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PubMed2000

A-bomb survivors: factors that may lead to a re-assessment of the radiation hazard.

BACKGROUND: The study cohort of the survivors of the A-bombs in Japan, used as the basis of the internationally accepted estimates of cancer radiation risk, was collected more than 5 years after the bombing and did not include those who died of bomb-related injuries before that date. This paper tests whether the people who survived, in spite of bomb-related injuries, are homogeneous in respect of variation of cancer risk with age with survivors without such injuries. METHODS: Appropriate statistical models are derived and fitted to survivor data by maximum likelihood and the resultant statistics used to test the homogeneity assumption. RESULTS: Significant differences were found between those with no injuries and those with multiple injuries and shown to be largely due to exposures before 10 or after 55 years of age having exceptionally high risks of late effects of radiation for survivors showing early effects, i.e. bomb-related injuries. CONCLUSIONS: Certain accepted dogmas about the biology of radiation risks in humans, such as 'cancer is the only late effect of radiation' and 'leukaemia is uniquely radiogenic amongst cancers', may be significantly in error. These are discussed.

Adolescent↗
PubMed1999

Lifetime prevalence of schizophrenia among individuals prenatally exposed to atomic bomb radiation in Nagasaki City.

OBJECTIVE: The aim of this study was to examine the relationship between prenatal exposure to atomic bomb (A-bomb) radiation and the development of schizophrenia in adulthood. METHOD: We investigated the lifetime prevalence of schizophrenia among people prenatally exposed to the 1945 Nagasaki A-bomb, using the schizophrenia register and the A-bomb survivors' database. RESULTS: Among 1867 prenatally exposed individuals, 18 subjects (0.96%) had developed schizophrenia later in life. The prevalence was significantly higher in people exposed in the second trimester of pregnancy than in those exposed in the third trimester. The closer they had been to the hypocentre, the higher was the prevalence, but no statistically significant linear relationship was seen. CONCLUSION: This investigation could not clarify the nature of exposure to A-bomb radiation as a risk factor for schizophrenia in the prenatal period.

Adult↗
PubMed2003

The pipe bomb: a modern terrorist weapon.

The use of pipe bombs by terrorist organisations around the world has risen dramatically. The pipe bomb is simple and easy to make and details of bomb construction are freely available from the Internet. Components can be found in most hardware stores and thus give little forensic information. Despite the increasing use of pipe bombs, clinicians may be unfamiliar with the type of injuries they cause. This paper describes two incidents of pipe bomb explosions and illustrates the type of injuries sustained by both terrorists and victims.

Adult↗
PubMed1996

The role of radiology in the Oklahoma City bombing.

PURPOSE: To evaluate the role of radiologic services in the assessment of injuries and identification of deceased victims of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Okla. MATERIALS AND METHODS: In cooperation with the Oklahoma University Health Sciences Center Disaster Studies Group, all victims of the Oklahoma City bombing who were treated in hospitals were evaluated. All radiologic studies performed in these patients during a 4-week period after the bombing were recorded. Major injuries incurred by the victims were noted but were not documented. In addition, assistance provided by radiologic services to the medical examiner's office for identification of deceased victims was assessed. RESULTS: On the day of the bombing, 99% (480 of 485) of the imaging studies performed were either plain radiography, primarily of the extremities and chest, or computed tomography (CT), half of which were of the head. Six deceased victims were identified solely by means of characteristics on radiographs. CONCLUSION: Almost all bombing-related radiologic studies were either plain radiography or CT. Other modalities had only limited roles. In deceased victims, plain radiography aided identification, and in many other victims it allowed localization of materials that were potential pieces of evidence.

Blast Injuries↗
PubMed1990

Rational risk estimation in relation to atomic bomb radiation.

This paper summarizes genetic and somatic data on persons exposed to low doses of atomic bomb radiation in Hiroshima and Nagasaki. Compared with experimental estimates, the new dosimetry system proposed in 1986 underestimates neutron doses, supporting qualitatively the conclusion by the 1965 dosimetry system that Nagasaki A-bomb emitted predominantly gamma rays whereas Hiroshima A-bomb emitted both gamma rays and fast neutrons. A theory based on two recessive mutations in hemopoietic stem cells is proposed to explain radiation leukemogenesis. The theory can explain, at least partly, the actual dose-response curve for incidences of acute leukemia in Hiroshima but cannot explain chronic leukemia in Nagasaki. Existence of a large threshold dose in the latter's dose relationship supports the hypothesis that A-bomb radiation at high doses above a threshold value was a promoter and/or progressor of leukemia. Various lines of evidence that support this hypothesis are presented. Hence, it is not warranted to assume that risk of death from cancer at a high dose, say, 1 Gy can be divided by 100 to obtain the risk at 1 cGy. Risk at low doses should be assessed by direct scrutiny of actual data at low doses in spite of their large statistical uncertainty. Actual data show that A-bomb survivors at 1-9 cGy had apparently lower incidences of tumors than unexposed persons.

