Pagwash Conference Nagasaki 2015

Plenary Session I Humanitarian Impact of Nuclear Weapons:Humanitarian Impact of Nuclear Weapons: Life-long Health Effects of Atomic BombingLife-long Health Effects of Atomic Bombing In Hiroshima and NagasakiIn Hiroshima and Nagasaki

　　 Masao Tomonaga, M.D., Ph.D.Masao Tomonaga, M.D., Ph.D. 　　　　　　　　　　　　　　　　　 　　 　 Honorary DirectorHonorary Director 　　　　　　 Japanese Red Cross Nagasaki Atomic Bomb HospitalJapanese Red Cross Nagasaki Atomic Bomb Hospital 　

Hiroshima Bomb (Uranium) Nagasaki Bomb (Plutonium)

Immediate death >120,000Immediate death >120,000Atomic Bomb survivors 140,000Atomic Bomb survivors 140,000 Immediate death >75,000Immediate death >75,000

Atomic Bomb survivors 74,000Atomic Bomb survivors 74,000

Aug. 6 1945Aug. 6 1945 Aug. 9, 1945Aug. 9, 1945

Nagasaki City from above : a few days before Atomic Bombing (US Air Force)

My home My home

Original target

University Hospital

Actual target

Just after Bombing

The point I survived

Ground ZeroGround Zero

Original targetOriginal target2.5 km2.5 km

Physical Damages Caused by the Nagasaki Atomic BombingPhysical Damages Caused by the Nagasaki Atomic Bombing

Heat rays２０００～５００℃

Burned to boneCarbonizationSevere burns　　 immediate death skin tear-off

By Yamahata

Heat

level (cal/cm2)

)

No medical aid but waiting for death No medical aid but waiting for death

By Yamahata

Nagasaki Medical University Hospital（旧）長崎医科大学付属毉院

Red CrossNagasaki

Atomic Bomb Hospital

Ground ZeroGround Zero

600m600m

900 Medical Students and Professors died900 Medical Students and Professors died

Acute Radiation Sickness(ARS): First sign is hair lossAcute Radiation Sickness(ARS): First sign is hair loss

Radiation and Burn combined usually led death

He recovered after 1.5 years’ bed life in this positionHe recovered after 1.5 years’ bed life in this position

Mr. Taniguchi gave a speech at NPT ConferenceIn 2010 at New York by showing his photo.

Only one ambulance at an elementary school with some doctors and nurses but no drug, no blood transfusion, no antibiotics.

All Hospitals were destroyed in Nagasaki CityAll Hospitals were destroyed in Nagasaki City

Sin-kozen Elemetary School

Many died of acute radiation sicknessMany died of acute radiation sickness

My HouseMy Housewas herewas here

By Joe O’Donnell, U.S. Army

MicrocephalyMicrocephaly

Control

Radiation during early pregnancyRadiation during early pregnancy

Distance from thehypocenter

Dea

th R

ate

Colon damage

Bone marrow damage

Normal controls

Death rate in the first three months due to injuries and Death rate in the first three months due to injuries and Acute radiation sickness (ARS)Acute radiation sickness (ARS)

Initial observation of increased rate of leukemia Initial observation of increased rate of leukemia among atomic bomb survivorsamong atomic bomb survivors

From [Leukemia ： Dameshek & Gunz 1974]

Leukemia dose response based on a quadratic excess absolute risk (EAR) model

0

5

10

15

20

3035

40

25

0 1 2 3 4Dose (SV)

Exce

ss c

ases

per

104

PY

0 1 2 3 4 50.0

0.5

1.0Ex

cess

Rel

ativ

e Ri

sk (

ERR)

Colon dose (Sv)Pierce AD, Shimizu Y, Preston DL, Vaeth M, Mabuchi K: Studies of the Mortality of atomic bomb survivors. Report 12, Part 1. Cancer: 1950-1990. Radiation Research, 146, 1-27, 1996

Solid cancer dose-response for a male of 30yearsof age at the time of exposure

Excess Pelative Risk (EPR): Ratio of death rate (or rate of incidence) for the exposed population and thedeath rate (or rate of incidence) in the control group. An ERR = 0.5 means an increase of 50%.

