The somatic effects of exposure to atomic radiation: the Japanese experience, 1947-1997.

Abstract

Fifty years ago, when the Atomic Bomb Casualty Commission came into being, the health consequences of exposure to ionizing radiation were poorly understood. It was known that, under appropriate circumstances in experimental systems, ionizing radiation could be carcinogenic, mutagenic, and teratogenic. However, the applicability of this information to the human species was uncertain, and epidemiologic studies were few in number. Moreover, most of the studies that were available involved individuals exposed to radiotherapy with whom the effects of radiation could be confounded with those of the illness being treated. Little was known about the dose–response relationships involved, the relative biological effectiveness of different qualities of radiation, or the factors that could modify risk. Undoubtedly, these uncertainties contributed to the decision of Colonel Ashley Oughterson and the Joint Commission for the Investigation of the Effects of the Atomic Bomb to recommend to Major General Norman Kirk, the Surgeon General of the Army, the need for long term studies of the effects of exposure to atomic radiation in Hiroshima and Nagasaki. This recommendation led President Truman to direct the National Academy of Sciences–National Research Council to undertake the requisite studies. But these uncertainties are echoed in the vagueness of the planning documents that established the Atomic Bomb Casualty Commission. These noted that the areas of concern were “cancer, leukemia, shortened life span, reduced vigor, altered development, sterility, modified genetic pattern, changes in vision, ‘shifted epidemiology,’ abnormal pigmentation, and epilation” (1). The organizational and logistic problems that confronted the newly created research institution were formidable (2). Japan was a devastated, occupied nation with few resources of its own. As a consequence, the Atomic Bomb Casualty Commission had to be largely self-sufficient. It needed to establish its own clinical facilities, recruit and train staff, and develop the means to meet other needs, such …