Adult↗
PubMed1991

Studies of radioactivity produced by the Hiroshima atomic bomb: 1. Neutron-induced radioactivity measurements for dose evaluation.

This review summarizes measurements made of 152Eu and 60Co radioactivity induced by neutron radiation from the Hiroshima atomic bomb (A-bomb) with the goal of estimating the neutron dose released by the bomb. Prior to these measurements, A-bomb-irradiated specimens such as rocks and pieces of concrete, which had not been shielded were collected. The specific radioactivity obtained (in bequerels per gram of Eu or Co) were compared with those calculated from DS86 neutrons. Findings of usefulness of 152Eu data within 700 m ground range are reported and systematic differences between measured activities and calculations are discussed. The 152Eu data were also useful for the discussion of circular asymmetry, and there was no asymmetry within the experimental errors. This review also covers the similar difference found in 32P data, which were measured immediately after the A-bomb, along with the other 152Eu and 60Co data. The need for more measurements of 152Eu activity in samples farther away from the hypocenter in order to verify the DS86 calculations is also discussed.

Humans↗
PubMed1991

Physical dosimetry at Nagasaki--Europium-152 of stone embankment and electron spin resonance of teeth from atomic bomb survivors.

Gamma-rays from thermal neutron-induced radionuclide of 152Eu in rocks near the ground center of the atomic bomb (A-bomb) explosion (hypocenter) in Nagasaki were measured with a pure germanium semiconductor detector. Depth profiles of 152Eu activity were obtained for 22 core samples taken from stone embankments on both sides of two rivers (the River Shimono-kawa and the River Urakami-gawa) within 500 m of the hypocenter since the activity in the rocks has a history of incident neutron energy. although the activities of the surface sections were varied from sample to sample, the slopes of depth profile in rock and the value of 152Eu activity in the depth of 240-280 mm were similar among the samples taken from the same location. On the other hand, neutron penetrating experiments using both a fast and a thermal neutron reactor were performed to obtain the relationship between the incident neutron energy spectra and the depth profiles of 152Eu activity in rock. The depth profiles in the bomb exposed samples were close to that obtained by using a 10 mm polyethelene moderator in the reactor experiments. Electron spin resonance (ESR) measurements from teeth of A-bomb survivors were carried out to estimate the individual gamma-ray dose of the survivors. The absorbed dose of ten tooth samples was estimated by ESR dosimetry. The results of ESR dosimetry were consistent with the calculations of tissue dose in air of A-bombs and irradiated shielding configuration of individuals.

Electron Spin Resonance Spectroscopy↗
PubMed1999

High incidence of meningioma among Hiroshima atomic bomb survivors.

Since the atomic bomb explosions in Hiroshima and Nagasaki, high incidences of leukemia, thyroid cancer and other tumors have been reported as atomic bomb-induced tumors. We investigated the incidence of meningioma among Hiroshima atomic bomb survivors. Sixty-eight patients surgically treated for meningioma who had been within 2.0 km of the hypocenter of the explosion were identified. Six hundred and seven non-exposed patients with meningioma were also studied. Treatment dates were from 1975 to 1992. The incidences of meningioma among 68 subjects within 2.0 km and 607 non-exposed patients were 8.7 and 3.0 cases per 10(5) persons per year, respectively. The incidences of meningioma among the survivors of Hiroshima in 5-year intervals since 1975 were 5.3, 7.4, 10.1, and 14.9, respectively. The incidences of meningioma classified by distances from the hypocenter of 1.5-2.0 km, 1.0-1.5 km and less than 1.0 km were 6.3, 7.6 and 20.0, respectively. The incidences of meningioma classified by doses to the brain of 0-0.099 Sv, 0.1-0.99 Sv and more than 1.0 Sv were 7.7, 9.2 and 18.2, respectively. The incidence of meningioma among Hiroshima atomic bomb survivors has increased since 1975. There was a significant correlation between the incidence and the dose of radiation to the brain. The present findings strongly suggest that meningioma is one of the tumors induced by atomic bombing in Hiroshima.

