Technical Report No. 2-91

Life Span Study Report 11. Part 3. Noncancer mortality, 1950-85, based on the revised doses (DS86)

Shimizu Y, Kato H, Schull WJ, Hoel DG

Editor’s note: 

The following journal articles, based on this ABCC technical report, were published in the scientific literature:

• Shimizu Y, Kato H, Schull WJ: A review of forty-five years study of Hiroshima and Nagasaki atomic bomb survivors. Mortality among atomic bomb survivors. J Radiat Res (Tokyo) 32S:212-30, 1991
• Shimizu Y, Kato H, Schull WJ, Hoel DG: Studies of the mortality of A-bomb survivors. 9. Mortality, 1950-1985: Part 3. Noncancer mortality based on the revised doses (DS86). Radiat Res 130:249-66, 1992

 

Summary

Deaths in the RERF Life Span Study (LSS) sample have been determined for the years 1950-1985 and previous reports have described analyses of cancer mortality using the revised Dosimetry System 1986 (DS86) doses (LSS Report 11, Parts 1 and 2). In this report, we examine the relationship to dose of deaths from all diseases other than cancer.

Although the evidence is still limited, there seems to be an excess risk for noncancer death at high doses (2 or 3 Gy and over). Statistically, a pure quadratic or a linear-threshold model (the estimated threshold dose is 1.4 Gy [0.6-2.8 Gy]) is found to fit better than a simple linear or linear-quadratic model. This increase in noncancer mortality is statistically demonstrable, generally, after 1965 and among the younger survivors (<40) at the time of the bombings, suggesting a sensitivity in this age group. For specific causes of death, an excess relative risk at the high dose level, that is, greater than or equal to 2 Gy, is seen in circulatory and digestive diseases. The relative risk is, however, much smaller than that for cancer.

These findings, based as they are on death certificates, have their limitations. Most significant, perhaps, is the possible erroneous attribution of radiation-related cancer deaths to other causes. At present, the contribution such errors may make to the apparent increase in noncancer deaths at the higher doses cannot be estimated as rigorously as is obviously desirable. However, even now, this increase does not appear to be fully explicable in terms of classificatory errors.

Further follow-up of mortality in this LSS cohort as well as of disease revealed by the biennial physical examinations of the morbidity subsample (Adult Health Study) of the LSS cohort will be needed to confirm this suggestion of a radiation-related increase in mortality from causes other than cancer, and to determine whether it results in a demonstrable life-shortening among the heavily exposed atomic bomb survivors.

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 deaths by cause of death among 75,991 Dosimetry System 1986 (DS86) subcohort members (1950-1985)
2. Relative risk (vs. 0 Gy) for mortality from all diseases except neoplasm and blood disease, 1950-1985
3. Relative risk (vs. 0 Gy) for mortality from all diseases except neoplasm and blood disease in groups combined by age at the time of the bombings (ATB) and period, 1950-1985 (cities and sexes combined)
4. Change in regression coefficient by period
5. Number of deaths and relative risk (vs. 0 Gy) for mortality from major causes of death, 1950-1985 (cities, and sexes combined)
6. Relative risk (vs. 0 Gy) of mortality from major causes of death for age at the time of the bombings <40, 1966-1985 (cities and sexes combined)
7. Risk estimates of mortality from all diseases except neoplasm and blood disease based on a linear-threshold model, with the threshold dose assumed to be 1.4 Gy
8. Projection of loss of life expectancy (in years) among survivors exposed to greater than or equal to 2 Gy (mean dose = 3.3 Gy)
9. Autopsy results for noncancer death certificate cases, all diseases except neoplasm and blood disease
10. Proportion of cancer deaths based on autopsy diagnosis among deaths stated to be due to noncancer causes on the death certificate
11. Relative risk of noncancer death based solely on misdiagnosis from radiation-induced cancer assuming no excess in noncancer deaths

List of Appendix Tables

1. Number of deaths by cause of death
2. A. Number of person-years at risk, sexes combined
   B. Number of person-years at risk, males
   C. Number of person-years at risk, females
3. A. Number of deaths from all diseases except neoplasm and blood disease, sexes combined
   B. Number of deaths from all diseases except neoplasm and blood disease, males
   C. Number of deaths from all diseases except neoplasm and blood disease, females
4. A. Number of deaths from infectious disease, sexes combined
   B. Number of deaths from infectious disease, males
   C. Number of deaths from infectious disease, females
5. A. Number of deaths from circulatory disease, sexes combined
   B. Number of deaths from circulatory disease, males
   C. Number of deaths from circulatory disease, females
6. A. Number of deaths from respiratory disease, sexes combined
   B. Number of deaths from respiratory disease, males
   C. Number of deaths from respiratory disease, females
7. A. Number of deaths from digestive disease, sex combined
   B. Number of deaths from digestive disease, males
   C. Number of deaths from digestive disease, females
8. A. Number of deaths from other disease, sexes combined
   B. Number of deaths from other disease, males
   C. Number of deaths from other disease, females
9. Regression coefficients of the linear-quadratic model for age greater than or equal to 40 at the time of the bombings (ATB) by period
10. Estimated coefficients of regression models for all diseases except neoplasm and blood disease
11. Estimated coefficients of regression models for various causes of death
12. Results of hematologic review of deaths certified as disease of the blood and blood-forming organs, 1950-1982
13. Accuracy of cause of death, noncancer deaths, 1950-1985
14. Proportion of deaths confirmed by clinical diagnoses among those exposed to greater than or equal to 2 Gy and examined in the Adult Health Study (AHS)
15. Confirmation of liver cirrhosis on the death certificate among members of the Adult Health Study (AHS) sample, Hiroshima
16. A. Comparison of cause of death and autopsy diagnosis: All diseases except neoplasm and blood disease
    B. Comparison of cause of death and autopsy diagnosis: Heart disease
    C. Comparison of cause of death and autopsy diagnosis: Liver cirrhosis
    D. Comparison of cause of death and autopsy diagnosis: Circulatory disease
    E. Comparison of cause of death and autopsy diagnosis: Coronary heart disease
    F. Comparison of cause of death and autopsy diagnosis: Stroke
17. A. Number and proportion of cancers reported in the Hiroshima and Nagasaki Tumor Registries among noncancer deaths by radiation dose
    B. Number and proportion of cancer cases reported in the Hiroshima and Nagasaki Tumor Registries among deaths stated to be due to noncancer causes on the death certificate by cause of death
18. A. Proportion of deaths at hospitals (%) by radiation dose, age ATB, period, and cause of death
    B. Relative risk at 1 Gy for mortality due to major cause of death by place of death
    C. Accuracy of cause of death on death certificate by place of death
    D. Radiation effect after adjusting for place of death