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Title: Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow

Abstract

The relationship between atomic bomb exposure and the incidence of multiple myeloma has been examined in a fixed cohort of atomic bomb survivors and controls in the life-span study sample for Hiroshima and Nagasaki. From October 1950 to December 1976, 29 cases of multiple myeloma were confirmed in this sample. Our analysis shows that the standardized relative risk (RR) adjusted for city, sex, and age at the time of bombings (ATB) increased with marrow-absorbed radiation dose. The increased RR does not appear to differ between cities or sexes and is demonstrable only for those survivors whose age ATB was between 20 and 59 years. The estimated risk in these individuals is approximately 0.48 cases/million person-years/rad for bone marrow total dose. This excess risk did not become apparent in individuals receiving 50 rad or more in marrow total dose until 20 years or more after exposure.

Authors:
; ; ;
Publication Date:
Research Org.:
Department of Hematology, Nagasaki University School of Medicine, Japan
OSTI Identifier:
6941802
Alternate Identifier(s):
OSTI ID: 6941802
Resource Type:
Journal Article
Resource Relation:
Journal Name: JNCI, J. Natl. Cancer Inst.; (United States); Journal Volume: 69:2
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; BONE MARROW; DELAYED RADIATION EFFECTS; MYELOID LEUKEMIA; RADIOINDUCTION; A-BOMB SURVIVORS; DOSE-RESPONSE RELATIONSHIPS; EPIDEMIOLOGY; HIROSHIMA; NAGASAKI; PATHOLOGY; RADIATION DOSES; RADIATION HAZARDS; ANIMAL TISSUES; ASIA; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; BODY; DISEASES; DOSES; HAZARDS; HEALTH HAZARDS; HEMATOPOIETIC SYSTEM; HEMIC DISEASES; HUMAN POPULATIONS; JAPAN; LEUKEMIA; NEOPLASMS; ORGANS; POPULATIONS; RADIATION EFFECTS; TISSUES 560151* -- Radiation Effects on Animals-- Man

