Minutes of the Eighth ABCC/RERF History Forum
Date:
Place:

15:00-16:20, Thursday, July 13, 2017
Auditorium of the Hiroshima Laboratory and Conference Room 4 of theNagasaki Laboratory (videoconference)
Speaker:Mr. Morito Dote (Former Assistant Chief of the Department of Epidemiology)
1962: Joined ABCC as a contact person, Pathology Field Section, Department ofMedical Sociology
1979: After being transferred to the Master File Section, Department ofEpidemiology and Statistics, he worked in the Field Operations Section and theTumor & Tissue Registry Office, etc.
1997: After retirement, he worked as Advisor to the Department ofEpidemiology till 1999
Moderator: Dr. Hashizume
Dr. Hashizume: The Local Cancer Registry is one of RERF’s most significant projects, andMr. Dote, today’s speaker, devoted himself to establishing this project. Now there is aJapanese cancer registry system to collect data about those who are diagnosed with cancerfrom medical institutes nationwide. When Mr. Dote started his career at ABCC, however,information about those who were diagnosed with cancer was top secret and kept within thehospital. When informing the patient and their family of a cancer diagnosis, special
consideration was required. Given these circumstances, it is surprising that ABCC
accomplished establishment of such a project to collect information on cancer diagnosis in thecities of Hiroshima and Nagasaki. I expect to hear interesting stories from him. Thank you forbeing here to share your story with us, Mr. Dote.
Mr. Dote: I will try my best to recall those days.
Dr. Hashizume: When you joined ABCC, I believe the Hiroshima City Medical Association
had already begun the Local Cancer Registry project. I wonder how ABCC was involved inthe project.
Mr. Dote: In 1957, entrusted by the Hiroshima City Medical Association, ABCC initiated theLocal Cancer Registry project, but ABCC stopped the project a little less than a year later. Theproject was resumed around 1975, and we collected materials tracing back to 1957. At first, I
recorded material from the medical charts stored at seven local hospitals in Hiroshima City. I
recorded tumor information starting three years after patients were discharged from thehospital. In order to carry out that duty, I transferred the medical charts from the hospital’s
medical chart room to another room. At the Hiroshima University School of Medicine, I had1

to put a desk in the medical chart room to keep a record of my work. I recorded informationfrom all the medical charts of those who were diagnosed with tumors and cross-checked itwith information from ABCC’s Life Span Study (LSS) participants, using master files storedat ABCC. Then, I coded them to register the information. At the Nagasaki Laboratory,employees did the same job. About 14 employees each at the laboratories of Hiroshima andNagasaki were engaged in this duty.
Dr. Hashizume: A few years ago, RERF launched a follow-up study of the Fukushima
emergency workers, but I heard a similar project was carried out when Dr. Shigematsu wasthe Chairman at RERF.
Mr. Dote: Under Dr. Shigematsu’s instruction, I was involved in the tumor registry study
targeting the nuclear power plant workers in Japan.
Dr. Hashizume: You worked as a social worker for nine years after joining RERF. Could youtell us what you did?
Mr. Dote: Shortly after being employed, I was assigned to the Clinical Contacting Section andI received training as a social worker to communicate with families of the deceased study
participants.
Dr. Hashizume: Please tell us about autopsy work.
Mr. Dote: When we obtained notification of a study participant’s passing, we visited theirfamily to get permission to perform an autopsy. After obtaining an agreement, we carried thebody to ABCC. We returned the body upon completion of the autopsy, but we had to choose
the right time to return it, taking funeral and cremation arrangements into consideration, inorder not to attract attention. Autopsies were carried out every day except for the three days
during the year-end and New Year holidays, when the crematories were closed. Since
autopsies tended to be performed late at night, a pathologist who lived in the BOQ (currently
known as the Hijiyama Hall) would become ill-tempered when I contacted him, which gave
me a hassle.
Deceased participants’ families frequently refused me after I identified myself as an ABCC
worker when I visited them to request an autopsy, but I tried very hard to make themunderstand the necessity of our study. For those whose family members had died of cancer
and who worried about themselves, I used to introduce the health examination conducted atABCC.

