Introducing the work of the Department of Clinical Studies

Q: Dr. Ohishi, Dr. Hida, please tell us about the studies conducted by the Department of Clinical Studies in Hiroshima and Nagasaki.

A: (Ohishi) The Department of Clinical Studies in Hiroshima and Nagasaki manages the Adult Health Study (AHS) of A-bomb survivors and the F1?Offspring Clinical Study (FOCS), which is a clinical health study of the children of A-bomb survivors. In these studies, the participants undergo health examinations, and based on the clinical and epidemiological information obtained, we investigate incidences of various diseases and health effects from radiation exposure.

Q: What kind of health examinations are carried out?

A: (Hida) We inquire about lifestyles (drinking, smoking, etc.) and medical histories. We also conduct a variety of tests: blood, urine, stool for occult blood, electrocardiogram, chest X-ray, and abdominal ultrasound. Clinical examinations are conducted by our physicians. Gynecologic and bone-density tests are conducted if requested by participants. For some individuals, thyroid and eye exams are conducted as part of our special clinical studies. In addition, with consent, we store biosamples obtained from the examinations, such as blood and urine, for future research.

Q: The Department of Epidemiology has investigated cause of death and cancer incidence in 120,000 people of the Life Span Study (LSS) and 77,000 of the Children of Atomic-bomb Survivors (F1) Study. Isn’t that enough? Is there really anything to be learned by having people undergo health examinations?

A: (Ohishi) With the LSS, mortality and cause of death as well as cancer incidence are studied, but we are unable to more broadly clarify the general effects on health from radiation. For that reason, the health examinations conducted in the AHS and the FOCS represent an extremely valuable opportunity for us to learn the health status of A-bomb survivors and their children. In addition, we work hard to make the examinations useful for early detection and treatment of disease and for the participants’ health maintenance. Also, by providing health examinations on a regular basis, the relationship between radiation exposure and the occurrence of non-cancer diseases, age-related changes, and changes in lab test results can be tracked. It is also a great advantage to be able to use the biosamples obtained from the health examinations to examine biomarkers* related to disease development.

* Substances in the body such as proteins and genes contained in blood, urine and tissue that serve as indicators for future disease development and possible treatment options.

Q: Please tell us about the differences between RERF’s health examinations and those offered by hospitals or local governments.

A: (Hida) AHS participants (about 25,000) and FOCS participants (about 13,000) were selected from among the 120,000 participants in the LSS, which is conducted by the Department of Epidemiology. A-bomb survivors have undergone health examinations at RERF once every two years starting in 1958 and the children of the A-bomb survivors once every four years since 2002. Such long-term health examination results are used to provide advice on lifestyle improvement, report to the participants’ personal physicians, and refer the participants to specialist physicians.

Q: What types of work take place in the Department of Clinical Studies? Are there any jobs that are unique to the Department?

A: (Ohishi) At first glance, we have many jobs that are similar to those at other general clinics. The departments at Hiroshima and Nagasaki are comprised of physician researchers, nurses, public health nurses, medical radiologists, clinical technologists, and administrative staff who support the health examination and research work. Among this numerous staff, contactors, who comprise public health nurses and administrative staff, serve as the gatekeepers of the Department of Clinical Studies. These workers provide assistance with regard to health examinations and, simultaneously, treat with great care the relationships developed over time with the A-bomb survivors and their children. Thanks to the contact staff’s efforts, we are able to maintain a high study participation rate of over 70%, allowing us to continue our high level of research. (For details, see our Facebook post of January 7, 2019.)

Providing information about the health examinations (image)

Q: There is a Department of Clinical Studies in Nagasaki, as well. In what way are Hiroshima and Nagasaki collaborating?

A: (Hida) In Hiroshima and Nagasaki, we do our best to provide the same high level of health examinations as possible. For example, we conduct interviews and consultations using the same methods, thoroughly controlling the quality of examinations. To exchange information and share problems, we hold video conferences and pay direct visits to each other, thereby identifying problems and improving operations. Of course, there is frequent communication by email and telephone, and so on. In this way, by visiting and talking, we sometimes come to realize the essence of problems or issues we may be having.

Q: How do you feed back to the health examination participants the results of the research? Also, please tell us about future plans for any improvements.

A: (Ohishi) We explain examination results in detail at the time of the consultation to the examinee. In addition, once a year, Hiroshima RERF sends out the health newsletter “Kenko no Mori” and Nagasaki its “Kane” newsletter. These publications provide articles on a variety of diseases, and may also include an introduction to RERF’s research and outlines of its research results. Examinees who want to know more about research results can ask us for more information. It may be necessary to increase the proportion of such explanatory articles. When the research results are published in the form of papers, concise summaries of the papers are posted on the RERF website.

Q: You are now recruiting researchers for the Department of Clinical Studies on the RERF website. What qualifications are you looking for in people you hope to recruit?

A: (Ohishi) We are now recruiting one researcher position in Hiroshima. We would like to recruit someone interested in studying radiation effects on the onset of cancers and non-cancer diseases (cardiovascular disease, liver disease, etc.) and perhaps interested in cohort studies* or research using biosamples. Since A-bomb survivors’ data have been stored since 1958 and blood samples since 1969, research not possible in other institutes can become a reality here. In addition, RERF meetings are often conducted in English, so researchers who have studied abroad can likely adapt quickly to working at RERF.

* Research that investigates a group of people using methods that examine the relationship between risk factors and disease by observing a group exposed to a certain factor and another group that is unexposed over a certain period of time, comparing the probability of developing the disease being studied.

Q: This may be a personal question, but please tell us your specialization and what led you to work for RERF. Please also tell us something about yourself: what you liked to do as a student and your hobbies.

A: (Ohishi) I belonged to the former First Department of Internal Medicine (present-day Department of Gastroenterology and Metabolism) at Hiroshima University, where I specialized in hepatology. At first, I joined research that was being conducted jointly by RERF and Hiroshima University to study the effects of radiation exposure and the risk of developing liver cancer using stored sera. As a student, I belonged to the tennis club and every week ran up to Hijiyama, where RERF is located. Watching historical dramas and movies and cheering on the local baseball team―the Hiroshima Carp―are my favorite activities for stress release. While it is not exactly a historical movie, I watched Bohemian Rhapsody?twice at the movie theater this spring.

(Hida) I belonged to the First Department of Internal Medicine at Nagasaki University, specializing in autoimmune disease such as rheumatoid arthritis. RERF research has shown that radiation affects immunity, and I specifically came to RERF to investigate that relationship. At that time, my son had turned three years old, and it was difficult for me to work at a hospital because I would have had to work on-call in order to respond to calls outside regular hours. At RERF, I didn’t have to work outside of regular hours and so it has been a very good workplace for me. I am comfortable working for RERF and have been working here for 20 years now. Music has been my hobby since I was a student, and I always look forward to seeing live music and musicals. I belong to a gospel music group and am in a choir singing backup for a good solo singer.

We would like to thank Dr. Ohishi and Dr. Hida for their important insights into their work at the Department of Clinical Studies in Hiroshima and Nagasaki.

For more information, please refer to the Department of Clinical Studies website page: