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Temporal changes in environmental health
risks and socio-psychological status in
areas affected by the 2011 Tsunami
in Ishinomaki, Japan
Makita K1,2, Inoshita K1, Kayano T1, Hagiwara K1, Asakawa M1, Ogawa K3, Noda
J1, Sasaki H3, Nakatani N3, Higuchi H1, Iwano H1 and Tamura Y1
1. School of Veterinary Medicine, Rakuno Gakuen University (RGU), Japan
2. International Livestock Research Institute (ILRI)
3. College of Agriculture, Food and Environmental Sciences, RGU

International Conference of EcoHealth 2013
Abidjan, Côte d’Ivoire
March 11, 2011, Ishinomaki
March 11, 2011, Ishinomaki
Objectives
• To understand environmental health risks
from microbiological and chemical hazards
– Level of hazard
– Probability of exposure (whether people live
affected areas again)

• To understand socio-psychological status of
evacuees
• To advise local government for better policy
support
Materials and methods
• Literature review
• Biological and chemical survey
– Stratified random sampling of neighborhood
associations
– Sample size based on Vibrio cholerae O1
prevalence (3.6% of river water), precision 90%
– Entomology, rodents, microbiology, ions and
heavy metals
– July and Aug 2011, and Aug 2012
Materials and methods
• Socio-psychological survey
– Participatory appraisals
– Questionnaire surveys: two urban (44 respondents) and one
rural (16) temporal housing complexes (Sep 2012)
– K6 as response variable for mental health
– Age, sex, health problem, family, friends, amusement, income,
environment
Study site
Phase I: Impact phase (0-4 days)
(Literature review)

• Deaths and missing 3,833: 20% of total casualty
19,139
• 13% of the city flooded (70% lived)
• 31.6% of population dislocated to shelters (51K)
• Health problems
– Tetanus 7, legionellosis 2 (by Tsunami)
– Dehydration, vomiting, diarrhea and deep vein
thrombosis (over crowded shelters)
Home

Disaster shelter
Phase II: Post-impact phase (4 days – 4 weeks)
(Literature review)

• Restoration of affected areas
• Construction of temporary housing complexes
• Diseases in disaster shelters
– Gastro-intestinal diseases 92, influenza 15,
respiratory diseases 788, rash 5, scabies 6 and
injury 2
– Hygiene established
– A few infectious disease outbreaks

Disaster shelter

Home, temporary
housing complex
Phase III: Recovery phase (>4 weeks)
(Literature, volunteer records and participatory methods)

• Closure of disaster shelters (Oct 11, 2011)
• Degradation of environment
– Fish from damaged processing factories
– Animal feed concentrate from damaged factories

Disaster shelter

Home, temporary
housing complex
Animal feed concentrates
and sludge (June 2011)

Rotten fish and flies
(June 2011)
Distributions of flies
(July 2011)
Total bacteria 108.7 (95%CI: 107.3-1010.1)
Enterobactericeae 108.0 (95%CI: 106.6-109.5)

Musca domestica

Spaerocerdae

Phomiaregina meigen

• Piled fish discarded by July 6
• Number of flies decreased by August
Rodents

Slope=0.08 (Log10), p=0.005
Apodemus speciosus

Mus musculus
Prevalence of Vibrio and Aeromonas
Surface water
Vibrio cholerae*
Vibrio fluvialis
Aeromonas hydrophila
Sludge
Vibrio cholerae*
Vibrio fluvialis
Aeromonas hydrophila
* non-O1, O139 V. cholerae

July 2011
n=13
3 (23.1%)
1 (7.7%)
1 (7.7%)
n=12
3 (25.0%)
4 (33.3%)
2 (16.7%)

August 2011 p-value
n=14
3 (21.4%)
1
3 (21.4%)
0.60
4 (28.6%)
0.33
n=12
3 (25.0%)
1
4 (33.3%)
1
2 (16.7%)
1
Microbiology for surface water (Log10 scale)
Total bacteria

