Table of Contents
From the Editors ......................................................................................................................................... 1
RERF News
Third Board of Councilors Meeting Held at the Hiroshima Laboratory ............................................... 1
Nagasaki RERF Holds Third Public Lecture Event for Citizens .......................................................... 3
Local Liaison Council Meetings Held at Hiroshima and Nagasaki ...................................................... 4
ICRP Vice-chair Jacques Lochard Visits RERF .................................................................................... 5
Senior Vice Minister Kenya Akiba of Ministry of Health, Labour and Welfare Visits RERF .............. 5Open House 2013 Held at Hiroshima and Nagasaki ............................................................................. 6
Staff News ............................................................................................................................................. 6
Visiting Student Fellow ......................................................................................................................... 8Awards Received by RERF Scientist, General Staff ............................................................................. 9
Conference and Workshop Reports
International Workshop: RERF Radiation Research in the Post-genomic Era,
by Yasunari Satoh and Yasuharu Niwa ............................................................................................ 10
Third Meeting of the Scientific and Ethics Committee for the Clinical Study of the
F1 Offspring of A-bomb Survivors Held, by Waka Ohishi .............................................................. 12
Fourth Epidemiological Training Workshop for Biologists, by Ritsu Sakata ..................................... 13
Science Articles
The Incidence of Leukemia, Lymphoma and Multiple Myeloma among Atomic Bomb
Survivors: 1950–2001, by Dale L. Preston and Harry M. Cullings ................................................ 15
Radiation-dose Response of Glycophorin A Somatic Mutation in Erythrocytes Associated with
Gene Polymorphisms of p53 Binding Protein 1, by Kengo Yoshida .............................................. 18
Alterations of Body Mass Index and Body Composition in Atomic Bomb Survivors,
by Yoshimi Tatsukawa ..................................................................................................................... 20
Human Interest Notes
A Retrospective of My Work at the Radiation Effects Research Foundation,
by Masazumi Akahoshi ................................................................................................................... 22
Report on the 19th Health Examination Project for A-bomb Survivors in North America,
by Yoshimi Tatsukawa ..................................................................................................................... 23
Facts and Figures
Results of Review of Basic Information Used in Individual Dose Estimates andRecalculation of Radiation Risks, by Toshiteru Okubo .................................................................. 25
Research Protocols and Recent Publications
Research Protocols Approved in May–October 2013 ......................................................................... 28
Recent Publications ............................................................................................................................. 29
Cover photographs: 2013 Open House event in Hiroshima (left); see page 6
Public lecture event for citizens in Nagasaki (right); see page 3This newsletter is published twice a year by the Radiation Effects Research Foundation (RERF;
formerly the Atomic Bomb Casualty Commission), established in April 1975 as a private,nonprofit Japanese foundation. It is supported by the government of Japan through its Ministryof Health, Labour and Welfare and by the United States through its Department of Energy (DOE),
in part by DOE contract DE-HS0000031 with the National Academy of Sciences. RERF becamea public interest incorporated foundation on April 1, 2012.
RERF conducts research and studies—for peaceful purposes—on medical effects of radiation
and associated diseases in humans, with a view to contributing to maintenance of the health andwelfare of the atomic-bomb survivors and to enhancement of the health of all humankind.
Editor-in-Chief: Harry M. Cullings, Chief, Department of Statistics
Technical Editor: Fumie Maruyama, Public Relations & Publications Office
Editorial Policy
Contributions to RERF Update receive editorial review only and do not receive scientific peer
review. The opinions expressed herein are those of the authors only and do not necessarily reflect
RERF policies or positions.
Contact: Mailing address: RERF Public Relations & Publications Office, 5-2 Hijiyama Park,
Minami-ku, Hiroshima 732-0815 Japan
Telephone: 81-82-261-3131; Facsimile: 81-82-263-7279
Internet: http://www.rerf.jp/

update 1

From the Editors / RERF News

From the Editors
Welcome to the second issue of RERF Updatefor 2013. It is late November in Japan, and thechilly weather has finally taken hold as temperatures have suddenly declined to seasonally typicalvalues in the last week, after a very mild early
autumn. The Yebisu Festival (Yebisu is a Japanese
god of good fortune and guardian of the ocean,fishing folk, and business prosperity) is in fullswing in downtown Hiroshima including Chuodori,
one of the city’s main streets, and the extensive
seasonal lighting display along Peace Boulevard,which has grown both in scale and popularity inrecent years with the advent of LED lighting, hasreturned in even greater profusion than last year.
This has been a time of changes in staff, with theeagerly awaited arrival of our new Associate Chiefof Research, Dr. Robert Ullrich, whose self-introduction appears in this issue, along with thoughts
on retirement by Dr. Masazumi Akahoshi, Chiefof the Clinical Studies Department in Nagasaki,
and self-introductions by a new researcher in
Statistics, Dr. Reid Landes, and a new fellow in
Epidemiology, Ms. Caitlin Milder. We bring you
the usual reporting on important events, including
the annual Open House, information on an award
received by one of our researchers, Dr. Hiromi
Sugiyama of Epidemiology, and reports on several
workshops and meetings. We have a number ofscience articles about current research taking place
at RERF, along with a report on the program inwhich RERF clinicians and other staff participate
in health examinations for A-bomb survivors living
in North America. RERF Chairman Dr. Toshiteru
Okubo has contributed a “Facts and Figures” pieceon the completion of a multi-year project at RERF
that has as its aim the improvement of survivors’
dose estimates by combining new technology and

Editor-in-Chief Harry Cullings (front, left), alongside Kotaro
Ozasa, Chief, Department of Epidemiology, speaking at apress conference on leukemia and other cancers among
A-bomb survivors (please refer to page 15)

computer-based methods with archival materials on
survivors’ locations at the times of the bombings
to improve the estimates of their map coordinates.
We hope that you will enjoy this winter issue as
we approach the year-end holidays and the time foranother bonenkai (a party to reminisce about, andsend off, the year about to end)!

Harry M. Cullings
Editor-in-Chief

Fumie Maruyama
Technical Editor

Third Board of Councilors Meeting Held at the Hiroshima Laboratory
The third meeting of the Board of Councilors(BOC) was held at RERF’s Hiroshima Laboratory
over the two days of June 18 and 19, 2013. All
Councilors as well as Directors, Auditors, and theJapanese Co-chair of the Scientific Advisory Committee (SAC) attended the meeting. Officials of the
U.S. and Japanese governments, the U.S. Embassyin Tokyo, and the National Academy of Sciences(NAS) participated in the meeting as observers. At
the beginning of the meeting, the representativesof the two governments gave greetings, expressing
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their commitment to providing continued support
to RERF. The following is a summary of the meeting’s proceedings.
Several reports were made for FY2012—anactivities report, settlement of accounts report,
and audit report—with the settlement of accounts
report approved as presented. The Councilors
raised questions and commented on the activities report including issues such as RERF’s futureplans, Biosample Center, and “black rain” exposure data.
RERF Update Volume 24, Issue 2, 2013

RERF NewsAs was done last fiscal year, reports also weremade about the major activity plans for FY2013,
including research projects related to the health of
A-bomb survivors and their children, projects aiming at revisions of individual radiation doses andthe effects on risk calculations from such revisions,the public release of research results, collaborations with other scientific organizations, training
programs for Japanese and overseas specialists,public information programs, and plans and budget estimates necessary to conduct these major
activities. Plans for further development of the Biosample Center, established in April 2013, were alsopresented.
Dr. Shunichi Yamashita, the Japanese SAC
Co-chair, reported on the recommendations madeby the SAC at its 40th meeting (held March 4–6,
2013, at the Hiroshima Laboratory), the focusof which was the SAC’s review of the activities
of RERF’s Department of Clinical Studies. Dr.
Yamashita reported that the SAC’s general recommendations included calls for further improvementof RERF’s research quality, serious consideration
to be paid to prioritization of research projects,
development of future plans for the reorganizationof RERF’s research structure and for the nurturingof its human resources, as well as enhancement of
RERF’s global impact and social contributions.
RERF’s responses to these recommendations were
presented and discussed. RERF’s efforts toward
establishment of the Biosample Center with a view
to developing a system for more efficient storage
and use of research samples were commended.
The Rules of Procedure of the Board of Councilors were established last year, and appointments
were made in accordance with the rules for the firsttime at this meeting. Two Councilors, three Directors, three Scientific Advisors, and two Local Advisors were appointed or reappointed.
Lastly, a decision was made to hold next year’s
BOC meeting and its informal executive session at
the Nagasaki Laboratory.
List of Participants
Councilors:
Mr. Masaaki Kuniyasu, Former Ambassador
Extraordinary and Plenipotentiary to the
Republic of Portugal
Dr. Yasuhito Sasaki, Special Advisor, Oncology
Center, Hidaka Hospital
Dr. Hiroo Dohy, Director, Japanese Red Cross
Chugoku-Shikoku Block Blood Center
Dr. Ohtsura Niwa, Professor Emeritus, Kyoto University
Dr. James D. Cox, Former Head, Department ofRadiation Oncology, The University of Texas
M.D. Anderson Cancer Center
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update 2
Dr. Shelley A. Hearne, Visiting Professor, Johns
Hopkins Bloomberg School of Public Health,
Department of Health Policy and Management
Dr. Jonathan M. Samet, Professor and Flora L.
Thornton Chair, Department of Preventive
Medicine, Keck School of Medicine; andDirector, Institute for Global Health, Universityof Southern California
Mr. James W. Ziglar, Senior Counsel, Van Ness
Feldman, and Senior Fellow and Advisor to theBoard, Migration Policy Institute (Former Sergeant at Arms of the United States Senate)
Directors:
Dr. Toshiteru Okubo, Chairman/Representative
DirectorDr. Roy E. Shore, Vice Chairman and Executive
Director
Mr. Takanobu Teramoto, Executive Director
Auditors:
Mr. Takashi Kohno, Hiroshima General Law/
Accounting Office (Hiroshima CPA Cooperative Office/A&A Tax Accountant Corporation)
Mr. David Williams, Senior Financial Advisor,
National Academy of Sciences
Co-chair of Scientific Advisory Committee:
Dr. Shunichi Yamashita, Director/Vice President,
Nagasaki University
Representatives of Supporting Agencies:
Mr. Takeshi Sakakibara, Director, A-Bomb Survivor Support Office, General Affairs Division,
Health Service Bureau, Ministry of Health,Labour and Welfare (MHLW)
Dr. Shuichiro Hayashi, Deputy Director, General
Affairs Division, Health Service Bureau,
MHLW
Mr. Hiromasa Kuroki, Deputy Director, A-Bomb
Survivor Support Office, General Affairs Division, Health Service Bureau, MHLW
Mr. Glenn S. Podonsky, Chief Health, Safety andSecurity Officer, Office of Health, Safety andSecurity, U.S. Department of Energy (DOE)
Dr. Patricia R. Worthington, Director, Office of
Health and Safety, Office of Health, Safety andSecurity, DOE
Dr. Isaf Al-Nabulsi, Japan Program Manager,
Senior Technical Advisor, Office of Health and
Safety, Office of Health, Safety and Security,
DOE
Mr. Dean C. Hickman, Special Advisor, Office of
Health, Safety and Security, DOE
Mr. Jeffrey Miller, Energy Attaché and Director,
DOE Tokyo Office
Dr. Kevin D. Crowley, Director, Nuclear and Radiation Studies Board, Division on Earth and Life
RERF Update Volume 24, Issue 2, 2013

update 3

RERF News
Studies, National Research Council, U.S.
National Academy of Sciences
RERF:
Dr. Kazunori Kodama, Chief Scientist

