The Investigation Committee on the Accident
at the Fukushima Nuclear Power Stations of
Tokyo Electric Power Company was formed June
7, 2011 by the Japanese government as an independent
body to investigate the March Fukushima Daiichi
nuclear disaster.
The Investigation Committee issued an interim
report in December 2011, and issued its final
report in July 2012.
== Investigation ==
=== The Committee ===
The Investigation Committee on the Accident
at the Fukushima Nuclear Power Stations (ICANPS)
was tasked with: "conducting an investigation
to determine the causes of the accident that
occurred at Fukushima Daiichi and Daini Nuclear
Power Stations of Tokyo Electric Power Company,
and those of the damages generated by the
accident, and thereby making policy proposals
designed to prevent the expansion of the damages
and the recurrence of similar accidents in
the future".
The 10 member, government-appointed panel
included scholars, journalists, lawyers and
engineers, was supported by public prosecutors
and government experts interviewed 772 people,
including plant workers, government officials
and evacuees, for a total of nearly 1,479
hearing hours - and released its final 448-page
investigation report on July 23, 2012.
Its report was the fourth investigation into
the crisis after the earlier release of a
parliamentary study, a private report by journalists
and academics as well as an investigation
by TEPCO.
=== Interim investigation report ===
For the interim report issued on December
26, 2011, the committee interviewed 456 people
over a total of 900 hours of hearings by Dec.
16, 2011.
The interim report was "a scathing assessment
of the response to the Fukushima disaster",
in which the investigative panel "blamed the
central government and the Tokyo Electric
Power Co., saying both seemed incapable of
making decisions to stem radiation leaks as
the situation at the coastal plant worsened
in the days and weeks after the disaster".
It attaches blame to Japan's central government
as well as Tokyo Electric Power Co., "depicting
a scene of harried officials incapable of
making decisions to stem radiation leaks as
the situation at the coastal plant worsened
in the days and weeks following the disaster".
The 507-page interim report, said Japan's
response to the crisis at Fukushima Daiichi
was flawed by "poor communication and delays
in releasing data on dangerous radiation leaks
at the facility", and poor planning also worsened
the disaster response, noting that authorities
had "grossly underestimated tsunami risks"
that followed the magnitude 9.0 earthquake.
The 15m (40-foot) high tsunami that struck
the plant was twice as tall as the highest
wave predicted by officials, and the erroneous
assumption that the plant's cooling system
continued to work after the tsunami struck
worsened the disaster.
"Plant workers had no clear instructions on
how to respond to such a disaster, causing
miscommunication, especially when the disaster
destroyed backup generators.
Ultimately, the series of failures led to
the worst nuclear catastrophe since Chernobyl".The
report concluded “It's inexcusable that
a nuclear accident couldn't be managed because
a major event such as the tsunami exceeded
expectations.”
An account said "[t]he report, which is highly
critical of Tepco as well as the authorities
contrasts with the conclusions of a separate
exercise by Tepco, which laid blame for the
crisis squarely on the natural disaster."
NISA, Japan's nuclear regulatory agency, received
"some of [the] strongest criticism" in the
report.
=== Final investigation report ===
The panel said the government and TEPCO failed
to prevent the disaster not because a large
tsunami was unanticipated, but because they
were reluctant to invest time, effort and
money in protecting against a natural disaster
considered unlikely.
"The utility and regulatory bodies were overly
confident that events beyond the scope of
their assumptions would not occur . . . and
were not aware that measures to avoid the
worst situation were actually full of holes,"
the government panel said in its final report.
TEPCO had even weighed in on a report about
earthquake risk and asked the government to
play down the likelihood of a tsunami in the
region, the report said.
The panel's report faulted an inadequate legal
system for nuclear crisis management, a crisis-command
disarray caused by the government and Tepco,
and possible excess meddling on the part of
the prime minister's office in the early stage
of the crisis.
The panel concluded that a culture of complacency
about nuclear safety and poor crisis management
led to the nuclear disaster.The report stated
that measures taken by TEPCO and the Japanese
nuclear regulator to prepare the Fukushima
nuclear plant for earthquakes and tsunamies
were "insufficient" and their response to
the Fukushima Daiichi nuclear disaster was
"inadequate."
"Preparedness for a large-scale complex disaster
was insufficient; and they were unprepared
for the release of a large amount of radioactive
materials into the environment caused by a
containment failure," noted the report with
respect to TEPCO and the Japanese Nuclear
and Industrial Safety Agency.