Enterobacteriaceae

p=0.5
*p=0.006

n=14

n=14

n=14

Bacillus spp.
p=0.4

n=12

n=17

n=14

Clostridium spp.
p=0.4

n=9

p=0.2

n=12

*p=0.02

n=17

n=9
Microbiology for sludge (Log10 scale)
Total bacteria

Enterobacteriaceae

*p<0.001

n=15

*p=0.046

n=15

n=15

Bacillus spp.
p=0.9

n=11

Clostridium spp.
*p<0.001

n=15

n=15

n=9

p=0.2

n=11

*p=0.004

n=15

n=9
Ions
Jul 2011

Aug 2011

Jul 2011

Aug 2011
Other findings
• Hepatitis E virus DNA (1/20 samples)
• No high level of heavy metal concentration
Socio-psychological results
• Wish to live in the same place again
– Urban: 30.6% (11/36)
– Rural: 64.2% (9/14), others upland relocation *Fisherman village

• Obstruct for making a wish (in urban areas)
– Financial problem (58.3%, 7/12)
Risk factors for severe mental health (Generalized Linear Models with Poisson errors)

Factors
Attributes Sample
Health problem of the respondent or Exist
26
family
Not exist
24
Friends in the housing complex
Exist
42
Not exist
16
Trusted person to counsel in the housing Exist
29
complex
Not exist
22

Percentage K6 p-value
52.0
3.0 <0.001

72.4
56.9

9.9
5.0 0.003
10.6
3.3 0.005
10.9
Conclusion
• Infectious diseases were well controlled
• Environmental health risk was low
• Rodents need to be monitored
• Mental care and financial supports are needed
for evacuees
Acknowledgements
•
•
•
•
•
•

Mitsui & co Ltd.
Ishinomaki City Council
NGOs (APCAS, PARCIC, P-CAT, Agarain)
Rauno Gakun University (RGU)
RGU volunteers
Participants in the study

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Temporal changes in environmental health risks and socio-psychological status in areas affected by the 2011 tsunami in Ishinomaki, Japan

