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What have we learned about health effects more than 40 years after the Three Mile Island nuclear accident? A scoping and process review
The worst commercial nuclear accident and the first large‐scale voluntary evacuation due to a nuclear event in United States history took place at Three Mile Island (TMI) in 1979. Within a short time, there was a well‐recognized impact of the TMI accident by public health officials and academicians...
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Published in: | Risk, hazards & crisis in public policy hazards & crisis in public policy, 2023-06, Vol.14 (2), p.129-158 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
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Citations: | Items that this one cites |
Online Access: | Get full text |
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Summary: | The worst commercial nuclear accident and the first large‐scale voluntary evacuation due to a nuclear event in United States history took place at Three Mile Island (TMI) in 1979. Within a short time, there was a well‐recognized impact of the TMI accident by public health officials and academicians upon mental health of nearby residents—particularly pregnant women. Despite long‐term and detailed follow‐up of this population for cancer outcomes, community concerns continue. Herein, we conduct a scoping and process review of fetal/maternal/child health (MCH) and cancer health outcomes, and consider the findings in light of subsequent accidents. The process evaluation is enhanced by unpublished transcripts of the Pennsylvania Department of Health's (PA DOH) TMI Advisory Panel on Health Research Studies (APHRS), comprised of experts from prominent US research institutions. Research and process strengths included a rapid initial house‐to‐house health census of over 35,000 individuals, intense medical record reviews, in‐person interviews of pregnant women within a 10‐mile radius, and coordination of multiple parallel studies by PA DOH with APHRS collaboration. Major limitations include (1) errors in causal inference, (2) limited radiation exposure assessment, (3) failure to include TMI never‐exposed groups in risk estimates, (4) exclusion of vulnerable populations, (5) nonindexed/never published investigations, and (6) government‐stated need for long‐term MCH follow‐up that was never conducted. Lingering unaddressed actual and perceived risks were identified as major common themes among TMI, Chernobyl and Fukushima accidents. These findings underscore the need for the establishment of mechanisms to ensure long‐term follow‐up and preaccident protocols designed to address major health issues with inclusion of vulnerable populations and perceived risks.
摘要
1979年,三哩岛(TMI)发生了美国历史上最严重的商业核事故和首次大规模自愿撤离。本文中,我们对胎儿/孕产妇/儿童(MCH) 和癌症结果进行范围综述和过程审查,并衡量了与后续事故相关的研究发现。过程评估包括宾夕法尼亚州卫生部 (PA DOH) TMI 健康研究咨询小组 (APHRS) 的记录。研究和过程优势包括对一项超过 35,000 人的快速初步挨家挨户健康普查、密集的医疗记录审查、对10英里半径内的孕妇进行面对面访谈、以及由PA DOH进行、APHRS协同参与的多项平行研究的协调工作。主要的不足之处包括: (1) 因果推理错误,(2) 有限的辐射暴露评估,(3) 未能将从未暴露在核事故中的TMI群体纳入风险估计,(4)未包括弱势群体,(5) 引用了未编入索引/从未发表过的调查,以及, (6) 政府要求的、但从未进行的长期 MCH随访。遗留的、未解决的实际风险和感知风险是TMI、切尔诺贝利和福岛事故中的主要共同主题。这些研究发现强调了建立用于确保长期随访和事故前方案的机制的必要性,这些方案旨在通过将弱势群体和感知风险包括在内的方式应对主要健康问题。
Resumen
El peor accidente nuclear comercial y la primera evacuación voluntaria a gran escala debido a un evento nuclear en la historia d |
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ISSN: | 1944-4079 1944-4079 |
DOI: | 10.1002/rhc3.12258 |