Longevity of atomic-bomb survivors

Background Conflicting claims have been made regarding biological and health consequences of exposure to low doses of radiation. Studies have suggested that certain low-dose exposed atomic-bomb survivors live longer than their peers. Earlier studies in other radiation-exposed populations demonstrated life shortening from mortality from cancer but lacked dosimetry and relied on comparison groups which may introduce bias because of lack of comparability. We have re-examined the effect of radiation on life expectancy in one cohort of survivors of the atomic bombings of Hiroshima and Nagasaki, Japan. Methods We did a prospective cohort study of 120 321 survivors. The study encompasses 45 years of mortality follow-up with radiation-dose estimates available for most cohort members. We calculated relative mortality rates and survival distribution using internal comparison (cohort-based estimation of background mortality). Findings Median life expectancy decreased with increasing radiation dose at a rate of about 1.3 years per Gy, but declined more rapidly at high doses. Median loss of life among cohort members with estimated doses below 1 Gy was about 2 months, but among the small number of cohort members with estimated doses of 1 Gy or more it was 2.6 years. Median loss of life among all individuals with greater-than-zero dose estimates was about 4 months. Interpretation These results are important in light of the recent finding that radiation significantly increases mortality rates for causes other than cancer. The results do not support claims that survivors exposed to certain doses of radiation live longer than comparable unexposed individuals. Because the cohort was intentionally constructed to contain a higher proportion of high-dose atomic-bomb survivors, average loss of life among all exposed atomic-bomb survivors would be less than the 4 months found for the study cohort.