三味線プロジェクト:「28の提言」を公表 / EU-OPERRA SHAMISEN project releases "28 recommendations"

三味線プロジェクト SHAMISEN Project」は、EUが「原発大事故後の被災者健康管理とリスク・コミュニケーションの在り方に対する提言を行うこと」を目的に、2015年12月に始めたプロジェクト(ちなみにSHAMISENというややふざけた名称は、同プロジェクトの正式名称 Nuclear Emergency Situations – Improvement of Medical and Health Surveillance(原子力緊急事態 — 医療保健サーベイランスの改善)の頭文字を逆にならべたもの)。日本からは福島医科大学(谷川攻一教授)、広島大学(神谷研二教授)、長崎大学(山下俊一教授)、放射線医学総合研究所(チエリ-・シュナイダー博士)が参加している。



The EU-OPERRA SHAMISEN project started in December 2015, with the goal of “producing a set of recommendations that would contribute to health surveillance and related communication with affected populations after nuclear accidents.” (The name of SHAMISEN, referring to a three-stringed traditional Japanese musical instrument, is the reversed abbreviation of Nuclear Emergency Situations – Improvement of Medical and Health Surveillance. A rather unusual name for such a serious endeavor.) SHAMISEN has 15 partner organizations, including 4 from Japan.

The SHAMISEN Project can be summarized as an apparently well-meaning attempt, in the face of the collapse of the “nuclear safety myth” after the major accidents at Three Mile Island, Chernobyl and Fukushima Daiichi nuclear power plants, to provide ideas how to live along with future major nuclear accidents, while presupposing continued use of nuclear power and saying nothing of an eventual exit from nuclear power —the best possible radiation protection measures.

The Project’s 28 recommendations are :

  1. The fundamental ethical principle of doing more good than harm should be central to accident management.
  2. Recognise the difference between health/medical surveillance and epidemiology, and their different objectives and data needs.
  3. Encourage a health surveillance strategy that targets the overall well-being of populations and not only addresses radiation effects, but also psychosocial and socio-economic impacts induced by the consequences of a nuclear accident.
  4. Ensure that health surveillance respects the autonomy and dignity of affected populations, and is sensitive to any inequity in the distribution of risks and impacts.
  5. Review existing health monitoring systems with particular emphasis on cancer registries and, where needed, improve or establish new ones for epidemiological surveillance. Disease registries must be expanded through better harmonisation and linkage within and between countries. All aspects related to data protection and ethical rules need to be addressed and resolved.
  6. Adapt dosimetry and individual exposure monitoring to the exposure pathways, the phase of the accident, the general situation and the different concerns and needs of people and society, and where needed, improve or establish new approaches of dose assessment.
  7. Build a radiation protection culture between radiation protection experts, healthcare workers, professionals and the general public.
  8. Establish early response and communication protocols with responsibilities and roles clearly laid out. Engage relevant stakeholders in the establishment of these protocols, and prepare the necessary material and channels to communicate with the public (including social media).
  9. Plan sheltering, evacuation and stable iodine distribution protocols, including prioritisation of vulnerable populations (e.g. children and pregnant women), and appropriate balancing of life-protection actions against the potential health impacts of evacuation, particularly for patients and nursing home residents.
  10. Prepare and facilitate training and education material and resources adapted to healthcare and other professionals, as well as other stakeholders.
  11. Prepare frameworks and checklists for epidemiological protocols, questionnaires and consent forms for individual dosimetric and health monitoring, and appropriate databases through local, national and international coordination, ensuring ethics approvals.
  12. Prepare action frameworks focused on dose assessment for workers and populations, with the objectives of: 1) monitoring as many individuals as possible, in particular among critical groups; and 2) collecting and maintaining the results and other relevant data for future needs.
  13. Foster participation of stakeholders and communities by engaging them in emergency preparedness, including planning for socio-economic health surveillance and, where appropriate, epidemiology.
  14. Ensure prompt sharing of accurate and reliable information (e.g., plant conditions, radiation dose, radiation protection actions) between nuclear plant representatives, authorities, experts and the population.
  15. Optimize the timing and support for sheltering and evacuation to reduce radiation exposure, avoid negative health effects arising from evacuation or relocation, and provide the necessary medical and psychological assistance.
  16. Create a common roster, collecting minimum prerequisite information from affected populations to allow ef cient medical and health follow-up and facilitate future epidemiological studies, where feasible, to be shared between relevant organisations with appropriate pre-obtained ethics approvals.
  17. Collect and store all radiation-related dosimetry data (both for workers and for the public) to ensure traceability of all measurements, even those that do not appear relevant from an immediate radiation protection viewpoint, since these may be crucial for accurate dose reconstruction at a later date.
  18. Provide support to populations who wish to make their own measurements, recommending reliable equipment and resources (e.g., apps, social media, information centres) that can contribute to the characterisation of population exposure and its evolution.
  19. Continue dose assessment for workers and affected population as, in this phase, dosimetry and monitoring can be useful for increasing radiological protection knowledge and culture, reassurance, helping people manage their own exposure and supporting epidemiology.
  20. Continue dose measurement support to populations by providing access to equipment such as personal dosimeters and mobile applications, food measurements and whole body counting, together with adequate expert counselling resources to support these measures.
  21. Build networks of experts – local facilitators – population to assist with the dissemination of scienti c information and facilitate two-way communication through the creation of dialogue spaces where affected people can voice their needs and worries and receive practical advice on everyday life.
  22. Have plans for lifting of evacuation orders as soon as possible to minimise the adverse effects of evacuation on physical and mental health of evacuees, and communities.
  23. Consider the preferences of people living in affected areas when deciding whether mitigation actions should be revised, lifted or extended according to the evolution of the situation (e.g. individual dose monitoring, decontamination of living places, psychosocial assistance, foodstuff surveillance).
  24. Expand support for affected populations to take into account social and economic upheavals caused by the accident on infrastructures and community welfare.
  25. Launch systematic health screening based on appropriate justi cation and design.Do not recommend systematic thyroid cancer screening, but make it available (with appropriate counselling) to those who request it.
  26. Clarify objectives and expected results of epidemiological studies, justifying the design and methods and explaining the limitations.
  27. Ensure long-term sustainability of follow-up of populations at risk for comprehensive ascertainment of potential health consequences of nuclear accident.
  28. Foster long-term participation of affected populations and communities by engaging them in decision-making, particularly with regard to health surveillance, with the aim of improving the relevance, ef ciency and acceptability of the interventions and maintaining radiation protection awareness.


報告書ダウンロード/Download the report Recommendations and procedures for preparedness and health surveillance of populations affected by a radiation accident​ (pdf)