IMPACT ON THE JAPANESE ATOMIC BOMB SURVIVORS OF RADIATION RECEIVED FROM THE BOMBS
IMPACT ON THE JAPANESE ATOMIC BOMB SURVIVORS OF RADIATION RECEIVED FROM THE BOMBS
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DOI：
10.1097/hp.0000000000000009
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发表时间：
2014-02-01
期刊：
影响因子：
2.2
通讯作者：
Cullings, Harry M.
中科院分区：
文献类型：
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作者：
Cullings, Harry M.
辐射效应研究基金会 (RERF) 对日本原子弹幸存者的各个群体进行研究，其中规模最大的是寿命研究 (LSS)，其中包括原子弹爆炸时在广岛或长崎的 93,741 人；还有一群在子宫内受到暴露的人和幸存者的孩子。本演示文稿试图从个人角度（特定年龄风险和综合终生风险，以及描述风险如何影响暴露时特定年龄的个人的预期寿命衡量标准）和群体角度（群体中过量发生的估计数量）角度总结炸弹辐射对幸存者的总体影响，包括早期和晚期影响。由于幸存者的剂量在较近的距离内已达到急性致命范围，因此他们中的一些人除了面临后期影响的风险外，还经历了辐射暴露的急性体征和症状。尽管癌症一直是晚期效应中的主要关注点，但由于剂量分布高度倾斜，大多数幸存者接受小剂量，因此 LSS 中过量癌症和造血系统恶性肿瘤的估计数量仅占总数的一小部分。例如，在最新的癌症发病率报告中，估计 17,448 起实体癌症中有 853 起是由炸弹辐射造成的。 RERF 研究表明，与辐射相关的癌症的风险因部位而异，并且子宫肌瘤等一些良性肿瘤也与辐射有关。非癌症晚期效应似乎与辐射剂量成正比，但相对风险过高，约为实体癌的三分之一，相应地，由辐射引起的病例总体比例较小。某些子类别存在特定风险，特别是循环系统疾病，包括中风和高血压等先兆性疾病。原子弹爆炸幸存者中与辐射有关的白内障是众所周知的，近年来的证据表明，在比以前认为的剂量水平低的情况下，就有风险。除了躯体效应之外，幸存者还经历了社会心理影响，例如不确定性、社会耻辱或拒绝以及其他社会压力。还描述了与子宫内暴露相关的发育缺陷，特别是认知障碍。辐射与其他危险因素的相互作用已被证明与癌症和非癌症疾病有关。目前的研究兴趣包括辐射是否会增加患糖尿病或除白内障以外的眼部疾病的风险，并且尽管迄今为止的研究结果呈阴性，但人们仍然对幸存者的孩子是否存在遗传效应抱有浓厚的兴趣。
The Radiation Effects Research Foundation (RERF) studies various cohorts of Japanese atomic bomb survivors, the largest being the Life Span Study (LSS), which includes 93,741 persons who were in Hiroshima or Nagasaki at the times of the bombings; there are also cohorts of persons who were exposed in utero and survivors' children. This presentation attempts to summarize the total impact of the radiation from the bombs on the survivors from both an individual perspective (both age-specific and integrated lifetime risk, along with a measure of life expectancy that describes how the risk affects the individual given age at exposure) and a group perspective (estimated numbers of excess occurrences in the cohort), including both early and late effects. As survivors' doses ranged well into the acutely lethal range at closer distances, some of them experienced acute signs and symptoms of radiation exposure in addition to being at risk of late effects. Although cancer has always been a primary concern among late effects, estimated numbers of excess cancers and hematopoietic malignancies in the LSS are a small fraction of the total due to the highly skewed dose distribution, with most survivors receiving small doses. For example, in the latest report on cancer incidence, 853 of 17,448 incident solid cancers were estimated to be attributable to radiation from the bombs. RERF research indicates that risk of radiation-associated cancer varies among sites and that some benign tumors such as uterine myoma are also associated with radiation. Noncancer late effects appear to be in excess in proportion to radiation dose but with an excess relative risk about one-third that of solid cancer and a correspondingly small overall fraction of cases attributable to radiation. Specific risks were found for some subcategories, particularly circulatory disease, including stroke and precedent conditions such as hypertension. Radiation-related cataract in the atomic bomb survivors is well known, with evidence in recent years of risk at lower dose levels than previously appreciated. In addition to somatic effects, survivors experienced psychosocial effects such as uncertainty, social stigma, or rejection, and other social pressures. Developmental deficits associated with in utero exposure, notably cognitive impairment, have also been described. Interaction of radiation with other risk factors has been demonstrated in relation to both cancer and noncancer diseases. Current research interests include whether radiation increases risk of diabetes or conditions of the eye apart from cataract, and there continues to be keen interest as to whether there are heritable effects in survivors' children, despite negative findings to date.