Disaster Medicine and Public Health Preparedness

Review Article

Long-term Radiation-Related Health Effects in a Unique Human Population: Lessons Learned from the Atomic Bomb Survivors of Hiroshima and Nagasaki

Evan B. Douple c1, Kiyohiko Mabuchi, Harry M. Cullings, Dale L. Preston, Kazunori Kodama, Yukiko Shimizu, Saeko Fujiwara and Roy E. Shore


For 63 years scientists in the Atomic Bomb Casualty Commission and its successor, the Radiation Effects Research Foundation, have been assessing the long-term health effects in the survivors of the atomic bombings of Hiroshima and Nagasaki and in their children. The identification and follow-up of a large population (approximately a total of 200 000, of whom more than 40% are alive today) that includes a broad range of ages and radiation exposure doses, and healthy representatives of both sexes; establishment of well-defined cohorts whose members have been studied longitudinally, including some with biennial health examinations and a high survivor-participation rate; and careful reconstructions of individual radiation doses have resulted in reliable excess relative risk estimates for radiation-related health effects, including cancer and noncancer effects in humans, for the benefit of the survivors and for all humankind. This article reviews those risk estimates and summarizes what has been learned from this historic and unique study.

(Disaster Med Public Health Preparedness. 2011;5:S122-S133)

(Received December 31 2010)

(Accepted January 13 2011)

Key Words:

  • review articles;
  • radiation effects;
  • survivors;
  • nuclear weapons;
  • nuclear warfare;
  • Hiroshima;
  • Nagasaki;
  • Japan;
  • World War II;
  • life expectancy;
  • leukemia;
  • neoplasms;
  • risk assessment;
  • eye diseases;
  • thyroid diseases;
  • cardiovascular diseases;
  • congenital abnormalities;
  • atomic bomb casualty commission;
  • radiation effects research foundation;
  • atomic bomb;
  • ionizing radiation;
  • cancer;
  • genetics;
  • health effects;
  • epidemiology;
  • excess relative risks


c1 Correspondence: Address correspondence and reprint requests to Evan B. Douple, Radiation Effects Research Foundation, 5-2 Hijiyama Koen, Minami-ku, Hiroshima 732-0815 Japan (e-mail: douple@rerf.or.jp).

Author Affiliations: Drs Douple, Cullings, Kodama, Shimizu, Fujiwara, and Shore are with the Radiation Effects Research Foundation; Dr Mabuchi is with the Division of Cancer Epidemiology and Genetics, National Cancer Institute; Dr Preston is with Hirosoft International.

The Radiation Effects Research Foundation is a private, nonprofit foundation funded primarily by the Japan Ministry of Health, Labour and Welfare and the US Department of Energy, the latter in part through the National Academy of Sciences. Additional support was received from the National Cancer Institute (contract N02-CP-2009-00005) and its Intramural Research Program, and the National Institute for Allergy and Infectious Diseases.