Radiologic practice since the atomic bombs Hiroshima and Nagasaki

Medical Radiation Exposure among Atomic Bomb Survivors: Understanding its Impact on Risk Estimates of Atomic Bomb Radiation

There have been some concerns about the influence of medical X rays in dose-response analysis of atomic bomb radiation on health outcomes. Among atomic bomb survivors in the Life Span Study, the association between atomic bomb radiation dose and exposures to medical X rays was investigated using questionnaire data collected by a mail survey conducted between 2007-2011, soliciting information on the history of computed tomography (CT) scans, gastrointestinal fluoroscopy, angiography and radiotherapy. Among 12,670 participants, 76% received at least one CT scan; 77%, a fluoroscopic examination; 23%, an angiographic examination; and 8%, radiotherapy. Descriptive and multivariable-adjusted analyses showed that medical X rays were administered in greater frequencies among those who were exposed to an atomic bomb radiation dose of 1.0 Gy or higher, compared to those exposed to lower doses. This is possibly explained by a greater frequency in major chronic diseases such as cancer in the ≥1.0 Gy group. The frequency of medical X rays in the groups exposed to 0.005-0.1 Gy or 0.1-1.0 Gy did not differ significantly from those exposed to <0.005 Gy. An analysis of finer dose groups under 1 Gy likewise showed no differences in frequencies of medical X rays. Thus, no evidence of material confounding of atomic bomb effects was found. Among those exposed to atomic bomb doses <1 Gy, doses were not associated with medical radiation exposures. The significant association of doses ≥1 Gy with medical radiation exposures likely produces no substantive bias in radiation effect estimates because diagnostic medical X-ray doses are much lower than the atomic bomb doses. Further information on actual medical X-ray doses and on the validity of self-reports of X-ray procedures would strengthen this conclusion.

Dental radiography exposure of the Hiroshima and Nagasaki populations

Dental radiography doses in Hiroshima and Nagasaki were estimated on the basis of survey data from dental hospitals and clinics in Hiroshima and Nagasaki, and doses were measured by thermoluminescent dosimeters and a phantom. Doses to organs, including the lens, pituitary fossa, thyroid gland, and skin were calculated from data obtained during a 2-week survey in both cities. The mean caput doses were calculated from the data indicating frequency per year and were tabulated by organs, age, teeth examined, type of examination, population, sex, and city. No significant difference was observed by age, population, sex, or city. Currently the doses incurred during dental radiography may not be sufficiently high to cause bias in the assessments for late radiation effects among atomic-bomb survivors. However, the mean caput thyroid doses of 62 mrad and 67 mrad in Hiroshima and Nagasaki, respectively, cannot be ignored from the standpoint of their potential in contributing to radiation-induced carcinogenesis.

Radiological practice in Hiroshima and Nagasaki: trents from 1964 to 1970

Use of X-ray in Hiroshima and Nagasaki from 1964 to 1970 was assessed according to numbers of films consumed, and the radiographic, fluoroscopic, and photofluorographic examinations performed. Except for chest photofluorography, a steady increase in the use of medical X-ray since Workd War II is demonstrated.