【Background】 Nuclear disaster medical assistance teams in Japan were founded in 2017, however, little is known about whether these teams are well equipped or the details of protocols or contracts between nuclear disaster base hospitals and prefectures with nuclear power generation facilities. 【Method】 1) In a telephone interview, we asked the clerks of nuclear disaster base hospitals whether they had nuclear disaster medical assistance teams, exclusive vehicles, uniforms, preparations for food and water, contracts with local governments, or a list of the first action team members. 2) A questionnaire survey was administered that asked each team member whether they accepted the possibility of radiological exposure and whether they recognized the contents of training covering responses to either usual disasters or nuclear disasters. 【Results】 1) Fifty of 55 institutes responded. Forty-four had nuclear disaster medical assistance teams, 50.0% had exclusive vehicles, 20.5% had uniforms, 22.7% had preparations for food and water, 4.5% had contracts with local governments, and 25.0% had a list of the first action team members. 2) Among the respondents, 25.3% indicated that they would not accept radiation exposure at a cumulative dose of 1 mSv (millisievert). The items that were independently positively and significantly associated with the variable “available to work in the event of a nuclear disaster” were the categories “age of their fifties” (odds ratio [OR], 3.2) and “concurrency of DMAT” (OR 1.7). 【Conclusion】 Some nuclear disaster base hospitals did not have nuclear disaster medical assistance teams. In order to develop first response systems for nuclear disasters, making a list of the first action team members and contracts between local governments are essential.

【Purpose】 Using simulation to determine measures for reducing the number of untreated deaths after The Nankai Trough Earthquake. 【Method】 An untreated death refers to a fatality occurring during the acute phase of a disaster due to insufficient medical care. Previously, employing a queuing model, we developed a discrete event simulation to model disaster medical response. Using this system, we calculated the count of severely injured individuals, the number of untreated deaths, and the untreated death rate (number of untreated deaths divided by number of seriously injured persons [%]) under current conditions and subsequent to the execution of disaster prevention and mitigation measures. 【Results/Discussion】 The simulated untreated death rates (%) for top eight prefectures with most injuries are as follows: Kochi prefecture (85.0%), Mie prefecture (81.5%), Wakayama prefecture (79.5%), Shizuoka prefecture (78.7%), Tokushima prefecture (75.4%), Ehime prefecture (66.7%), Aichi prefecture (64.1%), and Osaka prefecture (0.8%). The rate of reduction in untreated deaths is defined as the ratio of the number of untreated after disaster mitigation to the current number of untreated individuals. Following the implementation of disaster prevention and mitigation measures, untreated deaths in Aichi Prefecture decreased by 69.7%. Adopting similar measures, untreated deaths decreased by 80.7% in Shizuoka Prefecture, 70.9% in Mie Prefecture, and 85.7% in Osaka Prefecture. Additionally, Kochi Prefecture witnessed a 91.1% reduction in untreated deaths following the adoption of disaster prevention and mitigation measures. Implementing the same disaster prevention and mitigation measures as in Kochi Prefecture, led to a reduction of untreated deaths by 92.3% in Ehime Prefecture, 99.2% in Wakayama Prefecture, and 99.3% in Tokushima Prefecture. With the implementation of disaster prevention and mitigation measures, untreated deaths in many areas could be reduced to <30% compared to the current situation. In areas where the seriously injured bed occupancy rate (defined as number of seriously injured divided by number of beds) is <0.5, the untreated death rate is approximately 0.5. However, in areas where the seriously injured bed occupancy rate exceeds 0.5, the untreated death rate increases significantly. For instance, the untreated death rate reaches 70% in areas with a seriously injured bed occupancy rate of 1.0 and 80% in areas with a rate of 1.5. Thus, relying solely on DMAT medical resources is deemed unrealistic. 【Conclusion】 Using a disaster medical simulation system, we examined the untreated death rates in a simulated Nankai Trough Earthquake and drew the following conclusions. First, urgent improvements in earthquake resistance are needed in prefectures where the simulated untreated death rate exceeds 80%. Second, to maintain the untreated death rate below 5%, the bed occupancy rate for severely injured individuals should not exceed 0.5 in secondary medical care areas, i.e., medical districts that concentrate medical care for seriously injured people during a disaster. Third, implementing disaster prevention and mitigation measures akin to those in Aichi and Kochi prefectures could reduce the untreated death rate to below 30%. Finally, without significant improvements in disaster medicine to ensure all medical personnel are proficient in this area, it will remain challenging to secure sufficient medical resources to reduce the number of untreated deaths in The Nankai Trough Earthquake.