Mr. Eiji Akimoto, Chief of Secretariat
Mr. Douglas C. Solvie, Associate Chief of Secretariat
Mr. Yutaka Ogasawara, Associate Chief of Secretariat

Participants of the third Board of Councilors meeting held at Hiroshima RERF

Nagasaki RERF Holds Third Public Lecture Event for Citizens
RERF held its third public lecture event for
Nagasaki citizens at the Nagasaki A-bomb Museum
Hall, from 1:30 to 4:00 in the afternoon of June 29(Sat.). This open lecture series is carried out topromote exchange between RERF staff and thegeneral public including A-bomb survivors, by providing clear explanations about results and findings
from RERF’s longstanding research into A-bombradiation health effects. More than 120 people
attended the most recent event.
At the beginning of the public event, following greetings by Chairman Toshiteru Okubo, Mr.
Sumiteru Taniguchi, President of the Nagasaki
Atomic Bomb Survivors Council, shared with theaudience his memories from the time of the bombing of that city. He also expressed his expectations
for RERF’s continued cooperation and support.
The event consisted of two lectures. First, Dr.
Yoichiro Kusunoki, Chief, Department of Radiobiology/Molecular Epidemiology, spoke on “Physical changes induced by radiation exposure: Cancer
development and immune alterations,” explaining
various possible mechanisms of radiation-induced
disease development and the significance of elucidation of such mechanisms, information that is
expected to enable accurate estimation of diseaserisks as well as effective disease prevention andtreatment. Next, Dr. Ayumi Hida, Assistant Chief,
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Nagasaki Department of Clinical Studies, gave alecture titled “Findings from the long-term healthexamination program for A-bomb survivors,” introducing findings obtained from the Adult HealthStudy conducted over many years in language
appropriate for the layperson. She also expressed
her gratitude to the A-bomb survivors for theircooperation in the study and asked for their continued participation and support.
In the special remarks session after the two
lectures, Dr. Takehiko Koji, Dean of the Nagasaki
University Graduate School of Biomedical Sci-

Yoichiro Kusunoki, Chief, Department of Radiobiology/
Molecular Epidemiology, speaking at the third public lecture
for citizens in Nagasaki

RERF Update Volume 24, Issue 2, 2013

RERF News
ences, provided his feedback on the lectures andtalked about the roles to be played by RERF in
the future. The question-and-answer session that
followed was marked by many questions showing

update 4
a strong interest in health damages from radiation
exposure in general and other such issues, as wellas those originating from audience members anxious about their own health.

Local Liaison Council Meetings Held at Hiroshima and Nagasaki
The 19th meeting of the Hiroshima Local Liaison Council (HLLC) was held at Hiroshima RERF
on September 9, 2013. Of the 15 Council members,
14 (including one proxy) attended the meeting andexpressed many valuable opinions.
After the introduction of Council members
by Mr. Eiji Akimoto, RERF Chief of Secretariat,
RERF Chairman Toshiteru Okubo, in his opening
remarks, explained the objectives of establishmentof the liaison council. After greetings by HLLC
Chairman Dr. Toshimasa Asahara (President ofHiroshima University), the meeting’s proceedings began, with Dr. Okubo touching on RERF’s
present status, followed by reports made by Vice
Chairman and Executive Director Roy E. Shore
on recent progress in research, Chief Scientist
Kazunori Kodama on establishment of the RERF
Biosample Center, Dr. Okubo on progress in thecollaborative study with the U.S. National Instituteof Allergy and Infectious Diseases (NIAID), andExecutive Director Takanobu Teramoto on RERF’s
public relations activities. Each of these reports
was followed by a question-and-answer session. In
an exchange in one of the sessions, a Council member requested that RERF provide radiation-effects
training to physicians in Hiroshima.
It also was reported that the Biosample Center,established in April 2013, was undergoing preparations for the initiation in April 2014 of integrated
management of RERF’s archival biosamples. To
review future utilization of archival biosamples byboth RERF and outside researchers, the collectionof opinions from A-bomb survivors and other local
residents is considered necessary, and to that end,
it was announced that a panel discussion would
be held on November 30, 2013, as part of RERF’sseries of public lectures.
The 22nd meeting of the Nagasaki Local Liai-

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son Council (NLLC) was held at Nagasaki RERF
on September 25, 2013. Of the 21 Council members, 15 (including three proxies) were in attendance. After introduction of new Council members
by Mr. Akimoto and greetings by Dr. Okubo, theproceedings got underway, with NLLC Chairman Dr. Shigeru Katamine (President of Nagasaki
University) presiding over the meeting. As was thecase for Hiroshima, the current status of RERF andother issues were reported by RERF participants.
Each of the above reports was followed by aquestion-and-answer session and active debate
among the Council members, including aboutsuch topics as the objectives and management of
the Biosample Center, data in RERF’s possession,and RERF’s research achievements, resulting in
the expression of many valuable opinions. Dr.
Katamine concluded the 22nd NLLC meeting withclosing remarks: “The objectives of this Council
are to compile requests from the local communityand have them reflected in RERF’s operations. I
hope that RERF can fully review and then utilize
the comments and opinions expressed during thismeeting in that way in the future.”

22nd Local Liaison Council meeting held at Nagasaki RERF

RERF Update Volume 24, Issue 2, 2013

update 5

RERF NewsICRP Vice-chair Jacques Lochard Visits RERF
Vice-chair Jacques Lochard (Committee 4
Chair) of the International Commission on Radiological Protection (ICRP), together with Scientific
Secretary Chris Clement, Assistant Scientific Secretary Michiya Sasaki, and two other ICRP members, visited RERF on July 16. Staying at RERF for
more than three hours, the group engaged in discussions after being briefed on the following topics: “Outline of RERF research programs and dose
estimates” by Chairman Toshiteru Okubo; “Use ofcancer registries, radiation and heart disease, andrecent study results” by Chief Scientist Kazunori
Kodama; “Risk among children” by Dr. Kotaro
Ozasa, Chief of the Department of Epidemiology;
and “Radiation-induced cancer and spontaneouscancer” by Dr. Yoichiro Kusunoki, Chief of the
Department of Radiobiology/Molecular Epidemiology. The ICRP group was then led on a tour of
RERF’s facilities by Dr. Kodama, with the department chiefs briefing the group members on eachdepartment’s activities and research results using
explanatory panels and other information.

Vice-chair Jacques Lochard (third from right) listens to explanation by Waka Ohishi (second from right), Acting Chief,
Department of Clinical Studies

Senior Vice Minister Kenya Akiba of the Ministry of Health,Labour and Welfare Visits RERF
Senior Vice Minister Kenya Akiba of the
Ministry of Health, Labour and Welfare visited
RERF’s Hiroshima Laboratory on August 21,
2013. He spent more than one hour at RERF
with three other visitors, including Mr. Hidekazu
Inagawa, Chief of the Chugoku-Shikoku Regional
Bureau of Health and Welfare. At the beginningof his visit, Mr. Akiba was greeted by Chairman
Toshiteru Okubo, Vice Chairman Roy E. Shore,and others in the Chairman’s Office. He listenedwith interest to Chairman Okubo’s explanation of
the history of RERF and summary of its research
activities, frequently asking questions. Chairman
Okubo and Executive Director Takanobu Teramotothen took Mr. Akiba on a tour of the RERF facilities, including the health examination clinic for
A-bomb survivors and their children, the ABCCRERF historical panel exhibit, and the Biosample

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Center, which was established in April of thisyear.

Senior Vice Minister Kenya Akiba (left) listens to explanation
by Toshiteru Okubo, Chairman

RERF Update Volume 24, Issue 2, 2013

update 6

RERF News

Open House 2013 Held at Hiroshima and Nagasaki
RERF’s Hiroshima and Nagasaki Laboratories
held their 19th and 17th Open House events under
the theme “Studying and Understanding Radiation” on August 5–6 and August 8–9, 2013, respectively. Exhibits included the latest information on
ongoing RERF studies, which have continued toyield results thanks to the understanding and cooperation of many people including A-bomb survivors. This year’s Open House events also included
a special poster exhibit titled “Considering risks
from low-dose radiation exposure.”
In Hiroshima, one exhibit introduced RERF
public relations activities (such as open seminars
for citizens, tours of the facilities, acceptance ofvisitors and trainees from abroad, and dispatch of
lecturers). Several walking courses recommended
for different objectives were established, and theinstallation of guide signs near the ceilings madeit easier for visitors to take tours. On August 5, Mr.
Yuji Yoneyama, a licensed radiation protection
supervisor (General Affairs Section/Radioisotope
Facility), gave a lecture titled “What is radiation?” On August 6, Dr. Yoichiro Kusunoki, Chief,
Department of Radiobiology/Molecular Epidemiology, spoke on the topic “Why does radiationinduce cancer?” Both lectures were well attended,

Open House event held in Nagasaki

Open House event held in Hiroshima

and many questions were asked after the talks
concluded. Despite the intense summer heat, theHiroshima Laboratory drew 584 visitors over the
event’s two days, with many people having visited
the RERF Open House in past years and someattending both days of the event this year. The
Open House event provided an opportunity forlively communication between visitors and RERF
employees.
In Nagasaki, in addition to the abovementioned
special exhibit and regular exhibit introducing
research methods and achievements of RERF,
a featured panel exhibit titled “Nagasaki Association for Hibakushas’ Medical Care (NASHIM)”
introduced the Association’s activities. A total of
140 elementary school children from seven afterschool programs visited the Open House, and Mr.
Takanobu Teramoto, RERF Executive Director,
had the opportunity to speak to a group of young
elementary school teachers, demonstrating that thisyear’s Open House appealed to younger generations. A new quiz contest, introduced with the goalof persuading visitors to read our exhibits moreclosely by hiding the answers within the exhibit
texts, proved to be popular. Despite the intense
summer heat, the Nagasaki Laboratory drew 576
visitors over the event’s two days.

