Author Contributions: Drs Shigemura and Tanigawa had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Shigemura, Tanigawa, Nomura.
Acquisition of data: Shigemura, Tanigawa.
Analysis and interpretation of data: Shigemura, Tanigawa, Saito.
Drafting of the manuscript: Shigemura, Tanigawa, Saito.
Critical revision of the manuscript for important intellectual content: Shigemura, Tanigawa, Nomura.
Statistical analysis: Shigemura, Tanigawa, Saito.
Obtained funding: Shigemura, Tanigawa, Nomura.
Administrative, technical, or material support: Tanigawa.
Study supervision: Tanigawa, Nomura.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Drs Shigemura and Nomura provided voluntary mental health assistance to Tokyo Electric Company Fukushima Daiichi and Daini nuclear power plant employees according to official requests from Daini and a Japanese government cabinet order to the Ministry of Defense. Dr Tanigawa is a Daini part-time occupational physician. Dr Saito reported no conflict of interest disclosures.
Funding/Support: This work was supported by Health and Labour Sciences Research Grants (Research on Occupational Safety and Health H24-001) from the Ministry of Health Labour and Welfare of Japan.
Role of the Sponsor: The funding organization had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
Disclaimer: The views expressed in this article are those of the authors and do not reflect the position or policy of Tokyo Electric Company, Ehime University, National Defense Medical College, the Ministry of Defense, or the Japanese government.
Additional Contributions: We thank Tomoko Yamamoto, RN (Tokyo Electric Company [TEPCO] Fukushima Daini nuclear power plant), the medical team employees of Daiichi and Daini plants, and Yoshiko Kage (TEPCO R&D Center) for their invaluable cooperation. We also thank the plant workers for their study participation and dedicated recovery efforts. No compensation was received for their services.