  • 1. Temporal changes in environmental health risks and socio-psychological status in areas affected by the 2011 Tsunami in Ishinomaki, Japan Makita K1,2, Inoshita K1, Kayano T1, Hagiwara K1, Asakawa M1, Ogawa K3, Noda J1, Sasaki H3, Nakatani N3, Higuchi H1, Iwano H1 and Tamura Y1 1. School of Veterinary Medicine, Rakuno Gakuen University (RGU), Japan 2. International Livestock Research Institute (ILRI) 3. College of Agriculture, Food and Environmental Sciences, RGU International Conference of EcoHealth 2013 Abidjan, Côte d’Ivoire
  • 2. March 11, 2011, Ishinomaki
  • 3. March 11, 2011, Ishinomaki
  • 4. Objectives • To understand environmental health risks from microbiological and chemical hazards – Level of hazard – Probability of exposure (whether people live affected areas again) • To understand socio-psychological status of evacuees • To advise local government for better policy support
  • 5. Materials and methods • Literature review • Biological and chemical survey – Stratified random sampling of neighborhood associations – Sample size based on Vibrio cholerae O1 prevalence (3.6% of river water), precision 90% – Entomology, rodents, microbiology, ions and heavy metals – July and Aug 2011, and Aug 2012
  • 6. Materials and methods • Socio-psychological survey – Participatory appraisals – Questionnaire surveys: two urban (44 respondents) and one rural (16) temporal housing complexes (Sep 2012) – K6 as response variable for mental health – Age, sex, health problem, family, friends, amusement, income, environment
  • 8. Phase I: Impact phase (0-4 days) (Literature review) • Deaths and missing 3,833: 20% of total casualty 19,139 • 13% of the city flooded (70% lived) • 31.6% of population dislocated to shelters (51K) • Health problems – Tetanus 7, legionellosis 2 (by Tsunami) – Dehydration, vomiting, diarrhea and deep vein thrombosis (over crowded shelters) Home Disaster shelter
  • 9. Phase II: Post-impact phase (4 days – 4 weeks) (Literature review) • Restoration of affected areas • Construction of temporary housing complexes • Diseases in disaster shelters – Gastro-intestinal diseases 92, influenza 15, respiratory diseases 788, rash 5, scabies 6 and injury 2 – Hygiene established – A few infectious disease outbreaks Disaster shelter Home, temporary housing complex
  • 10. Phase III: Recovery phase (>4 weeks) (Literature, volunteer records and participatory methods) • Closure of disaster shelters (Oct 11, 2011) • Degradation of environment – Fish from damaged processing factories – Animal feed concentrate from damaged factories Disaster shelter Home, temporary housing complex
  • 11. Animal feed concentrates and sludge (June 2011) Rotten fish and flies (June 2011)
  • 12. Distributions of flies (July 2011) Total bacteria 108.7 (95%CI: 107.3-1010.1) Enterobactericeae 108.0 (95%CI: 106.6-109.5) Musca domestica Spaerocerdae Phomiaregina meigen • Piled fish discarded by July 6 • Number of flies decreased by August
  • 14. Prevalence of Vibrio and Aeromonas Surface water Vibrio cholerae* Vibrio fluvialis Aeromonas hydrophila Sludge Vibrio cholerae* Vibrio fluvialis Aeromonas hydrophila * non-O1, O139 V. cholerae July 2011 n=13 3 (23.1%) 1 (7.7%) 1 (7.7%) n=12 3 (25.0%) 4 (33.3%) 2 (16.7%) August 2011 p-value n=14 3 (21.4%) 1 3 (21.4%) 0.60 4 (28.6%) 0.33 n=12 3 (25.0%) 1 4 (33.3%) 1 2 (16.7%) 1
  • 15. Microbiology for surface water (Log10 scale) Total bacteria Enterobacteriaceae p=0.5 *p=0.006 n=14 n=14 n=14 Bacillus spp. p=0.4 n=12 n=17 n=14 Clostridium spp. p=0.4 n=9 p=0.2 n=12 *p=0.02 n=17 n=9
  • 16. Microbiology for sludge (Log10 scale) Total bacteria Enterobacteriaceae *p<0.001 n=15 *p=0.046 n=15 n=15 Bacillus spp. p=0.9 n=11 Clostridium spp. *p<0.001 n=15 n=15 n=9 p=0.2 n=11 *p=0.004 n=15 n=9
  • 17. Ions Jul 2011 Aug 2011 Jul 2011 Aug 2011
  • 18. Other findings • Hepatitis E virus DNA (1/20 samples) • No high level of heavy metal concentration
  • 19. Socio-psychological results • Wish to live in the same place again – Urban: 30.6% (11/36) – Rural: 64.2% (9/14), others upland relocation *Fisherman village • Obstruct for making a wish (in urban areas) – Financial problem (58.3%, 7/12) Risk factors for severe mental health (Generalized Linear Models with Poisson errors) Factors Attributes Sample Health problem of the respondent or Exist 26 family Not exist 24 Friends in the housing complex Exist 42 Not exist 16 Trusted person to counsel in the housing Exist 29 complex Not exist 22 Percentage K6 p-value 52.0 3.0 <0.001 72.4 56.9 9.9 5.0 0.003 10.6 3.3 0.005 10.9
  • 20. Conclusion • Infectious diseases were well controlled • Environmental health risk was low • Rodents need to be monitored • Mental care and financial supports are needed for evacuees
  • 21. Acknowledgements • • • • • • Mitsui & co Ltd. Ishinomaki City Council NGOs (APCAS, PARCIC, P-CAT, Agarain) Rauno Gakun University (RGU) RGU volunteers Participants in the study