Staff News
As of July 1, 2013, Reid D. Landes joined theDepartment of Statistics as a senior scientist, and asof October 1, Atsuko Sadakane, Senior Scientist,
Department of Epidemiology, was promoted toActing Chief, Laboratory of Pathology of the samedepartment. Robert L. Ullrich was appointed as
Associate Chief of Research, effective November
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1, to succeed former Associate Chief of Research
Evan B. Douple, who resigned at the end of
December 2012.
Dr. Ullrich is recognized internationally forhis groundbreaking research on mechanisms andrisk of cancer development following exposure toionizing radiation. He will work with Vice ChairRERF Update Volume 24, Issue 2, 2013

RERF Newsman (Chief of Research) Roy E. Shore to provide
scientific leadership of RERF’s research programsin clinical medicine, epidemiology, genetics, andradiobiology. An important focus of Dr. Ullrich’s
work at RERF will be on the application of biology, genomics, and bioinformatics to advance thescientific understanding of radiation carcinogenesis
in humans.
The above-mentioned two new research staff
members introduce themselves below.
Robert L. Ullrich, PhD
I joined RERF on November 1, 2013, as Associate Chiefof Research. After obtaining
my PhD at the University ofRochester, New York, I joined
Oak Ridge National Laboratory in the United States in1974 and served as Directorof that organization’s RadiaRobert L. Ullrichtion Carcinogenesis Unit until
1989, when I became Vice Chair and Director of
the Biology Division in the Department of Radiation Oncology at the University of Texas Medical
Branch. In 2001, I joined Colorado State University as a professor and Director of the Radiological
Health Science and Cancer Research Program.
In 2008, I moved back to the University of Texas
Medical Branch, where I served as the John Sealy
Distinguished Chair in Cancer Biology, a professor and Director of the Sealy Center for Cancer
Biology (SCCB), and most recently Director of theCancer Center.
My research over many years has focused onrisks and mechanisms of radiation-induced cancer.
Initially, this work investigated dose-response relationships at low doses and dose rates for radiationinduced cancer in mice. Subsequently, my laboratory at the University of Texas Medical Branchdeveloped cell and molecular approaches for the
study of mechanisms in the development of mammary cancer after radiation exposure. The mostrecent work at that laboratory has been funded by
the U.S. National Aeronautics and Space Administration (NASA) to establish a NASA specialized
center of research in radiation carcinogenesis, witha focus of studying cancer risks and mechanismsof cancer development following exposure to theunique forms of radiation encountered during
space travel.
I have served on a number of scientific advisorygroups both in the U.S. and internationally. In
the U.S., I served on committees for the National
Cancer Institute (NCI), the Department of Energy(DOE), NASA, the National Council on Radiation Protection & Measurements (NCRP), and the
National Academy of Sciences/National Research
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update 7
Council (NAS/NRC). Internationally, I have participated in advisory committees including theInternational Commission on Radiological Protection (ICRP), the European Commission (EC), andthe International Agency for Research on Cancer(IARC).
I am a member of several scientific societies,
including the American Association for Cancer
Research (AACR) and the U.S. Radiation ResearchSociety (RRS). Most recently the RRS awarded methat organization’s highest honor, the Failla Award,
for significant contributions to the radiological sciences.
I had visited RERF several times in the past andam excited about the opportunity to work with themany outstanding scientists here. RERF is truly aninternational resource.
Reid D. Landes, PhD
I joined the RERF Department of Statistics at the beginning of July 2013. Before
coming to RERF, I worked
in the Department of Biostatistics at the University of
Arkansas for Medical Sciences (UAMS). In total, I was
at UAMS for ten-and-a-half
Reid D. Landes
years. The first two years I
was a research associate. My wife and UAMS
colleagues encouraged me to return to school andobtain a PhD, so my family and I moved to Iowa,
where I entered Iowa State University. For my
PhD, I focused on Bayesian methods for calibration problems. Upon graduating from Iowa State in2005, we returned to UAMS. At UAMS, I primarily worked with psychologists and psychiatrists.
Some were studying addiction, some were studying
the elderly, and some were studying mental healthin military veterans. I also had the good opportunity to work on the Institutional Animal Care and
Use Committee—a group that provides review ofand guidance on animal studies. Acquaintances on
this committee introduced me to certain statistical issues encountered by radiation researchers
studying radiation countermeasures. Although thistype of research is not a focus of RERF, the experience brought radiation research, in general, to myawareness.
I first heard of RERF when Dr. Kyoji Furukawa,
who had studied with me at Iowa State, joined
RERF. In late 2010, I was hoping to find a sabbatical experience, and noticed a potential opportunity
with RERF. I was interested in RERF becauseof my recent work related to radiation research,and because I had lived in Japan before. Thoughthat opportunity did not open up at the time,
partly because of the 2011 Tohoku earthquake
RERF Update Volume 24, Issue 2, 2013

update 8

RERF Newsand tsunami, RERF stayed on my mind. Anotherpotential opportunity at RERF came open lastyear. I learned more about the objectives of RERF,
and discussed the opportunity with my wife anddepartment head. We all felt that it would be goodto gain valuable experience in statistical methods
used in large epidemiology studies and hopefully
to contribute substantially to the work at RERF. My
family and I decided to go for it. Fortunately, theopportunity was realized, and I was hired. Admittedly, my current plans are to strive to develop
good collaborations during my two-year contract.
When my contract concludes, I hope to introduce
my RERF collaborators to U.S.-based researchers
who can help in studies beneficial to both RERF
specifically and radiation research in general.
On a personal level, I have been interested

in Japan for quite some time. My best friend inkindergarten and first grade in elementary school
was Japanese. In college, Japanese exchange students from Ibaraki Christian College came to myschool, and we became friends. Then, after working as a high school math teacher in the U.S., I was
blessed with an opportunity to work as an assistantEnglish teacher in the Japanese Exchange Teaching Programme. I lived in what is now known as
Minami-Soma, Fukushima. After returning to the
U.S., I married my lovely wife, Angela. We have
one daughter, Novelynn, and two sons, Andy andJack. Away from work, I enjoy being with my family, worshipping my God, being with my church
family, running, and (now) learning Japanese.
I look forward to making both professional andpersonal relationships with everyone.

Visiting Student Fellow
Caitlin M. Milder (Scheduled training period:
October 24, 2013–October 23, 2014)
I am a visiting student fellow studying in the Epidemiology Department under theguidance of Dr. Eric Grant for
one year. I am being fundedthrough a David L. Boren
Fellowship, a program for
master’s degree students towork and study in a field andCaitlin M. Milder
country of importance to U.S.
national security.
I have spent most of my life in Arizona, andI graduated from the University of Arizona withtwo degrees—one in physiology and one in East
Asian studies. A year prior to graduation, I spent
six months at Waseda University in Tokyo studying Japanese in an intensive language program.
Although I had planned to stay a year in Tokyo, myuniversity requested that I return to the U.S. after
the 2011 earthquake, tsunami, and Fukushima Daiichi nuclear disaster. My aim to combine my inter-

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ests in Japanese and physiology in my professional
life had already pushed me in the direction of international health and epidemiology; the Fukushimadisaster fueled in me a desire to study the effects ofradiation on human health. These combined interests drove me to seek out opportunities to study andwork in the field of radiation epidemiology.
I am currently a master’s student at the Johns
Hopkins Bloomberg School of Public Healthstudying global-disease epidemiology and control
in the Department of International Health. I spent
my last year in Baltimore completing the coursework for my degree. The second half of my degree
work is designed to take place in the field. I spent
the last two months prior to joining RERF in Turkey working on statistical analyses of motivations
for seatbelt use in Turkey and the Russian Federation as part of the Bloomberg Philanthropies’ Road
Safety in Ten Countries Project. I am delighted tohave received the opportunity to study at RERF
for my second and final internship. I would like toexpress my gratitude for the chance to grow, learn,
and contribute to RERF’s research.

RERF Update Volume 24, Issue 2, 2013

update 9

RERF NewsAwards Received by RERF Scientist, General Staff
2013 Japanese Association of Cancer Registries
Scientific Promotion Award
Hiromi Sugiyama, Acting Chief
Tumor and Tissue Registry Office
Department of Epidemiology, Hiroshima
At the 22nd meeting of the Japanese Association of Cancer Registries, held on June 14, 2013,
I received the 2013 Scientific Promotion Award.
This award, established in 2012, is presented toyoung researchers who contribute to research using
population-based (well-defined population in a
specific geographical region) cancer registry data.
The research theme for which I received theaward was a review of how different methods ofcollecting population-based cancer registry data
(record abstraction or notification, as indicated in
the following paragraph) affected integrity (completeness), quality of data, and aggregation of data.
The conclusion was that, although completenessof population-based cancer registry data could beassured by using only notified information, moredetailed high-quality data could be collected using
record abstraction by trained abstracters.
Hiroshima has cancer registries with different
characteristics, such as the Hiroshima City Cancer Registry (information gathered on the basis ofrecord abstraction), Hiroshima Prefectural Cancer
Registry (notification received from hospitals), andHiroshima Prefectural Tumor Registry (pathological registration), a situation that made it possible
for me to conduct my review on this theme. Legislation concerning establishment of populationbased cancer registries continues to make progress,
and in the future hospitals will be legally obligatedto make notification of cancers to the registries,
ensuring that a certain level of data integrity will beachieved in all prefectures in Japan. To improve thequality of cancer registry data, however, continuous support, such as meetings to provide individuals in charge at medical institutions with explanations on how to fill out notification forms, will need
to be provided.
The Japanese Association of Cancer Registries
also presents the Distinguished Clerical Service
Award to those who have achieved a certain levelof technical skill in a central office overseeing
regional cancer registries. Thus far, 10 Hiroshima

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RERF employees have been commended. Ms.
Saori Nakamura, who has rendered distinguishedservice for nine years, received the award this year.
I am pleased that Ms. Nakamura and I, who bothjoined the RERF’s registry office around the sametime, were able to be awarded together.
At RERF, it is sometimes difficult and often
challenging to manage regional cancer registry andtumor registry work as well as descriptive epidemiology research and, at the same time, conduct
radiation epidemiology research. I have been able
to continue my work thanks to the guidance I havereceived from other RERF researchers, individuals
related to regional cancer registries in Hiroshima
prefecture, and members of population-based cancer registry study groups. I would especially like toexpress my appreciation to my RERF colleagues
who have lent their support to this cancer registrywork. I ask for everyone’s continued support andguidance.

Hiromi Sugiyama (left), Acting Chief, Tumor andTissue Registry Office, and Saori Nakamura,the same office, with their awards

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update 10

International Workshop: RERF Radiation Research in the
Post-genomic Era
Yasunari Satoh, Research Scientist
Laboratory of Biochemical Genetics, Department of Genetics
Yasuharu Niwa, Associate Senior Scientist
Laboratory of Cell Biology, Department of Radiobiology/
Molecular Epidemiology
An international workshop was held on March
7 and 8, 2013, at the RERF Hiroshima Laboratory,
under the theme “RERF Radiation Research in the
Post-genomic Era.”
In recent years, research based on next-generation sequencing (NGS) has been flourishing in
the fields of medical science and biology. NGS
enables the collection of enormous amounts ofexperimental data never before possible. Althoughnext-generation sequencers have not yet been
introduced at RERF, it is essential for RERF to use
NGS technology in its future research. The goal of
the workshop was to discuss possible uses of NGS
in determining radiation-induced mutation rates inhuman germ cells, and in studying radiation effects
related to carcinogenesis, immune function, andepigenetics. Both of these research areas are important aspects of RERF’s mission, and nine researchers well known in these fields in Japan and abroadwere invited to participate in the workshop to talkabout recent progress in NGS-based research andfuture research possibilities at RERF using NGS.
Dr. Yoshiaki Kodama (Chief, RERF Departmentof Genetics) inaugurated the event by introducing
the workshop’s aims and speakers. Dr. Jun-ichi
Asakawa (Senior Scientist, RERF Department of
Genetics) followed with a presentation titled “Brief
notes on transgenerational effects of A-bomb radiation.”
The workshop consisted of five sessions. In thefirst, “De novo mutations in germ cells,” Dr. Yoichi
Gondo (RIKEN; RERF Scientific Advisor) gave alecture on “High-resolution detection of germline
single nucleotide variations in the mouse by nextgeneration re-sequencing.” He reported that 1)
NGS was used to detect base substitutions in the
genome of F1 mice produced by mating C57BL/6J
male mice exposed to N-ethyl-N-nitrosoures(ENU), a chemical mutagen, with ENU-untreated
DBA/2J female mice; 2) whole-exome sequencing
was used to sequence approximately 50 Mb of themouse genome that encompasses virtually all of themouse coding regions; 3) about 100 ENU-induced
base substitutions per F1 mouse were detected; and4) two of the strengths of this method were that a
reliable mouse genome sequence—the sequence of
the C57BL/6J mouse strain decoded in the Mouse
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Genomes Project—was used as the reference
sequence, and that the information about 600,000
known single nucleotide polymorphisms (SNPs)
existing between the two strains of C57BL/6J andDBA/2J was used as the positive control.
The next speaker of the first session was Dr.
Katie Campbell (University of Washington), who
presented a talk titled “Estimating the humanmutation rate using autozygosity in a founderpopulation,” reporting on a study of large Hutterite
families living in the United States. She reported
that the aim of the study was to estimate the natural mutation rate in humans by examining almost
identical regions of two chromosome strands ofpaternal and maternal origins that resulted fromhaving a distant common ancestor on the paternal
and maternal sides. The analysis showed a mutation rate of 1.21 × 10–8 mutations per base pair per
generation, which increased 9-fold for bases within
CpG dinucleotides (9.72 × 10–8).
In the second session, “Detecting genetic variation and mutation using next-generation sequencer,”Dr. Ryan Mills (University of Michigan) gave a talktitled “Mapping structural variation by populationscale genome sequencing,” in which he presented
the results of the 1,000 Genomes Project Consortium. He first reported on the results of the pilot
phase of the project, which analyzed the wholegenome sequences of 179 individuals across four
ethnic groups: about 22,000 distinct deletions and6,000 insertions and tandem duplications weredetected. He also reported on the results of a subsequent phase of the project that analyzed an additional 1,092 individuals across 14 ethnic groups.
Dr. Mills’ talk was followed by a presentationfrom Dr. Akihiro Fujimoto (RIKEN) on “Comprehensive analysis of genetic variation by wholegenome sequencing.” Dr. Fujimoto reported on
the results of the first whole genome sequencing(WGS) of a Japanese individual, and of WGS of
27 hepatocellular carcinoma (HCC) cases. He
reported 1) that about three million SNPs and 5,000
deletions were found in the WGS of the Japaneseindividual; 2) that a list of recurrently mutatedgenes in HCC was generated from the latter (27HCC cases) WGS; 3) that multiple chromatin
regulators were mutated in about half of the tumors
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Conference and Workshop Reports