Within 1.5 km from ground zero, survivors tend Within 1.5 km from ground zero, survivors tend to develop three times more second or third to develop three times more second or third cancerscancers

Multiple Cancers among Nagasaki Atomic Bomb Survivours

Recent MDS (myelodyplastic syndromes) Survey Recent MDS (myelodyplastic syndromes) Survey in Nagasaki in Nagasaki “ “Second wave of leukmia”Second wave of leukmia”

MDS: Leukemia-related Blood Malignancy Frequently occur among elderly population (over 60 yrs)

Clinical FeatureClinical FeatureMorphological dysplasia as shown in photographs

　　 Anemia and low White Blood Cell counts Ineffective hematopiesis20-30% of patients with MDS eventually transform to AML　　　　 Chromosome abnormality in 50%Several subtypes with low to high AML transformationDignosis is difficult Tretment is difficult, very resistant to drugsIncreasing in the developed countriesAlmost equal to AML incidence in developed countries

Excess risk of MDS Excess risk of MDS

Masako Iwanaga et al: International J. of Oncology 2011

　　 Time trend of Atomic Bomb-related Time trend of Atomic Bomb-related CancersCancers

0 10 20 30 40 50 60Years since 1945Years since 1945

Dea

th e

xces

s

1st Leukemia Phase（（ AML/ALL/CML)AML/ALL/CML)

　 Solid Cancers Phase(Thyroid,Breast,Lung,Colon, Stomach, multiple cancers)

　　 2nd Leukemia Phase (MDS/AML)(MDS/AML)　　　　　　　　　　　　

Less than 20 yrs old ATBLess than 20 yrs old ATB

Early onset Late onsetLate onset

Hypothesis: Organ stem cell hit theoryHypothesis: Organ stem cell hit theory

A stem cellGamma &/or neutron rayspenetrate cell nucleus containing DNA double strand.DNA is cut but usually repaired to normal. However, miss-repair takes place occasionally, leading to cancer/leukemiaprone mutations.

Fusion genes for leukemiaFusion genes for leukemia

Why Atomic Bomb Helath Effects are long-lasting?Why Atomic Bomb Helath Effects are long-lasting?

Germ cells(sperm or ova) DNA damage may cause trans-Germ cells(sperm or ova) DNA damage may cause trans-generation effects to Hibakushas’ children (F1) ;generation effects to Hibakushas’ children (F1) ; Long-lasting anxiety for Atomic Bomb Survivors when Long-lasting anxiety for Atomic Bomb Survivors when they gave a birth to their children, because animal they gave a birth to their children, because animal experiments accumulated proved trans-generational effects. experiments accumulated proved trans-generational effects.

Many girls with face burn eventually lost chance of marriageMany girls with face burn eventually lost chance of marriage.Her lonely life was further enhanced by loss of many family members.

By Noriyuki Aida

Psychological Damage Study for Survivors after a half century(1995)Psychological Damage Study for Survivors after a half century(1995) by WHO General Health Questionnaire (GHQ) by WHO General Health Questionnaire (GHQ)

Depression, PTSD etc.

By Sumihisa Honda

ConclusionConclusion

The atomic bombs are “Gene-targeting weapon”.The atomic bombs are “Gene-targeting weapon”. The radiation immediately causes DNA damage,The radiation immediately causes DNA damage, that induces leukemia/cancers during that induces leukemia/cancers during survivors’ entire life. survivors’ entire life. Psychological effect” is also long-lasting and profoundPsychological effect” is also long-lasting and profound

From medical view point, nuclear weapons are apparentlyFrom medical view point, nuclear weapons are apparentlyanti-humanitarian in its nature.anti-humanitarian in its nature.

Together with its indiscriminate effects on human beings Together with its indiscriminate effects on human beings and devastating consequence on cities, only solution ofand devastating consequence on cities, only solution offort this danger and fear is their total elimination. fort this danger and fear is their total elimination.