Congenital Heart Disease After the Fukushima Nuclear Accident: The Japan Cardiovascular Surgery Database Study
Hirata Y, Shimizu H, Kumamaru H, Takamoto S, Motomura N, Miyata H, Okita Y.
J Am Heart Assoc. 2020 Jul 7;9(13):e014787. doi: 10.1161/JAHA.119.014787. Epub 2020 Jul 2.
Take Home Points:
- No increase was observed in the number of first time congenital cardiovascular surgeries between January 2010 and December 2013 in all of Japan and the area of the nuclear accident.
- The increase of the total number of congenital cardiovascular surgeries between 2010 and 2013 might be explained by a reduction in mortality for the initial surgery.
Commentary from Dr. Inga Voges (Kiel, Germany), section editor of Pediatric Cardiology Journal Watch: This important registry-based study assessed the effect of the Fukushima nuclear accident in March 2011 on the incidence of congenital heart disease. The authors hypothesized that the incidence of congenital heart disease did not increase after the accident.
Data from 59 facilities within the Japan Cardiovascular Surgery Database was used for the analyses. Information about patients who underwent all types of congenital cardiovascular surgeries between 1st January 2010 and 31st December 2015 at the 59 facilities were extracted from the database. Patients who were older than 2 years at the time of surgery were excluded from the analysis. The number of first congenital cardiovascular surgeries by the patients’ birth year–month in all 59 facilities and in the area of the nuclear accident (Tohoku region) was counted. Second, the percentage of live births in Japan that underwent their first congenital cardiovascular surgeries at the 59 facilities was calculated. Third, the total number of operations for complex diseases performed on patients one year old and younger per operation year, regardless of when the patients were born was counted.
Between 1st January 2010 and 31st December 2015 26 251 patients underwent 44 818 surgeries. Out of them, 11 919 patients were born between 2010 and 2013, and were 2 years or younger at the time of surgery. The authors did not observe a monthly increase in the number first congenital cardiovascular surgeries in all of Japan (Figure 1A) and in the Tohoku area (Figure 1B). Also no increase in the percentage of live births that underwent congenital heart surgeries was found (Figure 2A and 2B). The total number of all congenital cardiovascular surgeries increased between 2010 and 2013 whereas mortality for the initial operation went down.
In summary, this study gives new insights on the effects of the 2011 nuclear accident in Fukushima the incidence of congenital heart disease. It suggests that there was no obvious increase in the number of congenital heart disease patients.