ICRC SNAS For Humanitarian Law

Humanitarian Impact of Nuclear Weapons

Oslo, Norway, 2013

Medical Effects of a nuclear weapon detonation

“The Lifelong Health Effects of Atomic Bombs

by immediate DNA damage”

Masao Tomonaga, M.D., Ph.D.

Director (Emeritus)
Japanese Red Cross Nagasaki Atomic Bomb Hospital
 The second Conference on the Humanitarian Impact of Nuclear Weapons
Nayarit, Mexico, Feb 13-14, 2014
If Another 16 kiloton Atomic Bomb Detonates on
A Modern City; A study based on Hiroshima/Nagasaki cases

After
Before

Masao Tomonaga, M.D., Ph.D google

No.1
Scientific Research Group on the effects of nuclear weapons in various aspects
 Little Boy Fat Man
Two
Atomic Bombs
Used in War

Immediate Casualty
(Estimated)
Hiroshoma
Population 350,000
Death 140,000
Injured 78,000
Nagasaki
Population 270,000
Death 73,000
Injured 75,000

Total survivors
Hibakusha 270,000
Hiroshima Nagasaki

16 kiloton uranium 21 kiloton plutonium

No.2 (64kg; 850~900g detonated) 10kg(1kg detonated)
 Hiroshima

Complete destruction of city infrastructure

within 4.5 kilometer in radius

Railway station, Factories, Schools, Hospitals, Pharmacies,City Hall,

Railways, Street cars, Automobiles, Telecommunication, Electric facilities
Markets, Gas tanks, Wooden houses, Concrete buildings

Nagasaki

No.3
 University Hospital

Actual target
My home

Original target

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

The point I survived

Original target
2.5 km

Just after Bombing

 Red Cross
Nagasaki
Atomic Bomb
Hospital
Ground Zero

600m

Nagasaki Medical University Hospital

（旧）長崎医科大学付属毉院
900 Medical Students and Professors died
 Death rate according to the distance from ground zero

University Hospital

Survivor professors and students surveyed for death rate

within two months.
 Blast wind

Blast wind(m/sec)
Physical Damages Caused by the Nagasaki Atomic Bombing
 My House
was here

By Joe O’Donnell, U.S. Army

Heat rays
Hea
２０００～５００℃
t
leve
l
(cal/
cm2
))
Burned to bone
Carbonization
Severe burns
immediate death
skin tear-off

By Yamahata
He recovered after 1.5 years’ bed life in this position

Mr. Taniguchi gave a speech at NPT Conference

In 2010 at New York by showing his photo.
Acute Radiation Sickness(ARS): First sign is hair loss

Radiation and Burn combined usually led death

 Death curves

Distance from the Ground Zero

Acute Radiation Sickness :

the major cause of early death
Hair roots damage, Bone Marrow, Intestines

No.5
No medical aid but waiting for death

By Yamahata
 All Hospitals were destroyed in Nagasaki City
Sin-kozen Elemetary School Only one ambulance at an elementary school with
some doctors and nurses but no drug,
no blood transfusion, no antibiotics.

Many died of acute radiation sickness

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

Bone marrow damage

Death Rate

Distance from thehypocenter

Normal controls

Colon damage
Initial observation of increased rate of leukemia
among atomic bomb survivors

From [Leukemia：Dameshek & Gunz 1974]

 Breast Cancer Thyroid Cancer

Excess Malignant Diseases

Leukemia
Cancers
Multiple cancers

No.6
 40

35

Excess cases per 104 PY

30

25

20

15

10

0
0 1 2 3 4
Dose (SV)
Leukemia dose response based on a quadratic excess
absolute risk (EAR) model
 Excess Relative Risk (ERR) 1.0

0.5

0.0
0 1 2 3 4 5
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,
Excess Pelative Risk (EPR): Ratio of death rate (or rate of incidence) for the exposed
1996
population and the
death rate (or rate of incidence) in the control group. An ERR = 0.5 means an increase of 50%.