【Purpose】 A preliminary list of Damaged Hospital Continuation Support (DHCoS) simulations was created for medical institutions and social welfare facilities within a 30-km radius surrounding the nuclear power plant in Aomori Prefecture to estimate medical needs in case of a nuclear disaster. 【Methods】 Various information on medical and social welfare facilities located within a 30-km radius of the nuclear power plant was collected, and risk analysis of each facility was conducted regarding collapse, power outage, water cutoff, flooding, and radiation protection. 【Results】 Principally, gradual evacuation of one hospital and 43 social welfare facilities with no radiation protection functions would be required if the air radiation levels exceed the standard values. In case of an earthquake-associated complex disaster, one hospital and three social welfare facilities with a high risk of collapse in the acute phase would require early information gathering and evacuation support as necessary. Similarly, 14 social welfare facilities with a high risk of flooding would require support. 【Discussion】 The preliminary list of DHCoS is useful for determining the facilities that should establish medical and siege support systems through early information gathering and those that should be evacuated in stages from the viewpoint of radiation protection functions. The collection of information on the lifeline status of facilities in the vicinity of nuclear power plants and availability of radiation protection functions in various regions of Japan during normal times would lead to the prompt establishment of various support systems in case of a nuclear disaster. 【Conclusion】 Considering the nuclear disaster and status of radiation protection measures at each facility, the preliminary list of DHCoS was able to estimate medical needs.

【Purpose】 Hospital A, located in the Tokai region, which has little experience with disasters, is likely to play a key role in supporting community medical institutions providing disaster medical care in the event of a disaster. Hospital A developed its Business Continuity Plan (BCP), which needs to be revised following changes in hospital conditions, in 2018. The key points of the revision focus on retaining and securing human resources to maintain hospital functions and to concentrate hospital staff in the event of a large-scale disaster. Therefore, it is necessary to investigate an actual situation in which hospital staff would gather in the event of a disaster and consider the human resources management necessary to maintain hospital functions over the long term. 【Method】 Study participants were all 1,545 employees who worked at Hospital A during December 2023, when the survey was conducted. Employees were classified into regular and non-regular employees, and the types of non-regular employees were part-timers, temporary employees, and re-appointed employees. In addition, the occupations were classified into 12 categories. The survey questionnaires were sent using the electronic medical record questionnaire form because the study participants could use the electronic medical records system in Hospital A. According to the regulations of Hospital A, gathering in case of a large-scale disaster is an individual’s voluntary choice; hence, we asked participants about their willingness to assemble, on a seven-point scale, based on which we estimated the number of people who would assemble. We described the estimated numbers by computing time and profession. 【Results】 The response rate for this survey was 905 (58.6%). Of the 12 occupations that responded, less than 50% of the respondents were doctors, clerks, and nursing assistants. Among the 1,545 participants, only 746 (48.3%) indicated a willingness to assemble at Hospital A in case of a disaster. Among that group of 746, 708.9 (95.0%) were willing to assemble within one hour. Staff most likely to be present at Hospital A during the disaster were radiology technologists (22.5/34 people, 66.2%) and physicians (133.8/242 people, 55.3%). 【Discussion】 Our findings revealed a low level of concern about disaster prevention among the staff of Hospital A. This may be due to our questionnaire being in Japanese, which was difficult for non-native Japanese speakers to respond to. Despite conveying the significance of our research to the department heads, individual staff members may not have understood its importance. Moreover, the requirement of assembling within one hour of a disaster may lead to confusion among those gathered. Hence, the revised BCP requires efforts from both perspectives: strategies for intensively assembling human resources as well as dispersing the assembled hospital staff in anticipation of long-term disaster countermeasures. 【Conclusion】 Our survey was based on the assumption of a disaster emergency under normal circumstances. The results regarding the possibility of hospital staff assembling during a large-scale disaster at Hospital A showed that this could provide a basis for improving the BCP’s functionality. Our findings indicate that it is necessary to plan for long-term human resource management to maintain hospital functions immediately during and after a disaster.

