Lessons learned from the Great East Japan Earthquake: impact on child and adolescent health.

The Great East Japan Earthquake (the Tohoku Earthquake) was one of the most devastating natural disasters ever to hit Japan, and its social impact was so enormous that Japan may never be the same again. This was an unprecedented triple disaster: an earthquake followed by a devastating tsunami and, finally, the destruction of a major nuclear power plant with the leaking of large amounts of radiation. The destruction occurred despite the presence of a 10-m protection wall and the effects of the tsunami were seen as high as 40 m above sea level. About 78,000 residents from areas within a 20-km radius of the Fukushima Daiichi Nuclear Power Plant were evacuated together with another 10,000 residents from areas with elevated levels of radiation. In the afflicted area, 30% of the population was older than 60 years of age, but more than 60% of the deaths were in this age cohort. Children and adolescents younger than 19 years accounted for 6.5% of the deaths, and there were 229 survivors younger than 18 years who lost both their parents in the disaster and 1295 who lost one of their parents. The long-term psychological effects on children and adolescents remain uncertain.