update 11

in the HCC WGS; and 4) that hepatitis B virus
Akira Watanabe (Kyoto University), addressing
genome integration in the telomerase gene or thethe topic “Genome and epigenome analysis of iPS
MLL4 gene was frequently observed in HCC assocells for regenerative medicine,” talked about theciated with hepatitis B.
use of NGS to construct genomic and epigenomic
In the third session, “Some data and ideas fordatabases with the aim of producing clinicallyfuture studies,” Dr. Yasunari Satoh (Research
applicable induced pluripotent stem (iPS) cells. He
Scientist, RERF Department of Genetics) talked
reported that his team found a slight variation in theabout a study, “Model experiments using irradigene structure among iPS clones, and determined
ated human cultured cells,” being conducted in thethat a genomic and epigenetic match between iPS
Department of Genetics.
cells and the donor’s somatic cells is essential in
In the fourth session, “Applications of highthe clinical application of iPS cells. The presentathroughput sequencing to the immune system,”tions in this session made everyone realize anew
Dr. Harlan Robins (Fred Hutchinson Cancer Research
the importance of epigenetics in the post-genomic
Center) presented a talk on “Profiling the adaptiveera.
immune system with high-throughput sequencing.”
The symposium concluded with a roundtable
He reported the results of detailed analyses using
discussion chaired by Dr. Yoichiro Kusunoki
NGS of the immune system reconstructed by hema(Chief, RERF Department of Radiobiology/Molectopoietic cell transplantation and the T-cell receptor
ular Epidemiology). Symposium participants also
repertoire in tumor-infiltrating lymphocytes. Dr.
toured the facilities and learned more about
Ituro Inoue (National Institute of Genetics) then
RERF’s research.
presented “Comprehensive analyses of HLARERF benefited greatly from the symposium
genomic region,” reporting on methods of humanbecause RERF researchers were able to actively
leukocyte antigen (HLA) genotyping with NGS.
communicate with the visiting speakers and obtainIn the fifth session, “RNA sequencing and epitheir expert advice and cooperation concerning
genetics,” Dr. Yongli Xiao (U.S. National Instituteongoing research at RERF as well as studies in theof Allergy and Infectious Diseases) presented “Highplanning stages. These include model experiments
throughput RNA sequencing of an autopsy tissue
using irradiated human cells in culture, studies
sample from the 1918 influenza pandemic.” Heof transgenerational radiation effects using mice,reported that his team, using NGS, had sequenced
methods for detection of mutations and estimation
the flu virus genome and transcripts extracted fromof mutation rates, analysis of T-cell repertoires andformalin-fixed and paraffin-embedded (FFPE) lungepigenomics using archived lymphocytes that havetissue samples from two influenza pandemics, inbeen donated by A-bomb survivors on an ongoing1918 and 2009. They succeeded in almost combasis, and RNA sequencing using autopsied tissue
pletely recovering the genome sequences of both flu
samples from A-bomb survivors.
viruses, 1918 and 2009, and identified an immuneWe would like to express our appreciation to therelated gene expressed in lung tissues as well asJapanese Ministry of Health, Labour and Welfare,bacterial sequences associated with secondary
which funded the workshop; to the staff members
bacterial infections. He also reported on the effecof the Departments of Genetics and Radiobiology/
tiveness of application of duplex specific nuclease
Molecular Epidemiology; and to the many others(DSN) for minimizing ribosomal RNA effects.
who helped us organize the workshop.
Dr. Haruhiko Siomi(Keio University)
followed with a talktitled “Small RNAmediated transposon
silencing,” reportingon PIWI, an element
involved in the silencing of retrotransposons in the gonad.
The presentation also
described discoveryof new functions ofretrotransposons ingenome evolution,and of such molecular complexes as small
temporal RNAs. Dr. Participants of the International Workshop: RERF Radiation Research in the Post-genomic Era
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Conference and Workshop Reports

update 12

Third Meeting of the Scientific and Ethics Committee for theClinical Study of the F1 Offspring of A-bomb Survivors Held
Waka Ohishi, Acting Chief
Department of Clinical Studies, Hiroshima
The third meeting of the Scientific and Ethics Committee for the Clinical Study of the F1
Offspring of A-bomb Survivors was held at theHiroshima RERF Auditorium on April 25, 2013. At
the meeting, progress in the longitudinal F1 Clinical Study was reported. Dr. Nori Nakamura, Consultant, Department of Genetics, presented a talkon the topic “Past, present, and future—Heritable
genetic effects of radiation on humans,” which suggested future directions of research on the genetic
effects of radiation.
In the previous health effects study of the children of A-bomb survivors, a mail survey of 24,673
subjects and a clinical health study of 11,951 subjects were conducted between 2000 and 2006 to
determine the relationship between parental radiation exposure and the prevalence of multifactorialdiseases in children. The results of that study’s
combined analysis of six multifactorial diseases(hypertension, hypercholesterolemia, diabetes,
angina pectoris, myocardial infarction, and stroke)showed no evidence of increased risk related toparental radiation exposure. However, continuationof the study was recommended because in such
prevalence studies there tends to be a bias related todecision-making among the participants concerning whether or not to undergo health examinations.
Moreover, the average age of the subjects, about
49 years, was relatively low. In response to thisrecommendation, a research plan for the F1 Clinical Study was approved, based on deliberations at
the first meeting of the Scientific and Ethics Committee for the Clinical Study of the F1 Offspringof A-bomb Survivors, held on July 7, 2010, which
included experts from outside of RERF. Healthexaminations for the nearly 12,000 subjects were
initiated on November 24 of the same year.
The meeting’s proceedings began with greetings and introduction of committee members by
RERF Chairman Toshiteru Okubo, which was followed by greetings by Committee Chairman Tadao
Shimao. Dr. Ohishi then reported on the progress
made in the F1 Clinical Study in the two years since
its start. It was reported that the participation rate,
including scheduled health examinations, increased
from 69.2% in the first year to 76.0% for the twoyear period overall, which was close to the targeted
80%. This increase was encouraging, in light ofseveral measures that had been undertaken to
improve the participation rate, including those recommended by members of the Scientific and Ethics
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Committee at its second meeting, held on January
12, 2012, such as the effort to make contact by telephone with those whose addresses were unknown.
It was then explained that further analysis of eachof the individual multifactorial diseases using dataobtained in the last prevalence study showed “noevidence suggesting increased risk for individual
diseases related to paternal or maternal exposure
to radiation.” The fact that these results were published in the Journal of Radiological Protection
was also mentioned. Dr. Shimao praised the work,
stating in the general discussion and in his summary that “the various efforts to improve the participation rate and the resulting high participation
rate for the long-term continuous study showed that
health examinations were being conducted properly in response to the needs of the subjects.”
After a brief recess, Dr. Nakamura presented
his talk on the heritable genetic effects of radiation, reporting on genetic studies conducted at
ABCC-RERF and a study of non-A-bomb childhood cancer survivors and their children. Finally,
he explained in a readily understandable mannerthat the reason why heritable genetic effects ofradiation were difficult to detect in humans wasthat a substantial number of variations are alreadyaccumulated as natural mutations in our DNA, as
seen in recent genome analysis research. Under the
direction of Dr. Shimao, vigorous questions wereraised, after which the meeting concluded withremarks and words of appreciation by RERF Vice
Chairman Roy E. Shore.
Based on the attempts to maintain and improve
the participation rate in the F1 Clinical Study, thenumber of participants is expected to increase infour years (one cycle) to more than 9,500, which
is close to the original target of about 10,000. We
would like to continue to encourage continuous

The third meeting of the Scientific and Ethics Committee
for the Clinical Study of the F1 Offspring of A-bomb Survivors
held at the Hiroshima Laboratory

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Conference and Workshop Reports
participation in the health examinations by distributing relevant information via letters and contacts
by telephone, to ensure that the subjects understandthe significance of our study as well as the factthat the health examinations at RERF could leadto early detection of diseases and improved overall
health management.
Members of the Scientific and Ethics Committee for the Clinical Study of the F1 Offspring of A-bomb Survivors
Tadao Shimao (Chairman), Consultant, Japan
Anti-Tuberculosis Association
Hiraku Takebe (Vice Chairman), Fellow, Kinki
University Atomic Energy Research Institute
Hirotsugu Ueshima, Special Contract Professor,
Lifestyle-Related Disease Prevention Center,
Shiga University of Medical Science
Takashi Kawamoto, Professor, Graduate School of
Education, The University of Tokyo
Shinsuke Kimura, Attorney, Kimura Shinsuke Law
OfficeTakashi Gojobori, Vice Director and Professor,
National Institute of Genetics
Hideo Sasaki, Professor, Department of Nutritional Sciences, Faculty of Human Ecology,
Yasuda Women’s University

Steve Wing, Associate Professor, Department of
Epidemiology, School of Public Health, University of North Carolina
Kazuo Tajima, Director, Aichi Cancer Center
Research Institute
Masao Tomonaga, Director, Japanese Red Cross
Nagasaki Atomic Bomb Hospital
Taisei Nomura, Professor Emeritus, Osaka University
Norihiko Hayakawa, Professor Emeritus, Hiroshima
University
Katsumi Furitsu, Assistant Professor, Departmentof Genetics, Hyogo College of Medicine
Eiji Maruyama, Professor, Graduate School ofLaw, Kobe University
RERF Participants
Toshiteru Okubo, Chairman
Roy E. Shore, Vice Chairman
Takanobu Teramoto, Executive Director
Kazunori Kodama, Chief Scientist
Eiji Akimoto, Chief of Secretariat
Douglas C. Solvie, Associate Chief of Secretariat
Members, Working Group for the Clinical Study ofthe F1 Offspring of A-bomb Survivors
Research Scientists, Department of Clinical Studies