Brain↗
PubMed2002

T cells of atomic bomb survivors respond poorly to stimulation by Staphylococcus aureus toxins in vitro: does this stem from their peripheral lymphocyte populations having a diminished naïve CD4 T-cell content?

We found previously that the peripheral CD4 T-cell populations of heavily exposed A-bomb survivors contained fewer naïve T cells than we detected in the corresponding unexposed controls. To determine whether this demonstrable impairment of the CD4 T-cell immunity of A-bomb survivors was likely to affect the responsiveness of their immune systems to infection by common pathogens, we tested the T cells of 723 survivors for their ability to proliferate in vitro after a challenge by each of the Staphylococcus aureus toxins SEB, SEC-2, SEC-3, SEE and TSST-1. The results presented here reveal that the proliferative responses of T cells of A-bomb survivors became progressively weaker as the radiation dose increased and did so in a manner that correlated well with the decreasing CD45RA-positive (naïve) [but not CD45RA-negative (memory)] CD4 T-cell percentages that we found in their peripheral blood lymphocyte (PBL) populations. We also noted that the T cells of survivors with a history of myocardial infarction tended to respond poorly to several (or even all) of the S. aureus toxins, and that these same individuals had proportionally fewer CD45RA-positive (naïve) CD4 T cells in their PBL populations than we detected in survivors with no myocardial infarction in their history. Taken together, these results clearly indicate that A-bomb irradiation led to an impairment of the ability of exposed individuals to maintain their naïve T-cell pools. This may explain why A-bomb survivors tend to respond poorly to toxins encoded by the common pathogenic bacterium S. aureus.

Aged↗
PubMed1993

Did atomic bomb radiation influence the incidence of retinoblastoma in Nagasaki and Hiroshima?

The authors studied the effect of atomic bomb radiation in Nagasaki and Hiroshima on the incidence of retinoblastoma by examining the history of exposure to atomic bomb radiation among the grandparents and parents of retinoblastoma patients in Nagasaki and Hiroshima. Of 85 patients born in Nagasaki Prefecture from 1965 to 1986 and in Hiroshima Prefecture from 1966 to 1986, 42 had records to whether or not their grandparents and parents had been exposed to atomic bomb radiation. Seven had parents or grandparents exposed to atomic bomb radiation. These patients showed neither a high incidence of bilateral retinoblastoma nor a family history of retinoblastoma, although a higher incidence of cancer in the family history was found in the exposed group. Exposure to radiation showed no correlation with the onset of retinoblastoma. Moreover, the incidence of retinoblastoma in Nagasaki and Hiroshima Prefectures was almost the same as the average incidence in Japan. The authors failed to find evidence of increased incidence of retinoblastoma in the offspring of those exposed to atomic bomb radiation in Nagasaki and Hiroshima. However, this does not mean that the effect of radiation on the occurrence of retinoblastoma can be ruled out.

Adult↗
PubMed2006

Non-cancer diseases of Korean atomic bomb survivors in residence at Hapcheon, Republic of Korea.

Many Koreans, in addition to Japanese, were killed or injured by the atomic bombs detonated over Hiroshima and Nagasaki, Japan, in 1945. Our study examined noncancer diseases of Korean A-bomb survivors in residence at Hapcheon, Republic of Korea and evaluated whether they had significantly higher prevalence of noncancer diseases than non-exposed people. We evaluated a number of tests, including anthropometric measurements, blood pressure, blood chemistry, hepatitis B surface antigen, and urinalysis, of survivors (n=223) and controls (n=372). Univariate analysis revealed significantly lower fasting glucose and creatinine, and higher diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase, and blood urea nitrogen levels in the survivors than in the controls. The calculation of crude prevalence ratios (PRs) revealed that A-bomb survivors had a significantly higher prevalence of hypertension (PR, 1.16; 95% CI, 1.00-1.35) and chronic liver disease (2.20; 1.59-3.06) than controls. After adjusting for covariates (age, sex, body mass index, marital status, education, alcohol consumption, and smoking), A-bomb survivors had a significantly higher prevalence of hypertension (1.24; 1.06-1.44), chronic liver disease (2.07; 1.51-2.84), and hypercholesterolemia (1.79; 1.11-2.90) than controls. This study suggests that A-bomb exposure is associated with a higher prevalence of non-cancer diseases in Korean survivors.

