Technical Report No. 9-71

ABCC-JNIH Adult Health Study. Report 5. Results of the first five examination cycles, Hiroshima-Nagasaki, 1958-68

Belsky JL, Tachikawa K, Jablon S

Editor’s note:

The following journal articles, based on this ABCC technical report, were published in the scientific literature:
Belsky JL, Tachikawa K, Jablon S: The health of atomic bomb survivors: A decade of examinations in a fixed population. Yale J Biol Med 46:284-96, 1973
Belsky JL, Tachikawa T, Jablon S: The health of atomic bomb survivors: A decade of examinations in a fixed population. Hiroshima Igaku [J Hiroshima Med Assoc] 27:813-22, 1974 (in Japanese)

 

Summary

The ABCC-JNIH Adult Health Study (AHS), in its present form, was begun in 1958 as a program of biennial examinations of survivors of the atomic bombs. This report summarizes findings over the first decade of examinations in Hiroshima and Nagasaki. Prior reports have been issued which cover the first 4 years of effort.

Although clinic routine (including examination by physicians, laboratory tests, and X-ray procedures) was substantially unchanged over the period considered, a new dosimetry system has permitted analysis of data by radiation dose groupings. Brief summaries of this, as well as the population studied, and clinic procedure are given.

Participation in cycle examinations remained high throughout, and was still about 85% during the 5th biennium. Decreases in rate, from about 90% in 1958-1960, were about equal in the cities, sexes, and exposure groups. Reasons for this are proposed. Statistical comparisons among dose groups, controlled by city, sex, age, and cycle, comprise the tabulations of diseases, certain physical measurements, and laboratory and X-ray findings. These data are derived from the regularly scheduled 2-year examinations, and not from substudy projects.

The discussion is organized under the following headings and is briefly summarized as follows:

Radiation Effects are noted in diseases of thyroid (except cancer) and diseases of the eye. Increased prevalence, in survivors, of cancer of the thyroid, breast, and lung, which were more prominently seen in substudies, showed only suggestive trends in the present analysis. It was also noted that short stature, small heart and chest diameters and, possibly, lower blood pressures were tantalizingly more evident among heavily irradiated survivors, especially the young at the time of the bombing (ATB).

Intercity Differences in Disease Prevalence are given. In general, infectious diseases and infestations were more prevalent in Nagasaki, as were diseases of the liver and adjacent viscera. On the other hand, diabetes was more prevalent in Hiroshima, while physical measurements were similar.

Disease Differences between the Sexes are examined. These are, generally, similar to those reported in other countries. Notable exceptions are in diabetes, where AHS males predominate, and in levels of cholesterol.

Differences Associated with Age vary little from expected. It is of interest that both weight and certain hematologic findings decreased with aging.

Changes over the 5 Cycles are reported and reflect the effects of socioeconomic, nutritional, and medical care trends. More than any other comparison, changes with time also emphasize the importance of the substudy program for specific diseases, as well as the influence of changing medical personnel and laboratory techniques in explaining observed prevalence trends.

It is concluded that the general health examination, beyond benefits to the individual patient, as an epidemiologic tool provides valuable information. But, for those items that are shown to be possibly related to radiation effects of the atomic bombs, more detailed study is necessary.

Data gathered in scheduled as well as substudy examinations do permit, at least, one important generalization: those who were young and still developing ATB (from in utero stages to adolescence) who received high radiation doses are, clearly, the most sensitive to radiation injury in the ABCC-JNIH survivor population.
Editor’s note: The following components of this report contain data on communicable disease frequencies, allergies, malignancies, and many other symptoms that may be of interest from a public health standpoint.

 

Editor’s note: 

The following components of this report contain data on communicable disease frequencies, allergies, malignancies, and many other symptoms that may be of interest from a public health standpoint.

 

List of Tables

1. Number of Survivors (mid-cycle)
2. Participation Rates
3. Number of Deaths
4. Death Rates
5. Number Examined Each Cycle
6. Tuberculosis, All Forms
7. Latent Syphilis
8. Other Syphilis
9. Other Infective & Parasitic Diseases
10. Malignant Neoplasms of Digestive Organs & Peritoneum
11. Malignant Neoplasms of Respiratory System
12. Malignant Neoplasms of Breast & Genitourinary Organs
13. Malignant Neoplasms of Other & Unspecified Sites, Including Thyroid
14. Allergic Disorders
15. Diseases of Thyroid Gland
16. Diabetes Mellitus
17. Avitaminosis & Other Metabolic Diseases
18. Diseases of Blood & Blood Forming Organs
19. Vascular Lesions Affecting Central Nervous System
20. Other Diseases & Conditions of Eye
21. Diseases of Ear & Mastoid Process
22. Arteriosclerotic & Degenerative Heart Disease
23. Other Diseases of Heart
24. Hypertensive Heart Disease
25. Other Hypertensive Disease
26. Diseases of Arteries
27. Diseases of Veins & Other Diseases of Circulatory System
28. Bronchitis
29. Other Diseases of Respiratory System
30. Diseases of Stomach & Duodenum
31. Other Diseases of Intestines & Peritoneum
32. Diseases of Liver, Gallbladder, & Pancreas
33. Nephritis & Nephrosis
34. Other Diseases of Urinary System
35. Arthritis & Rheumatism, except Rheumatic Fever
36. Osteomyelitis & Other Diseases of Bone & Joint
37. Other Diseases of Musculoskeletal System

    Physical & roentgenologic findings

38. Height
39. Weight
40. Systolic Blood Pressure
41. Diastolic Blood Pressure
42. Heart Size, Transverse Diameter
43. Thoracic Cage Width
44. Heart Trans. Diam./Thor. Cage Width
45. ECG, Normal Report
46. ECG, Myocardial Ischemia
47. ECG, Myocardial Infarction

    Laboratory findings

48. Hemoglobin
49. Hematocrit
50. Sedimentation Rate
51. Total White Blood Cell Count
52. Differential Counts, Neutrophils
53. Differential Counts, Lymphocytes
54. Differential Counts, Monocytes
55. Differential Counts, Eosinophils
56. Differential Counts, Basophils
57. Cholesterol
58. Uric Acid
59. Proteinuria
60. Glycosuria
61. Blood in Stool
62. Ova or Parasites in Stool

 

List of Figures

1. Prevalence of Diseases of the Thyroid by Radiation Dose & City, Female Age 0-19 ATB
2. Prevalence of Other Diseases of the Eye by Radiation Dose & Sex, Hiroshima 0-19 ATB
3. Mean Standing Height by Radiation Dose, Sex, & City, Age 0-19 ATB
4. Prevalence of Hypertensive Heart Disease by Age ATB, Sex, & City
5. Prevalence of Diabetes Mellitus by Cycle, Sex, & City, Age 40-49 ATB