Fourth Epidemiological Training Workshop for Biologists
Ritsu Sakata, Associate Senior Scientist
Department of Epidemiology, Hiroshima
The fourth Epidemiological Training Workshop
for Biologists, hosted by the Council of Radiation
Effects Research Organizations, was conductedon August 26–27, 2013, at the RERF Auditorium
in Hiroshima. This workshop was initiated in2010 at the suggestion of Dr. Nori Nakamura,then RERF Chief Scientist, to promote mutual
exchange between biologists and epidemiologists. Dr. Nakamura had organized the workshops
since they began, but starting in 2013, when Dr.
Nakamura became Consultant to the Departmentof Genetics, the Department of Epidemiology
assumed responsibility for the event. Initially,
enrollment for this year’s workshop lagged, partly
because other radiation-related meetings were taking place around the same time, and we thus prepared for a small turnout. However, the number ofapplicants increased after mid-July, and eventually
32 participants, including 11 from RERF, joined
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the workshop. (The Council of Radiation Effects
Research Organizations, established to develop
understanding and enhanced collaboration amongradiation research organizations, consists of theInstitute for Environmental Sciences, Kyoto University, Nagasaki University, Hirosaki University,
Hiroshima University, Fukushima Medical University, National Institute of Radiological Sciences,and RERF.)
On the morning of the first day, participants
listened to the lectures “Radiation biology fornon-biologists” by Dr. Nakamura; “Epidemiology
for non-epidemiologists” by Dr. Sakata, Associate
Senior Scientist, Department of Epidemiology;
and “Descriptions of Life Span Study Report 14”
by Dr. Kotaro Ozasa, Chief, Department of Epidemiology. Afternoon sessions included “Genetic
effects in A-bomb survivors” by Dr. Yoshiaki
Kodama, Chief, Department of Genetics; “ComRERF Update Volume 24, Issue 2, 2013

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Conference and Workshop Reports
mentary on a paper: Risk of CT scans in childhood” by Dr. Atsuko Sadakane, Associate Senior
Scientist, Department of Epidemiology; “Risk in
the offspring of A-bomb survivors” by Dr. Eric J.
Grant, Assistant Chief, Department of Epidemiology; and “Risk from in utero exposure to radiation”
by Dr. Hiromi Sugiyama, Acting Chief, Tumor andTissue Registry Office, Department of Epidemiology.
In the evening of that first day, a party took
place at a venue outside of RERF. In addition tomost of the workshop participants, RERF Chairman Toshiteru Okubo, Vice Chairman Roy E.
Shore, and Chief Scientist Kazunori Kodama
attended the gathering. The participants engaged inconversation about their specializations, exchanged
opinions, and enhanced mutual understanding. At
the event, the younger participants expressed theneed for more opportunities to speak, a desire thatcame to fruition on the second day of the workshop, when younger researchers were more active,
presenting a number of questions and comments.
The second day’s lectures included “Cardiovascular disease risk among A-bomb survivors” by Dr.
Ikuno Takahashi, Research Scientist, Departmentsof Epidemiology and Clinical Studies; “Whatage at exposure means” by Dr. Nakamura; and“Trends in radiation effects studies outside Japan”
by Dr. Otsura Niwa, Professor Emeritus, Kyoto
University. A discussion about the future of theworkshop followed, during which numerous views
were presented. One participant proposed that thecurrent workshop, which is designed for beginners, and a study meeting intended for research
discussion be held in alternate years. Another idea
expressed was that the workshop should provide an
opportunity to discuss future directions in radiation
effects research. Another participant requested thatthe topic of risk communication be included in theworkshop. Other participants, on the other hand,requested continuation of the current workshop’s
focus on basics. Reasons offered for this argument
were that not all researchers engaged in radiation
effects research have attended this workshop, andthat the workshop has been useful in recalling theepidemiological mindset, which tends to be forgotten in the course of day-to-day work. Because
this was the fourth training workshop, and because
the number of participants was down this year, it
seemed necessary to discuss the program’s future;
we are truly grateful for the many productive comments we received from the participants.

Participants of the fourth Epidemiological Training Workshop for Biologists

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RERF Update Volume 24, Issue 2, 2013

update 15

Science Articles

The Incidence of Leukemia, Lymphoma andMultiple Myeloma among Atomic Bomb
Survivors: 1950–2001*
Dale L. Preston1 and Harry M. Cullings2
1

HiroSoft International Corporation, USA (Consultant, Department of Statistics, RERF)
2
Department of Statistics, RERF

*This article is based on the following publication:
Hsu WL, Preston DL, Soda M, Sugiyama H, Funamoto S, Kodama K, Kimura A, Kamada N,
Dohy H, Tomonaga M, Iwanaga M, Miyazaki Y, Cullings HM, Suyama A, Ozasa K, Shore RE,
Mabuchi K. The incidence of leukemia, lymphoma and multiple myeloma among atomic bomb
survivors: 1950–2001. Radiat Res 2013; 179(3):361–82 (doi: 10.1667/RR2892.1)

Study Findings
This report represents a 14-year update of findings on radiation risks for cancer-like diseases ofthe blood and lymphatic systems and provides
unique data regarding several questions:
What are the cumulative risks of these cancers since the atomic bombings? The data show
a total excess of 94 leukemia cases associated withradiation exposure among the 113,011 Life Span
Study (LSS) members. There was no excess of
Hodgkin lymphoma (HL), and a marginal excess of
non-Hodgkin lymphoma (NHL) among males but
none among females. There was no clear excess ofmultiple myeloma (MM).
How large is the risk at low doses? There wasa dose response with upward curvature for the radiation-related group of leukemia sub-types, which
implies there is less risk per mGy unit of dose at
low dose levels than at higher ones. In addition,risks varied markedly by time since exposure, age
at exposure, and leukemia sub-type.
Has the excess leukemia risk disappeared bythis many years after the bombings? Although
the excess risks generally declined with increasing
age or time since exposure, there was evidence thatthe radiation-associated excess risks, especiallyfor acute myeloid leukemia (AML), have persisted
throughout the follow-up period, though the excess
risks are low by 55 years after the bombings.
Explanation
Leukemia and other cancer-like diseases ofthe blood and blood-forming organs are typicallystudied together and considered to be different invarious aspects from other, i.e., “solid” cancers.
The diseases grouped here with leukemia include
cancers of the lymphoid system (lymphomas) and
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MM, a cancer of white blood cells called plasma
cells.
After exposure to ionizing radiation such as thatfrom the A-bombs, the risk of leukemia increases
sooner than that of the solid cancers, and leukemia was the first and most striking late effect ofradiation exposure seen among the Hiroshima andNagasaki atomic bomb survivors. Leukemia also
has a very high relative risk per unit radiation dose,compared to most solid cancers.
Leukemia has a number of sub-types, most ofwhich are considered to be associated with radiation exposure but some not. Even among the radiation-associated sub-types, in addition to analyzing
them as a group, there is an interest in analyzing
their radiation risks separately to see how they differ. Lymphoma is also not a single disease, having
the two major classifications HL and NHL.
Because a number of years had passed since thelast comprehensive RERF study of the incidence ofleukemia, lymphoma, and multiple myeloma, there
was a need for an update. This was a considerable
undertaking due to concerns about changes that
had occurred in the classification of these diseases
and their sub-types. RERF researchers, in collaboration with external researchers from Hiroshima
and Nagasaki, undertook a new analysis, which
includes 14 years of additional follow-up since thelast report, along with an expanded selection of risk
models.
1. Objective of the study
The objective of this study was to provide
comprehensive, updated risk estimates for theincidences of leukemia, lymphoma, and multiple
myeloma (MM) in relation to A-bomb radiation
dose.
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Science Articles
2. Study methods
Incident cases were ascertained and assembled
from the Leukemia Registry and the Hiroshima
and Nagasaki Tumor Registries using a series ofrules to give precedence to the better information
when there were discrepancies, providing incidence data on 113,011 LSS cohort members with
3.6 million person-years of follow-up from late in1950 through the end of 2001. Risk estimates weremade using Poisson regression on highly stratified tables of these data to characterize the shapeof the radiation dose-response relationship and, tothe extent the data allowed, to investigate variation in the excess risks with gender, attained age,
exposure age, and time since exposure. Both excess
absolute rate (EAR) and excess relative risk (ERR)(b) Dose response
Excess relative risk

Cases per 10,000 PY(a) Baseline rate

5
4
3
2
1
0
20

40

60

Attained age

15
10
5
0

80

0

Excess relative risk

40
30
20
10
0

Excess cases per 10,000 PY

20

40

60

Attained age(e) EAR at 1 Gy vs age

8
6
4
2
0
40

60

Attained age

3

50
40
30
20
10
0

80

10

20

2

(d) ERR at 1 Gy vs time

50

5

Excess cases per 10,000 PY

Excess relative risk(c) ERR at 1 Gy vs age

1

Weighted dose (Gy)

80

20

40

Time since exposure (yrs)60(f) EAR at 1 Gy vs time

10
8
6
4
2
0
5

20

40

Time since exposure (yrs)60

Figure. Summaries of the risk of leukemia other than CLL or adult T-cell leukemia (ATL) in the LSS. Plot
(Panel a) shows age-specific baseline (zero dose) rates in Hiroshima for men (black lines) andwomen (gray lines) for LSS cohort members born in 1895 (dash-dot line; age at exposure 50), 1915
(dash line; age at exposure 30), and 1935 (solid line; age at exposure 10). Panel b: illustrates theradiation dose response based on the ERR model with risks standardized to attained age 70 for a
person exposed at age 30 (born in 1915). The solid-black line illustrates the fitted linear-quadratic
dose response. The points are based on a nonparametric dose-response model, while the middledashed-gray line is a smoothed version of the dose category-specific estimates from the nonparametric fit. The upper- and lower-dashed-gray lines are plus and minus one standard error from thesmoothed fit. Panels c and d: illustrate the temporal pattern and age-at-exposure effects for our
preferred ERR model (ages at exposure indicated by lines are same as in Panel a). The fitted ERR
did not depend on either gender or city. Panels e and f: present the temporal pattern and age-atexposure effects for Hiroshima males based on the preferred EAR model (ages at exposure indicated by lines are same as in Panel a). The points in Panels c–f are nonparametric estimates for
exposure at age 10.
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Science Articles
models were considered. (The ERR is based on theassumption that radiation-related risk is proportional to the baseline [zero dose] risk, which typically may vary by age, sex, and other factors, while
the EAR assumes that the radiation-related risk
does not depend on the level of the baseline risk.)
3. Results(1) A total of 1,215 hematological malignancies
were identified among LSS cohort members,
944 of which were eligible for inclusion in theanalyses between 1950 and the end of 2001.
Almost 40% of the eligible cases were diagnosed after the end of the follow-up (1987)
used in the last comprehensive analyses of the
LSS data. About 40% of the cases were leukemias, another 40% were identified as NHL, andalmost 15% were MM. HL was uncommon.
Almost half of the leukemia cases were classified as AML, 20% were chronic myeloid leukemia (CML), and about 12% were acute lymphoblastic leukemia (ALL). As with otherpopulations in Japan, the incidence of chronic
lymphocytic leukemia (CLL) was remarkablylow.
(2) For the “radiation-related” group of leukemia
sub-types consisting of AML, ALL, and CML,
allowing for attained-age and time-since-exposure effects in the model, a concave upward
linear-quadratic (LQ) model that contains aterm for dose and a term for dose-squared
described the data significantly better thaneither a linear dose-response or pure quadratic

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update 17
dose-response model (Figure). The estimatedlinear dose effect in the LQ ERR model atattained age 70 after exposure at age 30 was
0.79 (i.e., a 79% excess) at 1 Gy and the estimated curvature was 1.2, which means that therisk coefficient for the square of dose was 1.2
times the coefficient for the linear dose effect.
For example, the total ERR at 1 Gy was 0.79 ×(1 + 1.2 × 12) = 0.79 × 2.2 = 1.74, whereas the
ERR at 0.01 Gy would be 0.79 × (0.01 + 1.2 ×
0.012) = 0.79 × 0.01012, which is very close to0.79/100—the dose-squared term contributes
almost nothing. Thus the estimated risk atlower doses is substantially less than it would
be for a purely linear dose response with thesame total ERR of 1.74 at 1 Gy. It was estimated that about 94 of the 312 cases of AML/
ALL/CML leukemia used in these analyses
were associated with the radiation exposure.
a. For AML analyzed separately (176 cases),a pure-quadratic model with an estimated
ERR at 1 Gy of 1.11 (standardized to age 70
after exposure at age 30) described the data
as well as a linear-quadratic model.
b. For NHL (402 of 437 lymphoma cases),
while there was some evidence of a statistically significant radiation effect in men,
there was no indication of a radiation effectin women.
(3) There was no evidence of radiation-associatedexcess risk for HL or MM.