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Dr. Hashizume: What do you think about having been an employee of ABCC/RERF?
Mr. Dote: I think I made a good decision. Working at ABCC/RERF was good, especiallybecause I was able to acquire extensive knowledge about diseases.
Dr. Hashizume: Now, I would like to solicit questions from the audience.
Dr. Kodama: In general, doctors have bad handwriting, including myself. In addition, English
and German are used for medical charts. How did you interpret them for recording?
Mr. Dote: My colleagues and I used to call some handwriting “earthworm” or “Fraktur” and it
was very difficult to make it out. I used to look up English and German words.
Dr. Niwa: I remember that telephone service was developed in Japan after 1955. Did you used
to make a telephone appointment to visit the participants’ houses to ask for an autopsy?
Mr. Dote: No. We visited them without any phone calls.
Dr. Nakamura: An autopsy is significant in determining the cause of death, but did theyunderstand its significance when you asked them to cooperate with an autopsy?
Mr. Dote: As I am not a doctor, I could not give them a technical account, but I explained theimportance of an autopsy as much as I could. Also, for those who desired to receive a
professional explanation, a pathologist explained the outcome of the autopsy.
Dr. Niwa: I would like to know the concordance rate between the cause of death on the deathcertificate and autopsy results.
Dr. Mabuchi: If the cause of death recorded in the death certificate was not listed as cancer, anautopsy had found that cancer was not related to cause of death. Discrepancies between those
two were so small that the epidemiological study was not influenced.
Dr. Niwa: Did you hear any stories about the difficulties the Nagasaki employees
encountered?
Mr. Dote: I do not think there was a large difference between Hiroshima and Nagasaki
regarding the cancer registry project. With regard to recording of the medical charts, there
were many cooperative hospitals in Nagasaki City, and I heard that recording was carried out
in a good environment.
3Mr. Yamada (Nagasaki): I was engaged in the recording work by putting medical charts on a
cardboard box in a warehouse or even in a mortuary.
Dr. Mabuchi: Both in Hiroshima and Nagasaki, we did recording at old hospitals or in small
spaces, which was hard. However, hospitals in Nagasaki were more cooperative than those in
Hiroshima, so we were able to collect better quality data. Autopsy work peaked in the 1960s,and about a half of the deceased AHS participants were dissected.
The number of autopsies started to decrease in the 1970s, and very few were dissected in the1980s. In addition to performing autopsies, we had a pathological diagnosis program. I do notknow when the program started, but this program enabled us to diagnose the tissues collectedthough operations performed at hospitals in Hiroshima. Also, this was the predecessor to thecurrent tissue registry program.
Dr. Hashizume: The number of pathologists is still small in Japan, but were there several
pathologists who could accurately diagnose the cause of death during the ABCC era?
Mr. Dote: ABCC had one pathologist and two American physicians. American doctors used tobe assigned every one or two years by turns.
Dr. Kodama: After performing an autopsy of a deceased AHS participant, we used to review
the autopsy results and the information obtained through the AHS, which was called a crossreview. Headed by the American department chief of Pathology, cross review meetings were
held, and junior physicians reported clinical findings in English. I was a member of theDepartment of Internal Medicine around 1974, the end of the ABCC era, and I learned a lot
during this period.
Dr. Mabuchi: I visit RERF twice a year and I am very happy to see Mr. Dote again for the firsttime in 17 years. Autopsy work in the 1960s was successfully performed thanks to about adozen contacting personnel members. I appreciate your hard work.
Dr. Hashizume: Thank you for sharing your story. This concludes the Eighth ABCC/RERF
History Forum.

Dr. Hashizume, left and Mr. Dote4