T . Ohba et al .: Radioprotection 2024 , 59 ( 2 ), 88 – 94 93
5 Study limitations
The study had some limitations . First , the study did not include an investigation of ‘ soft ’ aspects , such as the preparation of medical equipment and logistics flows — features that are considered important from a global perspective ( Marzaleh et al ., 2020 ; Munasinghe et al ., 2022 ). However , as shown in Supplementary Tab . 1 , the NDRHs functioned as core hospitals for general disasters , and the flow of medical materials , equipment and logistics ensured preparedness ( Japan Nuclear Regulation Authority , 2022 ). Additionally , the availability of materials and equipment related to nuclear disaster medicine was included as a requirement for designation ( Supplementary Tab . 1 ); therefore , we considered that the NDRHs already had materials and equipment related to nuclear disaster medicine ( Japan Nuclear Regulation Authority , 2022 ). Second , the study used a questionnaire survey which queried the existence of permanent facilities ; therefore , the sample size of responses was small compared with that for a typical questionnaire survey of individuals . As a result , we were unable to perform advanced statistical analyses , such as logistic regression analysis . However , sample sizes in previous studies that included surveys of targeted facilities were similar to that in our study ( Munasinghe et al ., 2022 ). Furthermore , given this pilot study ’ s aim of examining the availability of manuals on nuclear disasters , the existence of permanent facilities and the years that elapsed since designation as an NDRH , the study results are sufficiently novel even without the use of advanced statistical analysis methods . Finally , the development of nuclear emergency core hospitals is still ongoing in Japan . Therefore , based on the results of this study , we plan to conduct a full-scale survey of the awareness of nuclear disaster preparedness in each facility in 2024 or beyond . The expected results will contribute to standardising the level of medical care that is provided to contaminated injured patients across Japan .
6 Conclusions
Regardless of the number of years elapsed since designation asanNDRH , the existence ofa permanentfacilitywas relevantto the availability of manuals on nuclear disasters in medical establishments . We speculate that when a facility that provides nuclear disaster medicine is permanently present , the awareness of nuclear disaster preparedness increases at the facility , and the medical staff may be more motivated and engaged in the preparation of manuals that guide the utilisation of the hardware . Therefore , medical facilities that prepare for nuclear disaster must not only strengthen ‘ soft ’ aspects such as medical staff training but also ensure that the facilities are permanent . Strengthening both software and hardware aspects will make clear the level of national standard for medical care that should be provided to radioactively contaminated injured patients .
Acknowledgements We thank all of the facilities for participating in our study .
Funding
This work was supported by JSPS KAKENHI ( grant number JP19H03762 ).
Conflicts of Interest The authors declare no conflict of interest related to this article .
Author contribution statement
A . Hasegawa and T . Ohba : conceptualisation , methodology ; K . Iyama , A . Hasegawa , and T . Ohba : investigation , data curation ; T . Ohba : writing original draft , visualisation ; A . Hasegawa , K . Iyama , H . Yasuda , and H . Sato : writing-review and editing ; A . Hasegawa : funding acquisition . All of the authors have read and agreed to the published version of the manuscript .
Ethics approval
This study protocol was approved by the Fukushima Medical University Ethics Committee ( approval number : 2019-417 ). Informed consent
Once we received the responses to the questionnaire items from the target facilities via the Internet , we were permitted to use the responses in this study .
Supplementary material
Supplementary Table 1 . List of designation requirements for nuclear emergency core hospitals and advanced radiation emergency medical support centres in Japan .
The Supplementary Material is available at https :// www . radio pro-journal . org / 10.1051 / radiopro / 2023034 / olm
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