RERF Update Volume 24, Issue 2, 2013

update 18

Science Articles

Radiation-dose Response of Glycophorin A Somatic
Mutation in Erythrocytes Associated with Gene
Polymorphisms of p53 Binding Protein 1*
Kengo Yoshida
Department of Radiobiology/Molecular Epidemiology, RERF
*This article is based on the following publication:
Yoshida K, Kusunoki Y, Cologne JB, Kyoizumi S, Maki M, Nakachi K, Hayashi T. Radiationdose response of glycophorin A somatic mutation in erythrocytes associated with gene polymorphisms of p53 binding protein 1. Mutat Res 2013; 755(1):49–54 (doi: 10.1016/j.mrgentox.
2013.05.003)

Study Findings
Previous studies revealed that the fraction oferythrocytes with somatic mutations at the glycophorin A (GPA) gene locus increased with radiation dose in atomic-bomb survivors. It was foundin the present study that the manner in which GPA
mutations increased following radiation exposure(radiation-dose effects) differed by individual
differences in genetic background, i.e., DNA
sequences (gene polymorphisms). It also was suggested that p53 binding protein 1 (53BP1) plays asignificant role in DNA double-strand break repair
in hematopoietic stem cells following radiation
exposure.
(Note) Use of letters in italics, such as in GPA and
53BP1, indicates genes, whereas ordinary typeface, suchas GPA and 53BP1, is used to designate proteins generated by those genes. GPA gene mutations are usuallyconfirmed by the observation of protein alterations.

Explanation
The fraction of erythrocytes with mutations
at the GPA gene locus is considered to be one of
the indices of somatic mutations induced by ionizing radiation for estimating the degree of related
genome damage and cancer risk. Previous studiesof A-bomb survivors revealed that erythrocyte GPA
mutations increased with radiation dose, but it also
was reported that there was significant individual
difference in GPA mutation rates even after exposure to around the same radiation dose. The reason
for such individual difference in GPA mutation
rates was unclear, and the differences could not be

250
200
150
100
50
0

GPA mutation rate （×10 –6）

300

TCA homozygotes
TCA/GGC heterozygotes
GGC homozygotes

0

1

2

3

4

Radiation dose (Gy)Figure. Relationship among GPA mutations, radiation dose, and 53BP1
gene polymorphisms. Increase in GPA mutations varies by individual differences in DNA sequence of the 53BP1 gene. (Individuals with TCA homozygotes, TCA/GGC heterozygotes, and GGChomozygotes are shown in blue, green, and red, respectively.)
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RERF Update Volume 24, Issue 2, 2013

Science Articles
explained by differences in age at exposure, sex,city, or frequency of smoking.
In the present study, we examined whether individual differences in DNA sequences (gene polymorphisms) contributed to individual differences in
GPA mutation rates related to radiation exposure.
In particular, because it was suspected that thedifference in ability to repair DNA double-strand
breaks that are caused by radiation exposure may
be related to individual differences in GPA mutation rates, we focused on gene polymorphisms of
the 53BP1 gene, which is related to DNA doublestrand break repair. As a result, radiation-dose
effects on GPA mutation rates were found to varyslightly by 53BP1 gene polymorphism (Figure).
Although erythrocytes have a short life spanof around 120 days, an increase in the number ofReturn to Table of Contents

update 19
erythrocyte GPA mutations with radiation dose isstill observed even now, more than 60 years after
A-bomb radiation exposure. It can therefore beconsidered that mutations have been recorded in
the GPA genes of longer-lived hematopoietic stem
cells, which can differentiate into erythrocytes. In
other words, it is assumed that many of the erythrocyte GPA mutations observed in A-bomb survivors
reflect GPA mutations in hematopoietic stem cells.
For this reason, and because of the relationshipbetween erythrocyte GPA mutations and 53BP1
gene polymorphisms observed in the present study,
it is suggested that a group of proteins, including
53BP1, plays an important role in DNA doublestrand break repair in hematopoietic stem cells andsomatic mutations following radiation exposure.

RERF Update Volume 24, Issue 2, 2013

update 20

Science Articles

Alterations of Body Mass Index and Body
Composition in Atomic Bomb Survivors*
Yoshimi Tatsukawa
Department of Clinical Studies (Hiroshima), RERF
*This article is based on the following publication:
Tatsukawa Y, Misumi M, Yamada M, Masunari N, Oyama H, Nakanishi S, Fukunaga M,
Fujiwara S. Alterations of body mass index and body composition in atomic bomb survivors.
Int J Obes 2013; 37(8):1123–8 (doi: 10.1038/ijo.2012.193)

Study Findings
Both body mass index (BMI) and muscle massindex tended to decrease with increased radiationdose in both male and female A-bomb survivors.
Abdominal obesity index tended to increase amongfemales who were younger than 15 years of age at
the time of bombing (ATB).

from a study on whether radiation exposure isrelated to alterations of BMI and of body composition measured by DXA, taking age ATB into
consideration.
2. Study methods
Relationship between radiation exposure and
BMI was examined for 2,686 A-bomb survivors(834 males and 1,852 females) aged 48–89 (0–40
years ATB) who had participated in the AHS during the period 1994–1996. Further, the relationshipbetween radiation exposure and body composition
was examined for 1,729 of those survivors (550
males and 1,179 females) for whom body composition had been assessed by DXA.
In reviewing body composition, we used 1)
fat-free mass of extremities (both arms and both
legs; weight minus weight of bone and fat)/heightsquared, as an index of muscle mass, and 2) ratio oftrunk fat to extremity fat, as an index of abdominal

Explanation
We examined the relationship of radiation exposure to BMI and to body composition measured bysystemic dual-energy X-ray absorptiometry (DXA)
among subjects of the Adult Health Study (AHS), along-term follow up of the health of A-bomb survivors based on biennial health examinations.
1. Study purpose
No study has been conducted on whether
A-bomb radiation affected obesity or body composition such as muscle and fat. This paper resulted(A) Males younger than 15 years of age
at the time of bombing(B) Females younger than 15 years of age
at the time of bombing

P < 0.001

P = 0.03
Ratio of trunk fat to extremity fat

Fat-free mass of extremities/height squared(log-transformed values)(g/m2）

Radiation dose (Gy)Radiation dose (Gy)Figure. Relationship between body composition and radiation dose in atomic-bomb survivors. Index ofmuscle mass (fat-free mass of extremities/height squared) among males who were younger than age
15 ATB (Panel A), and index of abdominal obesity (ratio of trunk fat to extremity fat) among females
who were younger than age 15 ATB (Panel B)
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RERF Update Volume 24, Issue 2, 2013

Science Articles
obesity. In statistical analysis, age at examination,
age ATB (ages <15, ≥15), serum creatinine level,smoking and alcohol consumption status, presence of diabetes, history of ischemic heart disease
and malignant tumor, and menopausal status forfemales were taken into consideration.
3. Study results(1) Effects of radiation on BMIBMI tended to decrease with increased
radiation dose in both males and females.
Analysis by age ATB showed a significant
relationship between increased radiation doseand decreased BMI among males who wereyounger than age 15 ATB.

update 21
radiation dose. As in the case of BMI, examination by age ATB showed that the muscle
mass index tended to decrease with increased
radiation dose among males who were younger
than age 15 ATB. Among females who wereyounger than age 15 ATB, the abdominal obesity index tended to increase quadratically withradiation dose (Figure).
In this investigation of A-bomb survivors
around 50 years after A-bomb radiation exposure,decreased BMI and altered body composition withincreased radiation dose were suggested. Further
investigation is underway on how such body composition alterations are involved in the health statusof A-bomb survivors.

(2) Effects of radiation on body composition
Muscle mass index decreased with increased

Return to Table of Contents

RERF Update Volume 24, Issue 2, 2013

Human Interest Notes

update 22

A Retrospective of My Work at the Radiation Effects
Research Foundation
Masazumi Akahoshi, Former Chief
Department of Clinical Studies, Nagasaki
After being dispatched to RERF as part of arotation at the Third Department of Internal Medicine, Nagasaki University, in April 1988, I served
at RERF for 25 years, until the end of March 2013.
I remember that when Dr. Stuart Finch, thenChief of Research, asked me what I hoped to do at
RERF, I stated that I wanted to conduct researchon circulatory diseases, and that even though I was
not interested in the health effects of radiation,
I would do my best to cooperate in research.
Because he did not fire me then, I thought myconditions had been accepted. In the fall of thesame year, Professor Kondo of the Department of
Neurology, Hokkaido University, requested that
the RERF Nagasaki Laboratory participate in a
research team on dementia, and it was decided, due
to a recommendation from Clinical Studies Department Chief Kyoko Toyama, that I would participate. I never dreamed that this event would affectmy future to the extent that it did.
When I was preparing materials for the second
meeting of the research team in November orDecember 1989, I was warned not to give away
so many of the data to the team’s research because
RERF and U.S. researchers were planning to starta dementia study shortly thereafter. I was furious
but pledged to myself that I would not resign fromRERF until I created an environment in which theNagasaki Laboratory could take the lead on its
own research. That marked the beginning of myresearch career.
In the early 1990s, based on suggestions from
Drs. Midori Soda and Yasuko Amasaki, I started
collecting RERF data related to the themes menopause and cholesterol, the relationship between
body weight and blood pressure, and fatty liverand ischemic heart disease. Around that time, Drs.
Hiroaki Nonaka and Masako Tsuruta, who were
well versed in computer programs, Ms. Kaoru
Yoshida, who was interested in computers, and Mr.
Shinichiro Ichimaru, who was strong in mathematics, were assigned to our department. My epidemiological research advanced gradually with their
help and also thanks to a suggestion by Dr. Dale L.
Preston of the Department of Statistics that I consult with Dr. Eiji Nakashima concerning all matters related to statistical analyses at the Nagasaki
Department of Clinical Studies. In the late 1990s,
Return to Table of Contents