Abnormalities, Radiation-Induced↗
PubMed1992

Hyperparathyroidism among atomic bomb survivors in Hiroshima.

To determine the effect of exposure to atomic bomb radiation on the occurrence of hyperparathyroidism, the prevalence was determined among a population of 3,948 atomic bomb survivors and their controls in Hiroshima. The diagnosis of hyperparathyroidism was based upon histopathological findings or the presence of consistent hypercalcemia and elevated levels of serum parathyroid hormone. Primary hyperparathyroidism was diagnosed in 19 persons (3 males, 16 females). Females had approximately a threefold higher overall prevalence of hyperparathyroidism than males (P less than 0.05). The prevalence rates of hyperparathyroidism increased with radiation dose (chi2(1) = 12, P less than 0.001) after adjusting for sex and age at the time of the bombing. The estimated relative risk was 4.1 at 1 Gy (95% confidence limits 1.7 to 14). There was some evidence that the effect of radiation was greater for individuals who were younger at the time of the bombing. In conclusion, exposure to atomic bomb radiation affected the occurrence of hyperparathyroidism, suggesting that doses of radiation lower than those used in radiotherapy may also induce this disorder.

Adolescent↗
PubMed1990

Cancer risk among children of atomic bomb survivors. A review of RERF epidemiologic studies. Radiation Effects Research Foundation.

This article summarizes recent epidemiologic studies of cancer risk among the children of atomic bomb survivors conducted at the Radiation Effects Research Foundation. These children include two groups: (1) the in utero-exposed children (ie, those born to mothers who had been pregnant at the time of the bombings of Hiroshima and Nagasaki) and (2) the F1 population, which was conceived after the atomic-bombings and born to parents of whom one or both were atomic bomb survivors. Although from 1950 to 1984 only 18 cancer cases were identified among the in utero sample, cancer risk did appear to significantly increase as maternal uterine dose increased. However, since the observed cases are too few in number to allow a site-specific review, the increased cancer risk cannot be definitively attributed to atomic bomb radiation, as yet. For those members of the F1 population who were less than 20 years old between 1946 and 1982, cancer risk did not appear to increase significantly as parental gonadal dose increased. Follow-up of this population will continue to determine if the patterns of adult-onset cancer are altered.

Abnormalities, Radiation-Induced↗
PubMed1982

Pathology of atomic bomb casualties.

Thirty seven years ago, 6 August 1945 marks the date of the first atomic bombing never experienced in human history. It was dropped on Hiroshima and this was followed by a second bombing three days later on Nagasaki. The total deaths following exposure to the bomb by the end of 1945 totalled 140,000 (+/- 10,000) in Hiroshima and 70,000 (+/- 10,000) in Nagasaki. The present article described and outline of the physical effects of the atomic bomb and injury to the human body by exposure to the bomb.

Adolescent↗
PubMed1996

Physical injuries and fatalities resulting from the Oklahoma City bombing.

OBJECTIVE: To provide an epidemiologic description of physical injuries and fatalities resulting from the April 19, 1995, bombing of the Alfred P. Murrah Federal Building in Oklahoma City. DESIGN AND SETTING: Descriptive epidemiologic study of all persons injured by the bombing and of all at-risk occupants of the federal building and 4 adjacent buildings. Data were gathered from hospital emergency and medical records departments, medical examiner records, and surveys of area physicians, building occupants, and survivors. STUDY POPULATION: All persons known to have been exposed to the blast. MAIN OUTCOME MEASURES: Characteristics of fatalities and injuries, injury maps, and injury rates by building location. RESULTS: A total of 759 persons sustained injuries, 167 persons died, 83 survivors were hospitalized, and 509 persons were treated as outpatients. Of the 361 persons who were in the federal building, 319 (88%) were injured, of whom 163 (45%) died, including 19 children. Persons in the collapsed part of the federal building were significantly more likely to die (153/175, 87%) than those in other parts of the building (10/186, 5%) (risk ratio [RR], 16.3; 95% confidence interval [CI], 8.9-29.8). In 4 adjacent buildings, injury rates varied from 38% to 100%; 3 persons in these buildings and 1 person in an outdoor location died. The most frequent cause of death was multiple injuries. Among survivors, soft tissue injuries, fractures, sprains, strains, and head injuries were most common; these injuries were most often caused by flying glass and other debris and collapsed ceilings. CONCLUSIONS: The Oklahoma City bombing resulted in the largest number of fatalities of any terrorist act in the United States, and there were 4 times as many nonfatal injuries as fatalities. Disaster management plans should include the possibility of terrorist bombing, and medical preparedness should anticipate that most injuries will be nonfatal. The role of building collapse in fatal injuries should be considered in the design of buildings at high risk of being bombed so as to reduce injuries.