【Purpose】 It is often difficult to obtain information specific to pharmaceuticals during relief activities. This study aimed to develop a template for disaster relief pharmacists to share information efficiently with subsequently dispatched pharmacists. 【Methods】 Focusing on the pharmacist relief activities during the Noto Peninsula Earthquake, we investigated the information shared between the dispatched pharmacists and the pharmacists providing logistical support. Additionally, we conducted a survey to identify the information required during disasters. 【Results】 The information required by the dispatched pharmacists included “pharmaceutical operations,” “daily routines,” and “information related to dispatched life.” Many of the dispatched pharmacists felt burdened by the task of reporting information. 【Discussion】 Using the template developed in this study is expected to allow pharmacists to provide all the necessary information without omissions while reducing the reporting burden. It will facilitate quicker information sharing during disasters. 【Conclusion】 The information-sharing template proposed in this study is practical and efficient because it meets a need and can be used to smoothly share drug-specific information.

Disaster medical logistics are crucial in disaster-stricken areas as resources, such as lifelines, are limited, enabling medical teams to operate effectively. During disasters, logistics are supplied and coordinated by local governments, such as prefectural disaster management headquarters. Therefore, coordination between local governments and the receiving medical teams and institutions is essential. This study defined such coordination as the “Disaster Medical Logistics Resource Coordination System.” This study reported the efforts of Hyogo Prefecture to establish and refine the Disaster Medical Logistics Resource Coordination System. Hyogo Prefecture has progressively developed its coordination system. In 2004, the Hyogo Prefecture Emergency Medical Care System Operating Council was established. The logistics leaders were selected following the 2016 disaster medical logistics workshop. In 2017, the leaders formed the Hyogo Prefecture Logistics Working Group under the council. This working group aids in advancing the Disaster Medical Logistics Resource Coordination System. In 2018, the leaders identified critical logistical issues and reviewed disaster prevention agreements, modifying or creating new ones as necessary. These efforts underscore the importance of organizations that comprise disaster medical logistics personnel. However, securing the time and budget for these initiatives remains challenging. By preparing the Disaster Medical Logistics Resource Coordination System at the prefectural level, effective disaster medical services can be provided, reducing reliance on external support during disasters. The initiatives of Hyogo Prefecture serve as valuable references for other prefectures in developing similar systems.

Disasters necessitate a re-evaluation of dentists’ responsibilities and awareness. The Great East Japan Earthquake of 2011 significantly increased interest in disaster medicine and forensic odontology. As a result, training and drills have been actively conducted across Japan to ensure dentists are prepared to collaborate with other professionals during large-scale disaster scenarios. It is necessary to educate dental students early on about their potential role as dentists during emergencies and their roles and responsibilities in such situations. However, unlike general clinical dentistry, disaster dentistry is difficult to learn through direct experience. Therefore, the author’s university is working on practical activities for dental students. In particular, a three-day intensive course is organized for fourth-year students, which includes desk-based training, such as dental healthcare activities in disaster areas and victim identification activities, in addition to traditional classroom learning. This article outlines the disaster dentistry education provided to dental students at the university.