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In addition to the discrimination, the TEPCO nuclear workers, who are specially trained, are anxious that they will be transferred to a completely different kind of job, such as clerical work, if they should surpass the exposure limit, the doctors say.

“More than health risk, they are worried about social risk and employment risk,” said Takeshi Tanigawa, an epidemiologist with Ehime University’s medical school who visited the plant after the disaster and was the one of the first to report its harsh working conditions, which have since improved. He has been back 15 times since, and Shigemura later volunteered to join him.

The two doctors report that they are not aware of any case of radiation sickness or radiation burns among the workers, who undergo regular checks for radiation levels in their bodies.

A brief report on their experience visiting the Fukushima plant soon after the disaster that highlights the discrimination workers faced was published in Wednesday’s issue of The American Journal of Psychiatry.

The Japanese public and press, meanwhile, has offered the workers little praise, unlike the Western media, which during the height of the crisis portrayed the remaining band of workers at the plant as the heroic “Fukushima 50.” The domestic press instead emphasized how the dangers faced by the workers reflected the risks of nuclear power.

Culture helps explain some of these dynamics, including the strong Japanese sense of duty and group responsibility.

“People believe the workers share in the responsibility” for the disaster even though they didn’t cause it, Tanigawa said.

Disaster psychiatry is not well-developed in Japan. The 1995 Kobe earthquake brought growing awareness of the psychological trauma of disasters, but specialists in the field remain rare.

Research from the 1986 Chernobyl nuclear disaster suggests that mental health problems will persist for years.

Eighteen years after that crisis, Chernobyl clean-up workers experienced higher rates of depression, anxiety disorders, post-traumatic stress disorder, headaches and suicidal thoughts than the general population, according to a 2008 study in the journal Psychological Medicine.

Many TEPCO workers now live in a temporary barracks at a soccer stadium called J-Village, several kilometers (miles) south of the Fukushima Dai-ichi plant. Workers at J-Village approached by a journalist refused to talk, and other contractors said they would get in trouble with the utility if they did.

Environment Minister Goshi Hosono, who is also in charge of nuclear crisis management, has made a point of thanking the workers during visits to the Fukushima plant, and children from around Japan have sent drawings and words of encouragement. But the workers have told the doctors that in restricted areas around the plant, former neighbors have shouted, thrown bottles and shoved them during their brief visits home to retrieve belongings.

Such discrimination weighs heavily on the workers, said Shigemura.

“Showing appreciation to the workers is an urgent need. It’s totally lacking,” Shigemura said, adding that he believes stigmatization is a key factor in influencing the workers’ psychological distress.

A growing number of the workers tell the visiting psychiatrists of sagging motivation and hopelessness, and Shigemura warned that such attitudes could lead to `’misconduct or human error or sabotage.” He also said the workers are drinking more alcohol and smoking more.

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