Journal of Korean Medical Science · 8 authors, 6 centres
This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.
This study compared causes of death among 2,176 Korean atomic bomb survivors with 6,377,781 deaths in the general population from 1992 to 2019. Survivors had significantly higher proportional mortality from respiratory diseases (10.6% vs. 7.9%, p<0.001) and nervous system diseases (2.9% vs. 2.2%, p=0.018). These findings highlight the long-term health impacts of atomic bomb exposure and the need for continued medical surveillance of survivors.
**Background:** Atomic bombs dropped on Hiroshima and Nagasaki in August 1945 killed an estimated 70,000 Koreans. While Japanese studies have documented increased risks of cancer, cardiovascular, and respiratory diseases among atomic bomb survivors, no studies had examined mortality among Korean survivors. This study aimed to compare proportional mortality between Korean atomic bomb survivors and the general population from 1992 to 2019.
**Methods:** Of 2,299 registered atomic bomb survivors who died, 2,176 deaths from 1992–2019 were included (excluding 51 deaths before 1992 and 72 after 2019). Causes of death were linked via resident registration numbers to Statistics Korea's Causes of Death Statistics. The general population comprised 6,377,781 deaths during the same period. Causes were classified using the Korean Standard Classification of Diseases (version 8). Proportional mortality was calculated as the number of deaths from a specific cause divided by total deaths. Comparisons used ratio tests, and trends by distance from hypocenter (0–1 km, 2–3 km, ≥4 km) were assessed with Cochran-Armitage trend tests and χ² tests. Age at death was categorized as 45–64, 65–69, 70–74, 75–79, and ≥80 years.
**Key Results:** Among atomic bomb survivors, the mean age at death was 78.8 years (range 49–118). The most common causes of death were diseases of the circulatory system (553 deaths, 25.4%), neoplasms (546, 25.1%), and diseases of the respiratory system (231, 10.6%). Compared to the general population, survivors had significantly higher proportional mortality for respiratory diseases (10.6% vs. 7.9%, p<0.001), nervous system diseases (2.9% vs. 2.2%, p=0.018), and other causes (5.6% vs. 0.1%, p<0.001). The general population had higher proportional mortality for malignant neoplasms of digestive organs (14.7% vs. 13.2%, p=0.047), symptoms/signs (13.0% vs. 8.2%, p<0.001), and external causes (8.2% vs. 5.4%, p<0.001). By age group, survivors aged ≥80 years had significantly higher proportional mortality from neoplasms (16.4% vs. 14.1%, p=0.029), digestive diseases (4.1% vs. 2.9%, p=0.021), nervous system diseases (4.5% vs. 3.2%, p=0.019), and other causes (5.6% vs. 0.0%, p<0.001). Among survivors, those exposed at 0–1 km had a mean age at death of 81.4 years, 2–3 km: 80.9 years, and ≥4 km: 84.8 years (p<0.001), indicating younger death with closer exposure. No significant differences in proportional mortality by distance were found for specific diseases.
**Clinical Implications:** This first study of mortality among Korean atomic bomb survivors reveals that respiratory and nervous system diseases contribute disproportionately to deaths compared to the general population, especially in older survivors. The finding that survivors exposed closer to the hypocenter died at younger ages suggests a dose-response effect, though radiation dose estimates were unavailable. These results underscore the need for targeted health surveillance for respiratory and neurological conditions in aging atomic bomb survivors. Limitations include potential selection bias (only survivors who lived until the 1990s were registered), inability to calculate mortality rates, and missing exposure data for over 50% of survivors. Despite these, the study provides crucial evidence of long-term health consequences of radiation exposure in a previously unstudied population.