Nationwide Increase in Complex Congenital Heart Diseases After the Fukushima Nuclear Accident

Background-After the Chernobyl nuclear accident in 1986, an increase in the incidence of congenital heart disease (CHDs) in the neighboring countries was reported. In 2011, Japan experienced the Great East Japan Earthquake and the nuclear accidents at Fukushima. However, a nationwide study of their effects has not been conducted yet. Methods and Results-We used data covering the period between 2007 and 2014 from the annual surveys conducted by the Japanese Association for Thoracic Surgery, which included almost all of the operations pertaining to 46 types of CHDs in Japan. CHDs were divided into 2 groups based on complexity, the time of occurrence during heart development, and age at operation. We estimated the change in the number of the operations per 100 000 live births between pre- and postdisaster using a negative binomial generalized linear mixed model. Overall, a significant 14.2% (95% CI, 9.3-19.4) increase in the number of operations for complex CHDs in neonates and infants per 100 000 live births was found, whereas those performed for patients of 1 to 17 years old showed no significant change during the study period. Conclusions-The number of operations for complex CHDs in neonates and infants in Japan significantly increased after the massive disaster, and its level was maintained thereafter. The number of operations for complex CHD was not equal but closely correlated to the live birth prevalence of complex CHDs. Therefore, some meaningful increase in the live birth prevalence can be assumed; however, the precise cause of the increase is unknown.