The long-term effects of drinking alcohol for stress coping on mental health symptoms among Fukushima nuclear plant workers: The Fukushima NEWS Project Study

Objective The Fukushima nuclear disaster in 2011 caused psychological distress among plant workers. A three-year follow-up study was conducted to understand the longitudinal relationship between workers’ alcohol drinking for stress coping and mental health symptoms. Methods The present study analyzed 405 Fukushima Daiichi and Daini nuclear power plant workers, who responded to the open-ended questions about their own stress reduction efforts in 2012. Elements were extracted from the descriptions and categorized into ‘coping by drinking alcohol’ and ‘adaptive stress coping’. Mental health symptoms were assessed annually from 2012 to 2014. The relationships between stress coping and mental health symptoms over time were analyzed using a mixed-effects logistic regression model. Results Thirty-five workers drank alcohol for stress coping (12 drank alcohol only; 23 reported adaptive stress coping as well). The workers who drank alcohol only had significantly high Impact of the Event Scale-Revised (IES-R) (β = 9.61, p = 0.008), Athens Insomnia Scale (AIS) (β = 2.66, p = 0.008), and CAGE scores (β = 1.38, p < 0.001) in 2012. The significant effects on IES-R and CAGE persisted through 2014; however, the effect on AIS decreased over time (β = -1.16, p = 0.045). The workers who drank alcohol and implemented adaptive stress coping had significantly higher CAGE scores in 2012 (β = -0.08, p = 0.008), and the impact increased over time (β = 0.51, p = 0.003). Conclusions In the study population, drinking alcohol for stress coping increased the risk of problem drinking, as well as post-traumatic stress response and insomnia, especially in the absence of adaptive stress coping. Because these effects persist over years, professional education and guidance and continuous monitoring of coping content are considered necessary from the early post-disaster period.