Cause of Death↗
PubMed1997

Injuries due to letter bombs.

In Austria in late 1993 ten letter bombs were sent to outstanding persons who have been engaged in the care of foreigners. Four of these bombs detonated, when they were opened by the addressee. The remaining six bombs were discovered in time and could be deactivated by specialists. The construction of these bombs and the lesions sustained by the four victims will be discussed. The injuries mainly concerned the left hand, i.e., the hand used by right-handed persons to hold a letter when opening it. The way holding the letter was of crucial influence on the degree of injury, as with the same explosive charge (which can be assumed deducing from the investigation of the deactivated bombs) injuries varied considerably. They ranged from minor tissue-lesions to mutilated fingers and the risk of exsanguination.

Adolescent↗
PubMed2006

Radiation dose-response relationships for thyroid nodules and autoimmune thyroid diseases in Hiroshima and Nagasaki atomic bomb survivors 55-58 years after radiation exposure.

CONTEXT: Effects of irradiation on thyroid diseases such as thyroid nodules and autoimmune thyroid diseases have not been evaluated among people exposed to radiation more than 50 years in the past. OBJECTIVE: To evaluate the prevalence of thyroid diseases and their radiation-dose responses in atomic bomb survivors. DESIGN, SETTING, AND PARTICIPANTS: Survey study comprising 4091 cohort members (mean age, 70 [SD, 9] years; 1352 men and 2739 women) who participated in the thyroid study at the Radiation Effects Research Foundation. Thyroid examinations were conducted between March 2000 and February 2003. MAIN OUTCOME MEASURES: Prevalence of thyroid diseases, including thyroid nodules (malignant and benign) and autoimmune thyroid diseases, and the dose-response relationship of atomic bomb radiation in each thyroid disease. RESULTS: Thyroid diseases were identified in 1833 (44.8%) of the total participants (436 men [32.2% of men] and 1397 women [51.0% of women]) (P<.001). In 3185 participants, excluding persons exposed in utero, not in the city at the time of the atomic bombings, or with unknown radiation dose, the prevalence of all solid nodules, malignant tumors, benign nodules, and cysts was 14.6%, 2.2%, 4.9%, and 7.7%, respectively. The prevalence of positive thyroid antibodies, antithyroid antibody-positive hypothyroidism, and Graves disease was 28.2%, 3.2%, and 1.2%, respectively. A significant linear dose-response relationship was observed for the prevalence of all solid nodules, malignant tumors, benign nodules, and cysts (P<.001). We estimate that about 28% of all solid nodules, 37% of malignant tumors, 31% of benign nodules, and 25% of cysts are associated with radiation exposure at a mean and median thyroid radiation dose of 0.449 Sv and 0.087 Sv, respectively. No significant dose-response relationship was observed for positive antithyroid antibodies (P = .20), antithyroid antibody-positive hypothyroidism (P = .92), or Graves disease (P = .10). CONCLUSIONS: A significant linear radiation dose response for thyroid nodules, including malignant tumors and benign nodules, exists in atomic bomb survivors. However, there is no significant dose response for autoimmune thyroid diseases.

Aged↗
PubMed1996

Incidence of intracranial meningiomas in Nagasaki atomic-bomb survivors.

Among the Nagasaki atomic-bomb survivors registered at the Scientific Data Center for Atomic-Bomb Disaster, Nagasaki University School of Medicine, 45 cases of surgically treated intracranial meningioma were collected from 6 hospitals with departments of neurosurgery in or near Nagasaki City during the period from 1973 to 1992. All 45 patients were over 40 years of age at the time of diagnosis. Subsequently, the 45 cases were statistically analyzed in relationship to the estimated distance from the hypocenter by age, gender, intracranial location, histology and latent period. The analysis showed a high correlation between incidence of meningiomas and distance from the hypocenter. The incidence among Nagasaki atomic-bomb survivors over 40 years of age, especially in those proximally exposed, appears to be increasing, in inverse proportion to the exposure distance, since 1981, 36 years after the explosion of the atomic bomb.

Adult↗