Citation Formats

Ichimaru, M., Ishimaru, T., Mikami, M., and Matsunaga, M. Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow. United States: N. p., 1982. Web.
Ichimaru, M., Ishimaru, T., Mikami, M., & Matsunaga, M. Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow. United States.
Ichimaru, M., Ishimaru, T., Mikami, M., and Matsunaga, M. Sun . "Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow". United States. doi:.
@article{osti_6941802,
title = {Multiple myeloma among atomic bomb survivors in Hiroshima and Nagasaki, 1950-76: relationship to radiation dose absorbed by marrow},
author = {Ichimaru, M. and Ishimaru, T. and Mikami, M. and Matsunaga, M.},
abstractNote = {The relationship between atomic bomb exposure and the incidence of multiple myeloma has been examined in a fixed cohort of atomic bomb survivors and controls in the life-span study sample for Hiroshima and Nagasaki. From October 1950 to December 1976, 29 cases of multiple myeloma were confirmed in this sample. Our analysis shows that the standardized relative risk (RR) adjusted for city, sex, and age at the time of bombings (ATB) increased with marrow-absorbed radiation dose. The increased RR does not appear to differ between cities or sexes and is demonstrable only for those survivors whose age ATB was between 20 and 59 years. The estimated risk in these individuals is approximately 0.48 cases/million person-years/rad for bone marrow total dose. This excess risk did not become apparent in individuals receiving 50 rad or more in marrow total dose until 20 years or more after exposure.},
doi = {},
journal = {JNCI, J. Natl. Cancer Inst.; (United States)},
number = ,
volume = 69:2,
place = {United States},
year = {Sun Aug 01 00:00:00 EDT 1982},
month = {Sun Aug 01 00:00:00 EDT 1982}
}
  • The relationship between atomic bomb exposure and the incidence of multiple myeloma has been examined in a fixed cohort of atomic bomb survivors and controls in the life-span study sample for Hiroshima and Nagasaki. From October 1950 to December 1976, 29 cases of multiple myeloma were confirmed in this sample. Our analysis shows that the standardized relative risk (RR) adjusted for city, sex, and age at the time of bombings (ATB) increased with marrow-absorbed radiation dose. The increased RR does not appear to differ between cities or sexes and is demonstrable only for those survivors whose age ATB was betweenmore » 20 and 59 years. The estimaged risk in these individuals is approximately 0.48 cases/million person-years/rad for bone marrow total dose. This excess risk did not become apparent in individuals receiving 50 rad or more in marrow total dose until 20 years or more after exposure.« less
  • The incidence of leukemia during 1950 to 1971 in a fixed mortality sample of atomic bomb survivors in Hiroshima and Nagasaki was analyzed as a function of neutron and ..gamma.. kerma and marrow doses. Two dose-response models were tested for acute leukemia, chronic granulocytic leukemia, and all types of leukemia, respectively. Each model postulates that the leukemia incidence depends upon the sum of separate risks imposed by ..gamma.. and neutron doses. In Model I the risk from both types of radiation is assumed to be directly proportional to the respective doses, while Model II assumes that whereas the risk frommore » neutrons is directly proportional to the dose, the risk from ..gamma.. rays is proportional to dose-squared. The analysis demonstrated that the dose-response of the two types of leukemia differed by type of radiation. The data suggested that the response of acute leukemia was best explained by Model II, while the response of chronic granulocytic leukemia depended almost linearly upon neutron dose alone, because the regression coefficients associated with ..gamma.. radiation for both Models I and II were not significant. The relative biological effectiveness (RBE) of neutrons in relation to ..gamma.. rays for incidence of acute leukemia was estimated to be approximately 30/(Dn)/sup 1/2/ (95% confidence limits; 17/(Dn)/sup 1/2/ approx. 54/(Dn)/sup 1/2/) for kerma and 32/(Dn)/sup 1/2/ (95% confidence limits; 18/(Dn)/sup 1/2/ approx. 58/(Dn)/sup 1/2/) for marrow dose (Dn = neutron dose). If acute and chronic granulocytic leukemias are considered together as all types of leukemia, Model II appears to fit the data slightly better than Model I, but neither model is statistically rejected by the data.« less
  • For the period 1950-69, 231 cases of breast cancer were identified among 63,275 female atomic bomb survivors and nonexposed controls; 187 were among survivors for whom dose estimates were available. The estimated absolute risk per rad was 1.9 excess cases per 10/sup 6/ person-years at risk over this period for women who were 10 years old or older at the time of bombing (ATB), substantially less than published estimates largely based on X-ray and fluoroscopy data from smaller samples of younger North American women. The Hiroshima and Nagasaki dose-response curves were similar, which suggested approximate equivalence of neutron and gammamore » radiations in their carcinogenic effect on breast tissue, and were consistent with a linear model. An identifiable radiation effect was evident before 1955. For women of comparable ages ATB, the time from 1945 to diagnosis did not vary by dose, nor was there evidence that radiation caused breast cancer to develop in these women at earlier ages than usual. No breast cancers were found up to 1969 among atomic bomb survivors under age 10 ATB, nor were any substantial numbers observed until 1960 in those 10-19 years old ATB. By 1965-69, however, the cohort 10-19 years old ATB exposed to high or medium doses was experiencing a much greater excess of breast cancer than was observed in women 35 years old or older ATB who were exposed to any dose level. This suggests that the breast tissues of adolescent females may be more sensitive than those of older women to the effects of ionizing radiation. Finally, for each age-ATB interval (10-19, 20-34, 35-49, and 50+ yr), women exposed to 100+ rads had, by 1969, already approximated or exceeded their lifetime expectations (after 1950) of breast cancer as calculated from Japanese cancer registry data.« less
  • The occurrence of lenticular opacities among atomic bomb survivors in Hiroshima and Nagasaki detected in 1963-1964 has been examined in reference to their ..gamma.. and neutron doses. A lenticular opacity in this context implies an ophthalmoscopic and slit lamp biomicroscopic defect in the axial posterior aspect of the lens which may or may not interfere measureably with visual acuity. Several different dose-response models were fitted to the data after the effects of age at time of bombing (ATB) were examined. Some postulate the existence of a threshold(s), others do not. All models assume a ''background'' exists, that is, that somemore » number of posterior lenticular opacities are ascribable to events other than radiation exposure. Among these alternatives we can show that a simple linear ..gamma..-neutron relationship which assumes no threshold does not fit the data adequately under the T65 dosimetry, but does fit the recent Oak Ridge and Lawrence Livermore estimates. Other models which envisage quadratic terms in gamma and which may or may not assume a threshold are compatible with the data. The ''best'' fit, that is, the one with the smallest X/sup 2/ and largest tail probability, is with a ''linear gamma:linear neutron'' model which postulates a ..gamma.. threshold but no threshold for neutrons. It should be noted that the greatest difference in the dose-response models associated with the three different sets of doses involves the neutron component, as is, of course, to be expected. No effect of neutrons on the occurrence of lenticular opacities is demonstrable with either the Lawrence Livermore or Oak Ridge estimates.« less
  • The present study demonstrates an increased prevalence of malignant lymphoma and multiple myeloma in survivors of the atomic bomb in Hiroshima exposed to 100 rad or more; a similar relationship is not evident in Nagasaki. This apparent discrepancy is tentatively attributed to known physical differences in the radiation spectrum emitted by the 2 bombs and/or biological differences between the inhabitants of Hiroshima and Nagasaki. Other observations of interest include the following: the risk of developing lymphoma or multiple myeloma appears to be greater in persons exposed at less than 25 years of age than in people who were 25 ormore » more years old at the time of the bomb; the appearance time is shorter in the younger age group exposed to 100 rad or more in comparison with less heavily exposed persons, and also in comparison with heavily exposed persons in the older age groups. (auth)« less