I started to publish papers on Nagasaki RERF’s
own research in scientific journals (Circulation
and American Journal of Epidemiology [1996],
Atherosclerosis and Hypertension Research [2001],
International Journal of Obesity and Related Metabolic Disorders [2002], and Hypertension Research[2006]).
At a workshop held at the Hiroshima Laboratory
at the beginning of this new century, I presented myresearch showing that fatty liver (metabolic syndrome) was somehow involved in the developmental mechanisms of myocardial infarction among
A-bomb survivors. Workshop participants severely
criticized my presentation, indicating their doubtsthat fatty liver developed due to radiation exposure.
This rekindled my fighting spirit, and I ultimately
succeeded in publishing a paper on the relationshipbetween fatty liver and radiation exposure (Hypertension Research [2003]), breaking my originalpromise with Dr. Finch.
In 2000, doctors dispatched from the First
Department of Internal Medicine, Nagasaki University, started to serve at RERF for extended periods, and as the department chief, I became deeply
involved in their studies on radiation health effects.
I was engaged in the research from the planningstage to analysis, conducting group discussions
with Dr. Ayumi Hida (Sjögren syndrome; Nutrition and Cancer [2005], Annals of the Rheumatic

Masazumi Akahoshi in his office at RERF

RERF Update Volume 24, Issue 2, 2013

Human Interest Notes
Disorders [2008, 2010], Experimental and Clinical
Endocrinology and Diabetes [2012]), Drs. Misa
Imaizumi, Tan Tominaga, and Toshiro Usa (thethyroid; Journal of Clinical Endocrinology andMetabolism [2004, 2005], JAMA [2006], Journalof Clinical Endocrinology and Metabolism [2008],
Thyroid [2011]), Dr. Kiyoto Ashizawa (the thyroid;
Clinical Endocrinology [2010]), and Dr. Nobuko
Sera (chronic kidney disease; Radiation Research[2012]). This experience of uncovering the healtheffects of A-bomb exposure with other researchers
was valuable for me.
Around the same time, Drs. Kiyotaka Matsuo,
Takeshi Baba, Manabu Moriya, Akira Tsuneto,
Daisuke Haruta, and Saburo Kusumoto joined
RERF from the Third Department of Internal Med-

update 23
icine, Nagasaki University, and conducted interesting research for the purpose of obtaining theirdoctoral degrees. Especially in the field of cardiac
arrhythmia, I was fortunate to engage in epidemiological research of lethal arrhythmia based on new
concepts.
Starting now, I would like to return to the earlydays of my career and contribute to community
medical care at a nursing complex designed for
medical care, centering on a long-term care concept. This facility includes Japan’s first large-scale
long-term nursing home for the elderly, as well as a
special care-unit nursing home, which is one of justa dozen such nursing homes in Japan.
In conclusion, my 25 years at RERF were full ofinteresting human relationships.

Report on the 19th Health Examination Project for
A-bomb Survivors in North America
Yoshimi Tatsukawa, Associate Senior Scientist
Department of Clinical Studies, Hiroshima
The health examination project for A-bomb
survivors resident in North America was initiated under the sponsorship of the then Ministryof Health and Welfare in 1977 as a collaborative mission between the Hiroshima Prefectural
Medical Association (HPMA) and RERF. The
activity, folded in 2007 into a project initiated by
the present-day Ministry of Health, Labour andWelfare (MHLW) to support A-bomb survivors
living overseas, has been entrusted by MHLW to
the Hiroshima prefectural government, and thenby the prefecture to the HPMA. A medical team isdispatched to four cities in the U.S. (Los Angeles,
Honolulu, San Francisco, and Seattle) every two
years, and this was the 19th such project. I visited
San Francisco and Seattle during the last (18th)
mission and this year stayed in the Los Angeles
area (city of Torrance) and Hawaii (Honolulu) for
13 days, from June 26 to July 8, to engage in healthexaminations for A-bomb survivors. I am gratefulto the research scientists and other staff members at
the Department of Clinical Studies who supported
health examination activities at RERF during myabsence.
The Los Angeles and Hawaii medical teamthat I took part in this time was led by Dr. Jitsuro
Yanagida (Permanent Director, HPMA) and consisted of a total of 10 members, including fivephysicians, a gynecologist who participated in
Return to Table of Contents

the health examinations only in Hawaii, and four
administrative staff members dispatched by theHiroshima and Nagasaki city governments and the
HPMA. An employee from the Hiroshima prefectural government later joined the team in Hawaii
as an investigator. The male physicians must havefelt uncomfortable, as four out of the six physicians and all the administrative staff members werefemale. The San Francisco and Seattle medical
team conducted health examinations over 15 days
for A-bomb survivors resident in North America,
from July 17 to 31.
A major system change was instituted for this
19th project in Los Angeles and Hawaii. Previously, we conducted blood and other tests during
our visits to North America. This time, however,A-bomb survivors underwent health exams at local
medical facilities in advance, and five physiciansof the team explained the results and provided
healthcare advice to the examinees. In addition,
lung and stomach cancer screening was introduced.
Although there was some confusion due to thechange, we were able to complete the project successfully with instruction from Dr. Yanagida andcooperation from the staff members. I was very
relieved to hear an A-bomb survivor in Los Angeles indicate that he was grateful to be able to listen
to our explanation of the exam results in Japanese,rather than simply to receive exam results as was
RERF Update Volume 24, Issue 2, 2013

Human Interest Notes
done in the past. I realized how different medicalcare is in Japan and the U.S. when I participatedin the previous tour, but it was educational for me
this time to be able to read detailed U.S. chest andstomach X-ray reports and see just how differently
they are handled compared with Japanese hospitals.
The number of A-bomb survivors undergoinghealth examinations is on the decline due to aging,and those who have been supporting this North
America project for so long are also aging. We willneed to review how to conduct health examinationsin North America in the future based on our experi-

update 24
ence from this visit. I hope the health examination
project that has been conducted over these years
since its inception will continue to be a bridge of
medical support for A-bomb survivors living inNorth America.
In conclusion, for the support and cooperation
they have provided to the health examination project, I would like to express my sincere appreciation
to the American Society of Hiroshima-Nagasaki
A-bomb Survivors, local medical associations andphysicians, Providence Little Company of Mary
Medical Center Torrance (Los Angeles), Kuakini
Medical Center (Hawaii), and all of our volunteers.

At the venue of A-bomb survivors’ health examination program in Los Angeles. Yoshimi Tatsukawa,author, is fifth from the right at rear.

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RERF Update Volume 24, Issue 2, 2013

update 25

Facts and Figures

Results of Review of Basic Information Used in
Individual Dose Estimates and Recalculationof Radiation Risks
Toshiteru Okubo, Chairman
With publication of the dosimetry system DS02
(in 2003), a method for estimation of individual
radiation doses was completed, but work involving
reexamination of exposure locations remained. We
recently completed that work by achieving 1) consistency in use of number of digits for coordinate
information of exposure locations, 2) adjustment
of distortions in U.S. Army maps, and 3) re-identification of exposure locations using a geographic
information system (GIS).

History of work
Nov. 2007 Start of review of original survey
records for the Life Span Study (LSS)
cohortReview of data entered on the basis of original
Master Sample Questionnaire (MSQ) forms(confirmation of exposure locations/coordinates); entry of items for which no data had
been entered in the past (date and locationof entry into the city, “black rain” exposure/non-exposure); this process led to discovery ofinconsistency in number of digits used for theentered data.
Apr. 2009 Establishment of Dosimetry Committee
May 2010 Completion of orthorectification* ofcomposite aerial photographs
Dec. 2010 Completion of triangular interpolation
calculation formula for correction of
map distortions
Feb. 2011 Initiation of work to reconfirm exposure locations using aerial photographs and neighborhood drawings
Mar. 2012 Completion of abovementioned work
*Orthorectification is a process whereby an aerial photograph is geometrically corrected to eliminate distortions
from topographic relief, lens distortion, and camera tilt.

Report on results of work
1) Correction of inconsistency in data entry of
exposure location coordinates—Effects ofrestoring truncated digits used for the entereddata
Starting in 2007, coordinate and other data
regarding exposure locations were reexamined
Return to Table of Contentson the basis of the MSQ records of LSS subjects,
and data that had not previously been input wereentered. This data work was completed in 2010.
It was found that, for a majority of LSS subjects
without shielding survey records, digits for tens ofyards (up to but not including 100 yards, or 91.4m) in the map coordinates had been truncated in
the original data (Table). This resulted in a difference between actual distances from the hypocenterand the entered distances of up to 127 yards. A
difference of 100 m at a distance of 2 km from the
hypocenter results in a difference of 30 mGy in air
kerma dose in Hiroshima or 55 mGy in Nagasaki.
All of the previously truncated data were thenrestored. Overall, distance from the hypocenter
became slightly closer in Hiroshima but farther in
Nagasaki.
Table. Digit-restoration cases compared with cohort
subject numbers
Entire LSS
cohortmembers

A-bombsurvivors in
the cohort

Number oftruncated-digit
cases (%)

Hiroshima
Nagasaki

82,214
38,107

61,98431,75733,464 (54.0)
24,350 (76.7)

Total

120,32193,741

57,814 (61.7)

2) Correction of map distortions and elongation—
Systematic revision for non-shielding-survey
subjects
Based on use of aerial photographs of Hiroshima
and Nagasaki prior to the atomic bombings, simple
orthorectified aerial photographs with coordinate
information were created of both cities. Common
points on these simple orthorectified photographs
and the army maps (about 100 common points foreach city) were determined for comparison purposes, and the images of the army maps were mathematically stretched within triangles connecting
these points to correct any distortions. In addition,
the army map coordinates used until that point intime for exposure location coordinates were converted to new plane rectangular coordinates.
Subjects of this systematic correction numbered 70,995 people for whom no shielding survey
RERF Update Volume 24, Issue 2, 2013

update 26

Facts and Figures
records were available. Of this total, 12,465 people
were located within 2,000 m of the hypocenters.
The distortions in Hiroshima were larger, and withthe correction process, there was an area oriented
from northwest to southeast in which distancesfrom the hypocenter became farther by around
10–50 m, and an area at a fairly significant distanceto the north in which distances became closer bymore than 50 m (refer to map of Hiroshima in Figure 1).
3) Methods and results of precise determination of
exposure locations
For 22,746 cases with shielding survey records,
GIS software was used to superimpose neighborhood drawings on the aforementioned simple
orthorectified aerial photographs, with precise
exposure locations being re-determined. At thesame time, recalculation of distance from the hypocenter based on the plane rectangular coordinatesof the obtained A-bomb exposure locations was
carried out. As a result, the differences in distancefrom the hypocenters showed bilaterally symmet-

ric distribution, with changes due to the revisions
being in the range of ±50 m in both cities (Figure2). Estimates showed that only a very small systematic error was involved: the center of distribution shifted slightly away from the hypocenter ineach of the cities, with the average shift in distancebeing 5 m in Hiroshima and 4 m in Nagasaki.
4) Effects of corrections described in 1)–3) aboveon radiation doses and cancer risks
The plots comparing new and old individual
doses (Figure 3) show doses in both cities to be
distributed more or less evenly about a line at a
45-degree angle that represents no change, with theaverage doses remaining unchanged. With regard
to the distribution of differences between the new
and old doses, the differences were slightly larger
in Nagasaki, and the distribution of the new doses
was systematically lower especially at 100 mGyor less. Only the all-solid-cancer risk calculations
have been completed, and the excess relative riskchanged only slightly, from 0.427 to 0.450, with nosignificant effects on confidence intervals.

