The U.S. Army Public Health Command played a significant public health role in the aftermath of the March 11, 2011, Japanese earthquake and tsunami. USAPHC responders monitored radiation levels from the damaged Fukushima Daiichi nuclear power plant, checked the safety of water and food, and assessed search-and-rescue dogs coming into the country to assist in finding the missing.
A year-and-a-half later, it looks as though USAPHC will have a decades-long role to play through the creation and maintenance of the Operation Tomodachi Registry.
The registry's purpose is to provide general information about the incident; location-based, estimated radiation doses for the DOD-affiliated population; and a way for registry users to contact the registry staff. Launched Sept. 5, 2012, the registry currently includes estimated radiation exposure information for 13 mainland Japan locations where most of the approximately 70,000 DOD-affiliated people were during the incident.
"We used this opportunity to build a model for future exposure registries, one that's flexible enough to manage a wide range of potential environmental exposures," according to Brad Hutchens, an environmental engineer whose program lead the creation of the registry and will manage it as part of the Defense Occupational and Environmental Health Readiness System. "Development of this registry is unique, because DOD has not previously taken such a proactive approach."
One significant reason for DOD's approach was the health concern of Soldiers and family members in Japan. "People are generally concerned about radiation," Hutchens said. "They wanted to make sure it was properly monitored and documented."
Jerry Falo, a USAPHC radiation safety expert who holds a doctorate in health physics, agrees.
"We've all seen the images portrayed in movies and on TV; they reinforce people's fear of radiation," Falo said. "We (scientists) know what happens at high levels of radiation exposure--much higher than those seen with this accident--but at the levels seen in the DOD-affiliated population, the Health Physics Society's position statement says it best: 'Risks of (adverse) health effects are either too small to be observed or are nonexistent.'"
Falo was part of a working group of DOD scientists charged with estimating radiation doses in locations where DOD-affiliated personnel were present. Health effects from radiation exposure are not expected in the DOD-affiliated population.
The working group included experts in health physics, nuclear engineering, radiological health sciences and medical physics from the three U.S. military services, the Armed Forces Radiobiological Research Institute, and the Defense Threat Reduction Agency. They analyzed the radiation levels in mainland Japan from March 12 to May 11, 2011, applying U.S. standards to data gathered by multiple agencies from multiple sources.
"We looked at DOD, Department of Energy and Japanese government environmental data on air, water, soil and external (monitoring) measurements. We looked at breathing rates, ingestion rates and time spent outdoors," Falo said. "We took high-side EPA estimates and assumed no time indoors for 60 days--it's unlikely that a person's actual radiation doses would be higher than the levels described in the registry."
Registry dose estimates currently include adults by age groupings and children by age groupings. In the future, dose estimates for embryos, fetuses and nursing infants will be included.
This documentation can be used by medical providers to discuss patient concerns about potential radiation exposures they may have received during the March 12 to May 11, 2011, timeframe.
"Much is done at the time (an incident occurs) to reduce risk, take care of people and address the situation, but we haven't always created documentation for the long term," Hutchens pointed out.
By the end of the calendar year, the nearly 70,000 identified people will be entered into DOEHRS and associated to the location-based estimates.
USAPHC was selected to create the registry because of its experience in managing DOEHRS and because of its experience in creating and managing the Operation Desert Storm Kuwait Oil Fires project, Hutchens said. DOEHRS manages industrial hygiene, environmental health, radiation and incident reporting data for the DOD.
In addition to its technical and scientific expertise, the USAPHC contributed risk communication expertise to the development of the registry.
"I help the subject-matter experts take that incredible amount of data and translate it to what it means to service members, families and DOD-affiliated people who were on the island or in the other designated areas at the time the registry covers," said senior USAPHC risk communicator Bethney Davidson.
As the registry was planned, transparency of communication and the provision of usable information "for years to come" were key communication goals, she added.
The Office of the Assistant Secretary of Defense (Health Affairs), Force Health Protection and Readiness is the sponsoring agency, and experts from the Defense Threat Reduction Agency, Naval Health Research Center and others contributed to the registry content.
The registry is online at http://registry.csd.disa.mil/otr.
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