. During an earthquake, individuals located in places near the epicentre can feel the shaking or displacement of the ground (Centre for Research on the Epidemiology of Disasters [CRED], 2009). After-shocks are also caused by seismic waves after the major earthquake and might be of similar and lesser intensity. Tsunamis are a specifi c by- product of earth-quakes, which originate beneath the ocean fl oor. A tsunami may produce high waves, which approach the shoreline. The health impact of a tsunami is similar to that of a fl ash fl ood, which will be discussed in a later section.
How is it reported?
The Richter scale is the most commonly used scale to report the strength or the amount of energy released by an earthquake. It is calculated from the amplitude of the largest seismic wave recorded for a given earthquake and reported on a logarithmic scale. For each whole number increment of the Richter scale score, the strength of the earthquake increases ten times. A level- 8 earthquake on the Richter scale is ten times stronger than a level- 7 earthquake. However, the Richter