Figure 1. Hiroshima: Change of ground distance due to “rubber sheeting”

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RERF Update Volume 24, Issue 2, 2013

update 27

Facts and Figures

Figure 2. Ground distance change

Figure 3. Changes in dose estimates

Return to Table of Contents

RERF Update Volume 24, Issue 2, 2013

Research Protocols

Research Protocols Approved in
May–October 2013
RP 1-13 Analyses of Molecular Characteristics of Lung Cancer among Atomic-bomb
Survivors
Taga M, Hamatani K, Ito R, Niwa Y, Grant EJ, Ozasa
K, Katayama H, Misumi M, Sui H, Harris CC, Yasui
W, Kusunoki Y
Background: Excess relative risk of lungcancer among atomic-bomb (A-bomb) survivors remains high even now, more than 60 years
after the bombings, indicating a prolonged radiation effect on development of lung cancer. One
approach to seek at the molecular level how radiation exposure affected development of lung cancer
was initiated in a pilot study (RP B37-04). Preliminary results suggest the possibility that frequenciesof certain gene mutations (e.g., the TP53 tumor
suppressor gene) and methylation levels (e.g., theretrotransposon LINE1) may be associated withradiation exposure. However, molecular alterations
observed in the pilot study mainly lacked statistical significance in terms of radiation dose, andsmoking effects were excluded from the statisticalanalyses. Molecular biological profiling with anadequate panel of carcinogenesis-related genes iscurrently considered to be an effective tool for amechanistic approach to understanding lung cancer etiology. Such profiling of lung cancer among
A-bomb survivors will be useful for better understanding of radiation carcinogenesis in the lung.
Hypothesis and specific aim: We hypothesizethat the profile of genetic and/or epigenetic alterations in radiation-associated lung cancers among
A-bomb survivors differs from that in sporadic(not radiation-associated) lung cancers. To test
this hypothesis, we will analyze genetic and epigenetic alterations related to lung carcinogenesis
using lung cancer tissue specimens obtained from
A-bomb survivors.
Study design and methods: Samples to be used
are archival lung cancer tissue specimens collectedby the local pathologist network in Hiroshima andthose stored at RERF. Using biological materials
obtained from these tissues and epidemiological
data from the Life Span Study, we will examine
genetic and epigenetic alterations associated withlung carcinogenesis, and analyze associations
between these molecular alterations and radiation dose in lung cancer as well as pre-cancerous
lesions, considering 1) histological type (e.g.,squamous cell carcinoma or adenocarcinoma) andgrade of differentiation, and 2) smoking effects.

Return to Table of Contents

update 28
RP 2-13 Estimation of Genetic Risk of Radiation on Mature Oocytes of Mice by Using
Next Generation Sequencer
Satoh Y, Furukawa K, Cullings HM, Nakamura N,
Nishimura M, Shimada Y, Asakawa J
The genetic risk estimation of human radiation
exposure has relied for the most part on mousestudies focusing on specific loci, although sensitivity varied from one locus to another. To better
understand the mean mutation-induction rate per
genome, a large number of genes per individual
needs to be examined concurrently. For this purpose, we have examined radiation-induced mutation frequency by measuring deletions detectedwith two-dimensional gel electrophoresis, whichscans some 1,000 loci, and high-density microarraycomparative genome hybridization, which surveys
approximately 70% of the genome. In this research
protocol, we propose to conduct a detailed investigation by whole-genome sequencing of mouseparents and their offspring born to 4-Gy irradiatedmature oocytes using next generation sequencing.
We will clarify the mutation frequency and spectrum for small deletions/insertions, inversions, andtranslocations that are not detectable by the abovementioned methods.

RERF Update Volume 24, Issue 2, 2013

Recent Publications

Recent Publications(Japanese): the original article is in Japanese

Boffetta P et al. (RERF: Grant EJ, Ozasa K): Body
mass, tobacco smoking, alcohol drinking andrisk of cancer of the small intestine—A pooled
analysis of over 500,000 subjects in the Asia
Cohort Consortium. Ann Oncol 2012 (July);23(7):1894-8.
Hammer GP, Scheidemann-Wesp U, SamkangeZeeb F, Wicke H, Neriishi K, Blettner M: Occupational exposure to low doses of ionizing radiation and cataract development: A systematic
literature review and perspectives on future studies. Radiat Environ Biophys 2013 (August);
52(3):303-19.

update 29
sure: An issue from computed tomography scans
to Fukushima. Health Phys 2013 (November);105(5):424-9.
Miki D, Ohishi W, Ochi H, Hayes CN, Abe H,
Tsuge M, Imamura M, Kamatani N, Nakamura
Y, Chayama K: Serum PAI-1 is a novel predictor
for response to pegylated interferon-α-2b plus
ribavirin therapy in chronic hepatitis C virus
infection. J Viral Hepat 2012 (February);
19(2):e126-33.
Nakashima E, Neriishi K, Minamoto A, Ohishi W,
Akahoshi M: Radiation dose responses, thresholds, and false negative rates in a series of cataract surgery prevalence studies among atomic
bomb survivors. Health Phys 2013 (September);105(3):253-60. (RERF Report 12-12)

Hayashi T, Ito R, Cologne JB, Maki M, Morishita
Y, Nagamura H, Sasaki K, Hayashi I, Imai K,
Yoshida K, Kajimura J, Kyoizumi S, Kusunoki Y,
Ohishi W, Fujiwara S, Akahoshi M, Nakachi K:
Effects of IL-10 haplotype and atomic bombradiation exposure on gastric cancer risk. Radiat
Res 2013 (July); 180(1):60-9. (RERF Report
11-12)

Neriishi K: Cataract in A-bomb survivors. Nihon
Hakunaisho Gakkaishi [J Jpn Soc Cataract Res]
2013; 25:75-9. (Japanese)

Kiuchi Y, Yokoyama T, Takamatsu M, Tsuiki E,
Uematsu M, Kinoshita H, Kumagami T, Kitaoka
T, Minamoto A, Neriishi K, Nakashima E,
Khattree R, Hida A, Fujiwara S, Akahoshi M:
Glaucoma in atomic bomb survivors. Radiat Res
2013 (October); 180(4):422-30. (RERF Report
8-12)

Ohishi W, Cologne JB, Fujiwara S, Suzuki G,
Hayashi T, Niwa Y, Akahoshi M, Ueda K, Tsuge
M, Chayama K: Serum interleukin-6 associatedwith hepatocellular carcinoma risk: A nested
case-control study. Int J Cancer 2014 (January);134(1):154-63. (RERF Report 14-12)

Kusunoki Y: Key points and pitfalls of flow cytometry analysis—Basic tasks in practical clinicalresearch. Igaku no Ayumi [J Clin Exp Med] 2013
(June); 245(12):981-5. (Japanese)
Kyoizumi S, Kubo Y, Kajimura J, Yoshida K, Imai
K, Hayashi T, Nakachi K, Young LF, Moore MA,
van den Brink MRM, Kusunoki Y: Age-associated changes in the differentiation potentials ofhuman circulating hematopoietic progenitors to
T- or NK-lineage cells. J Immunol 2013 (June);
190(12):6164-72. (RERF Report 13-12)
Lee JE et al. (RERF: Grant EJ, Ozasa K, OhishiW): Meat intake and cause-specific mortality: A
pooled analysis of Asian prospective cohort studies. Am J Clin Nutr 2013 (October); 98(4):103241.
Mettler FA, Constine LS, Nosske D, Shore RE:
Ninth Annual Warren K. Sinclair Keynote
Address: Effects of childhood radiation expoReturn to Table of Contents

Ohishi W, Chayama K: Risk factors for non-B, C
hepatocellular carcinoma. Rinsho Shokaki Naika[Clin Gastroenterol] 2012 (May); 27(5):587-93.
(Japanese)

Ohishi W, Fujiwara S, Chayama K: Study of viral
hepatitis in a longitudinal cohort of A-bomb survivors. Elucidation of viral hepatitis based on acohort study. Tokyo: Medical Review; 2013
(October), pp 86-95. (Japanese)
Ozasa K: Effects of radiation in atomic-bomb
survivors who were young at the time of bombing. Nihon Shoni Ketsueki/Gan Gakkai Zasshi[Jpn J Pediatr Hematol Oncol] 2013; 50(1):15-7.
(Japanese)
Preston JR, Boice JD, Brill AB, Chakraborty R,
Conolly R, Hoffman FO, Hornung RW, Kocher
DC, Land CE, Shore RE, Woloschak GE: Uncertainties in estimating health risks associated with
exposure to ionising radiation. J Radiol Prot
2013 (September); 33(3):573-8.
Shore RE: Lessons from Fukushima: Scientists
need to communicate better. Bull World HealthOrgan 2013 (June); 91(6):396-7.

RERF Update Volume 24, Issue 2, 2013

Recent Publications
Sueoka E, Sueoka-Aragane N, Sato A, Ide M,
Nakamura H, Sotomaru Y, Taya C, Yonekawa H,
Kitagawa T, Kubota Y, Kimura S, Nakachi K,
Tanimoto K: Development of lymphoproliferative diseases by hypoxia inducible factor-1alphais associated with prolonged lymphocyte survival. PLoS ONE 2013 (April); 8(4):e57833.
Takahashi I, Ohishi W, Mettler FA, Ozasa K, Jacob
P, Ban N, Lipshultz SE, Stewart FA, Nabika T,
Niwa Y, Takahashi N, Akahoshi M, Kodama
K, Shore RE, the International Radiation andCardiovascular Disease Workshop participants:
A report from the 2013 International Workshop: Radiation and Cardiovascular Disease,
Hiroshima, Japan. J Radiol Prot 2013 (December); 33(4):869-80.

update 30
Publications Using RERF Data
The following publications represent research done by
non-RERF scientists based on the data publicly available from RERF.

Schöllnberger H, Kaiser JC, Jacob P, Walsh L:
Dose-responses from multi-model inference forthe non-cancer disease mortality of atomic bomb
survivors. Radiat Environ Biophys 2012 (May);
51(2):165-78. Erratum in: Radiat Environ Biophys 2013 (March); 52(1):165-6.
Schöllnberger H, Kaiser JC, Walsh L, Jacob P:
Reply to Little et al.: Dose-responses from multimodel inference for the non-cancer disease mortality of atomic bomb survivors. Radiat Environ
Biophys 2013 (March); 52(1):161-3.

Tatsukawa Y, Cologne JB, Hsu WL, Yamada M,
Ohishi W, Hida A, Furukawa K, Takahashi N,
Nakamura N, Suyama A, Ozasa K, Akahoshi M,
Fujiwara S, Shore RE: Radiation risk of individual multifactorial diseases in offspring of theatomic-bomb survivors: A clinical health study. J
Radiol Prot 2013 (June); 33(2):281-93. (RERF
Report 28-11)
Tatsukawa Y, Misumi M, Yamada M, Masunari N,
Oyama H, Nakanishi S, Fukunaga M, Fujiwara
S: Alteration of body mass index and body composition in atomic bomb survivors. Int J Obesity2013 (August); 37(8):1123-8. (RERF Report
4-12)
United Nations Scientific Committee on Effectsof Atomic Radiation (Kelly GN, Golikov V,
Constine LS, Nagel HD, Nosske D, Shore RE):
Sources, Effects and Risks of Ionizing Radiation, Volume II. Scientific Annex B: Effects ofradiation exposure of children. New York: United
Nations; 2013, 269 p.
Walsh L, Shore RE, Auvinen A, Jung T, Wakeford
R: Re: Cancer risk in 680 000 people exposed tocomputed tomography scans in childhood oradolescence: Data linkage study of 11 million
Australians [letter]. BMJ 2013 (June 4). Available from: http://www.bmj.com/content/346/
bmj.f2360/rr/648506
Yoshida K, Kusunoki Y, Cologne JB, Kyoizumi S,
Maki M, Nakachi K, Hayashi T: Radiation doseresponse of glycophorin A somatic mutation inerythrocytes associated with gene polymorphisms of p53 binding protein 1. Mutat Res-Gen
Tox En 2013 (July); 755(1):49-54. (RERF
Report 1-13)

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RERF Update Volume 24, Issue 2, 2013