Japan is crippled after a massive earthquake and a massive tsunami, and it faces severe health threats both in the immediate future and in the longer term.
The greatest near-term health concerns are traumatic injury, lung problems in survivors of near-drowning, risk of infection, psychological distress, and contamination of drinking water. With millions displaced from their homes and many thousands injured, it is likely becoming more and more difficult for emergency workers to reach and treat those most in need. Even a highly sophisticated industrialized society like Japan is severely handicapped when it loses power.
Radiation risk is a growing concern. The Japanese Nuclear and Industrial Safety Agency has reported that at least 160 workers have already been exposed to radiation. Fifteen workers have been hospitalized with acute radiation sickness, which affects rapidly growing cells and tissue such as that found in the gastrointestinal tract, hair, reproductive tract, and blood.
Symptoms of radiation sickness include nausea, vomiting, diarrhea, headache, and fever. Victims can develop itchy, swollen, or “burned” skin, and can lose their hair. To become severely ill, you would likely have to be exposed to around 100 rem of radiation, or 10,000 times more than you would receive from a chest X-ray. The first step in managing radiation is decontamination, which involves removing clothes, washing, treating organs that have been damaged, and treating the pain that results.
Then there are the longer-term health risks, prominent among them cataracts, birth defects, and cancer. Following the infamous Chernobyl meltdown in 1986, close to 6,000 cases of thyroid cancer in children were linked to exposure to iodine-131, which can stay in the body close to a week and is absorbed by the thyroid gland, damaging it. Studies have revealed that those who took potassium iodide pills in Poland in the wake of Chernobyl (10.5 million children and 7 million adults) were mostly protected from thyroid cancer.
For this reason, the Japanese government is justified in handing out potassium iodide pills as a prophylactic measure, though this move will definitely spread fear and raise the anxiety level by sending the message that radiation exposure is imminent.
Potassium iodide protects the thyroid, but it does not protect against other cancer-causing components of radiation. Following Chernobyl, there appears to have been an increased incidence of leukemia in cleanup workers, though the radiation has not been proved to be the cause. Strontium-90 is absorbed by the bones and can lead to leukemia, and cesium is absorbed into the bloodstream and can lead to solid tumors (such as cancer of the kidney, liver, or pancreas). Perhaps most worrisome of all, plutonium-239 has a radioactive half-life of 24,000 years and is a known cause of lung cancer.
As always in a disaster of this magnitude, as serious as the physical risks are, the psychological risks are just as great. Growing anxiety is tied to fear of the unknown, and ultimately to fear of death. Post-traumatic stress disorder is likely to be a prominent feature of this tsunami, just as it was after the 2004 disaster in Sri Lanka, where close to 50 percent of adults and 30 percent of children were affected. Victims can expect to experience sleepless nights, panic, depersonalization, and nightmares.
For the island of Japan, with all its resources, sophisticated infrastructure, and self-reliance, help from the rest of the world is surely welcomed. The U.S. is offering its assistance in the humanitarian effort, beginning with the massive, comforting presence of the USS Ronald Reagan, a floating city that includes a floating hospital.
— Marc Siegel, M.D., is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a Fox News medical contributor.