It noted for example that Fukushima staff
was poorly trained to deal with the crisis
after the plant's reactors went into meltdown.
TEPCO did not adequately train employees "to
think independently and to act, and lacked
flexible and proactive thinking required for
crisis response", the report said.
Tepco was criticized by the panel for failing
to give most workers dosimeters that would
have kept track of their exposure to harmful
radiation as they fought to contain meltdowns
in the early days of the crisis.
While Tepco had access to hundreds of dosimeters
sent from other nuclear power plants across
Japan, managers of the company failed to put
them to use — a sign that the company paid
little heed to worker safety, the report said.
Because of poor communication among Fukushima
officials, the police and Japanese Self-Defense
Forces personnel, the evacuation of Futaba
hospital and its nearby health care facility
for the elderly, located just 5 km from the
damaged plant, was delayed.
Residents living around the Fukushima plant
may also have been able to keep exposure to
minimum if the government had effectively
used a computer system to predict the spread
of radioactive materials, even though data
on the damaged reactors were not available.Besides
a failure of disaster management and risk
analysis, TEPCO lacks “sufficient enthusiasm
to fully investigate the Fukushima disaster
and learn lessons to prevent recurrence even
more than one year after the accident,”
the report said.
The investigators of the panel said TEPCO
has to address problems within its own culture
that contributed to its failings in the crisis,
including employees “not fully trained to
think for themselves.”
“We still don’t perceive much enthusiasm
in the accident investigation from” the
company, the report said.
“TEPCO must take our findings sincerely
and resolve the problems to achieve a higher
level of safety culture across the company.”
The ICANPS report also said interference by
then Japan prime minister Naoto Kan at the
time of the disaster created confusion in
the response to the crisis.
"It must be said that more harm was done (than
good) as his involvement ... could have confused
the scene, potentially missing opportunities
to make important judgments and creating opportunities
for misjudgments," the report said.
Kan's office was criticized by the ICANPS
panel for controlling information, delaying
crucial announcements to the public and overly
softening expressions about the severity of
the accident, causing confusion, threats to
health and public distrust in the government.Japanese
officials ignored the risks of an atomic accident
because they believed in the 'myth of nuclear
safety'., i.e. the notion that severe accidents
don't happen at nuclear power plants in Japan.
"The fundamental problem lies in the fact
that utilities, including Tokyo Electric Power
(TEPCO), and the government failed to see
the danger as reality," the report said.
It also said that they were under the 'notion
that severe accidents do not happen at nuclear
plants in our country'.
"Because the government and the power utilities,
including Tepco, were biased by the safety
myth, thinking they would never ever face
such a serious accident, they were unable
to realize that such a crisis could occur
in reality.
This appears to be the fundamental problem,"
the panel said in its final report.
Tepco thus failed to prepare adequate tsunami
defenses or crisis management procedures to
deal with a station blackout, the panel's
report said.
"The Fukushima crisis occurred because people
didn't take the impact of natural disasters
so seriously," University of Tokyo engineering
professor Yotaro Hatamura, who chaired the
commission, told a news conference.
"Even though there were new findings (about
the risk of a tsunami), Tepco couldn't see
it because people are blind to what they don't
want to see."Nuclear regulators did not pay
sufficient attention to improvements in nuclear
safety standards as recommended by the International
Atomic Energy Agency (IAEA) and the Japanese
Nuclear Industrial and Safety Agency had been
promoting nuclear energy without being open
about the inherent risks.
According to the report, the Nuclear and Industrial
Safety Agency strongly opposed a plan in 2006
to enhance preparedness against a nuclear
disaster, fearing such a move would raise
concerns about the safety of nuclear power
among residents living near atomic plants.
The failure of the central and local governments
to consider the possibility of a nuclear accident
caused by multiple factors such as earthquakes
and tsunami also caused a delay in responding
to the accident.
According to the report there was an insufficient
crisis management structure for ensuring the
safety of local communities.
The Japanese government failed to give a detailed
announcement about what was happening and
how it might affect people living nearby,
while the Nuclear and Industrial Safety Agency
was reluctant to inform the media that reactor
1's fuel rods possibly melted, although it
knew that was quite likely.The panel suggested
that post-Fukushima safety steps taken at
nuclear power plants across the country have
not been enough to cope with a complex catastrophe.
"We understand that immediate safety measures
are being further detailed and will materialise
in the future.
But we strongly urge the people concerned
to make continued efforts to take really effective
steps," said the panel, chaired by University
of Tokyo engineering professor Yotaro Hatamura.