Solid cancer dose-response for a male of 30years

of age at the time of exposure
Multiple Cancer Study in Atomic Bomb Survivors
in Nagasaki Ichiro Sekine et al
 Life-long effects of Ionizing Radiation:
Children at the time of Bombings now
developing Cancers and Leukemia

Early onset Late onset

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

1st Leukemia Phase Less than 15 yrs old ATB

2nd Leukemia Phase

0 10 20 30 40 50 60 68
Years since 1945
No.7
 Recent MDS (myelodyplastic syndromes) Survey in Nagasaki
“Second wave of leukmia”

MDS: Leukemia-related Blood Malignancy

Frequently occur among elderly population (over 60 yrs)

Clinical Feature
Morphological dysplasia as shown in photographs
Anemia and low White Blood Cell counts
Ineffective hematopiesis
20-30% of patients with MDS eventually transform to AML
Chromosome abnormality in 50%
Several subtypes with low to high AML transformation
Dignosis is difficult
Tretment is difficult, very resistant to drugs
Increasing in the developed countries
Almost equal to AML incidence in developed countries

Masako Iwanaga et al:

International J. of Oncology 2011
Excess risk of MDS
 Why Atomic Bomb Helath Effects are long-lasting?

Hypothesis: Organ stem cell hit theory

High dose exposure

causes massive DNA destruction A stem cell
and cell death Gamma &
Organ failure and eventual early death Neutron rays
(Bone Marrow, Intestines etc.)
due to Acute Radiation Sickness(ARS)

Low/moderate dose exposure

causes DNA damage and
long-lasting genetic instability,
finally leading to the development of
leukemia/cancer.

Germ cells(sperm or ova) DNA

damage may cause
trans-generation effects to Fusion genes for leukemia
Hibakushas’ children (F1)
 An evidence: Chromosome aberrations in short-distance
survivors
Frequency of abnormal cells

White cells Red cells

Radiation Dose

Amenomori T. et al: Experimental Hematology

 Another evidence: 53BP1 Focus formation in normal
looking skin cells adjacent to Skin Cancer of Short distance
survivors
Survivor A：1.1km Survivor B：3.6km (control)

Dealyed genetic instability !! Nakajima et al: Cancer 2008

Radiation during early pregnancy

Microcephaly

Control
 By Noriyuki Aida

Many girls with face burn eventually lost chance of marriage.

Her lonely life was further enhanced by loss of many family members.
Psychological Damage Study for Survivors after a half century(1995)
by WHO General Health Questionnaire (GHQ)
By Sumihisa Honda

Depression, PTSD etc.

 Long-term consequences of atomic bomb radiation
in Hiroshima and Nagasaki Survivors
Population-based study on leukemia and cancer statistics
Hiroshima/Nagasaki combined
Fixed No. of expected Percent
population death No. of Excess cases Radiation-
of survivors in 50 years death Related

Leukemia
all doses 86,611 296 203 93 46%
2Gy< 2,709 64 8 56 88%

Cancers
all doses 105,427 17,448 16,500 853 10.7%
2Gy< 2,211 185 111 74 61%

No.8
 Hydrogen Bomb
1 Megaton
at 2400 m

Atomic bomb
16 Kiloton
at 600 m

18km G0
G0
4.5km

Nuclear detonations
Above a Virtual Modern City with
1 Million Population
No.10
 Blast
4.5km

Heat and
Radiation G0
2.8 km

Atomic Bomb 16 Kiloton at 600 m

No.11
Blast
18km
Radiation
3km
Heat
G0
14 km

Hydrogen Bomb 1 Megaton at 2400 m

 Immediate and Late Casualty of Nuclear Detonations
in a Modern Virtual City
with 1,000,000 population and 400,000 in suburb

16 kiloton 1 megaton
atomic bomb hydrogen bomb
Immediate Death 66,000 370,000

Immediate Injury 205,000 460,000

Radiation-affected 155,000 36,000
population (within 2.8 km) (within 3 km)
Excess Leukemia 220 70

Excess Cancers 12,000 650

No.13
 Destruction of City Infrastructure
Infrastructure
Traffic facilities; high way, road, bridge, airport, port, railways, station
Public buildings; city hall, offices, water reservoir, police, fire station
Factories, oil tanks, gas tanks, electric facilities, post office
Medical facilities; hospital, pharmacy, nursery home
Schools; University, high school, elementary school
Broad casting, telecommunication, IT communication
Residences, houses, disposal, city park, etc.

20 kiloton class 1 Megaton class

Within 1 km complete complete
1~5 km Complete ~ partial complete ~ partial

5~10 km slight ~ no partial

No.14
In conclusion

1. The atomic bombs are “Gene-targeting weapon”.

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

2.These medical and scientific results clearly indicates

the antihumanitarian nature of nuclear weapons.
.
3. The present nuclear weapons-dependent world secu
has serious inherent danger for human survival.
Only their elimination can make our Globe free from
nuclear weapons and safe.