"Both the government and companies should
establish a new philosophy of disaster prevention
that requires safety and disaster measures
against any massive accident and disaster...
regardless of event probability," the report
said.The report criticized TEPCO's argument
that the nuclear accident was due to a tsunami
of an unimaginable, unpredictable scale.
It stated, "The reason the accident was beyond
assumptions was because no attempt was made
to make assumptions due to a safety myth that
had no basis in fact."
The ICANPS panel said that there was no proof
that the earthquake was a key factor in the
disaster, but added that a certain degree
of impact could not be ruled out.
Many scientists and activists have disputed
the Japanese government and TEPCO's findings
that the plant's cooling systems were knocked
out by giant waves that slammed into the plant,
suggesting it was the initial earthquake that
damaged the reactors.
TEPCO's own investigation put the blame for
the accident solely on the tsunami.
The panel, however, called on TEPCO to review
data that had been presented to it, saying
that it believed that it contained errors.
It also said TEPCO covered up unfavourable
data in a computer analysis attempting to
measure the extent of damage inside the reactors.Commission
chairman Yotaro Hatamura said that due to
time restrictions, his panel was unable to
address the concerns of residents, and the
international community, who questioned whether
the damaged reactors and the pool of used
nuclear fuel at Fukushima's No.4 reactor could
withstand another earthquake.
"I now understand what people are worried
the most about is the vulnerability of the
No.4 spent fuel pool.
I wish we had started an investigation on
it much earlier," Hatamura said.Based on the
lessons learned from the accident, the panel
proposed the government and utilities take
safety steps regardless of the probability
of tsunami and other events that could have
a potentially strong impact, and review disaster
reduction measures when important new findings
are revealed.
The final report included seven recommendations
for preventing a recurrence of the Fukushima
nuclear accident, such as safety measures
and ways to prevent the spreading of damage.
The panel didn't recommend charges against
any of those involved in the Fukushima Daiichi
nuclear disaster, but the panel called on
the government to take immediate action on
certain issues, such as ensuring off-site
nuclear accident management centres are protected
against the kind of massive radiation leaks
that rendered the one at Fukushima unusable.
It recommended that all nuclear operators
in Japan conduct a comprehensive risk analysis
of their facilities and urged the Japanese
government and TEPCO to conduct further investigations
to fully disclose the cause of the Fukushima
Daiichi nuclear disaster, because there are
many unresolved issues, such as the process
by which radioactive materials leaked out
of the Fukushima No. 1 plant.
“The government shouldn’t close its accident
investigation into Fukushima with the end
of probes by our committee and the parliamentary
commission,” Hatamura’s panel reported.
“When radiation levels fall, detailed on-site
examination inside reactor buildings, including
examination of quake effects, must be carried
out.”
=== 
Fukushima Nuclear Accident Independent Investigation
Commission ===
On July 5, 2012, the National Diet of Japan
Fukushima Nuclear Accident Independent Investigation
Commission released an executive summary report
of The Fukushima Nuclear Accident.
The report "blames Japanese culture for the
fundamental causes of the disaster."
== Membership ==
Yotaro Hatamura, Chairperson; Professor Emeritus
of the University of Tokyo, Professor of Kogakuin
University
Kazuo Oike, Director, International Institute
for Advanced Studies, Former President of
Kyoto University
Shizuko Kakinuma, Team Leader, Research Center
for Radiation Protection, National Institute
of Radiological Science
Yukio Takasu, Project Professor, Institute
for Advanced Global Studies, The University
of Tokyo, Former Permanent Representative,
Ambassador Extraordinary and Plenipotentiary
of Japan to the International Organizations
in Vienna, and the United Nations in New York
Toshio Takano, Attorney-at-Law, Former Superintending
Prosecutor of Nagoya High Public Prosecutors
Office
Yasuro Tanaka, Professor of Meiji Law School,
Former Chief Justice of the Sapporo High Court
Yoko Hayashi, Attorney-at-Law
Michio Furukawa, Mayor of Kawamata Town, Fukushima
Prefecture
Kunio Yanagida, Writer, Critic
Hitoshi Yoshioka, Vice-President of Kyushu
University
=== 
Technical advisors ===
Seiji Abe, Professor, Kansai University
Masao Fuchigami, Advisor, Komatsu Ltd., Ph.D.
in Engineering
== See also ==
National Diet of Japan Fukushima Nuclear Accident
Independent Investigation Commission- formed
by law
