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The real death count for Hiroshima and Nagasaki was at least 210,000 – and more later. 

The real death count for Hiroshima and nagasaki was 210,000 It was not 15,000 for Hiroshima and 74,000 for Nagasaki. That does not reflect birth defects, or other health effects we now know, are part of nuclear bomb fallout

The Atomic Bombings of Hiroshima and Nagasaki: A Summary of the Human Consequences, 1945-2018, and Lessons for Homo sapiens to End the Nuclear Weapon Age

Masao Tomonaga Pages 491-517 | Received 01 Sep 2019, Accepted 02 Oct 2019, Accepted author version posted online: 13 Nov 2019, Published online: 02 Dec 2019


Seventy-four years have passed since the atomic bombings of Hiroshima and Nagasaki. Approximately 210,000 victims died, and another 210,000 people survived. The damage to their health has continued, consisting of three phases of late effects: the appearance of leukemia, the first malignant disease, in 1949; an intermediate phase entailing the development of many types of cancer; and a final phase of lifelong cancers for hibakusha who experienced the bombing as a child, as well as a second wave of leukemia for elderly hibakusha and psychological damage such as depression and post-traumatic stress disorder. Thus, the human consequences of the atomic bombings have not ceased; many people are still dying of radiation-induced malignant diseases.  Therefore, it is too early to finalize the total death toll. Hibakusha have faced a never-ending struggle to regenerate their lives and families under the fear of disease. As the only group of Homo sapiens experiencing real nuclear attacks, hibakusha have continued to engage in a lifelong movement to eliminate nuclear weapons. Political leaders, especially of nuclear-weapon states, must learn the wisdom of the hibakusha to save Homo sapiens from possible global extinction by nuclear war.


The first nuclear weapon was detonated in New Mexico on 16 July 1945. That test explosion was soon followed by the wartime use of two atomic bombs on Hiroshima and Nagasaki on August 6 and 9, respectively. This opened the nuclear weapon age in the history of humanity. In the long history of wars and weapons, Homo sapiens had finally gained an ultimate weapon of mass destruction capable of obliterating itself……………………………….

Immediate Death and Early Lethal Consequences of the Bombings


Under the two gigantic mushroom clouds, approximately 280,000 citizens in Hiroshima and 240,000 in Nagasaki were suddenly thrown into chaos and agony. A total of approximately 140,000 in Hiroshima (Hiroshima 1971) and 73,000 in Nagasaki (Nagasaki, 1977) died instantaneously or within five months due to the combined effects of three components of physical energy generated by nuclear fissions: blast wind (pressure), radiant heat, and ionizing radiation.  A total of more than 210,000 remaining victims, 140,000 in Hiroshima and 74,000 in Nagasaki, survived the first five months of death and agony and became hibakusha (Figure 1 on original).

A curve of death rates calculated in the aftermath by the surviving medical staff and students of Nagasaki Medical College showed almost 100% in residents living within a 500-meter radius of ground zero; 90% within 1,000 meters; 50% within1,500 meters; and 10% within 2,000 meters, making a clear concentric figure (Figure 2) (Shirabe 2006). Later the death-rate curve of Hiroshima was compared with Nagasaki’s, revealing that two curves were very similar, as if two scientific experiments were conducted. Among areas within 1,000 meters, the Nagasaki Medical School Hospital was exceptional – The death rate in the facility was as low as 43%. This is obviously because of the shielding effect of the thickest concrete walls of the hospital buildings.

Figure 2. [on original] Death rates by distance from ground zero in the first three months in areas of Nagasaki city.

The residents of both cities were mostly noncombatant civilians, including many women and children. Military combatants were only a minority. There were fewer adult males than females, and most of the males worked at military arsenals. Many young men went to war in the later stages of World War II. Young students were employed by military arsenals located close to ground zero; that increased the number of victims.

Citizens were suddenly thrown into firestorms at home, factories, and schools; on open roads or on ground; in automobiles and trams; and in city offices, hospitals, pharmacies, fire stations, and almost all city structures.

Many survivors spent the night on the road or the ground (Figure 3). Subsequently, many severely injured victims were forced to remain where they survived the first strike without being provided any meaningful medical treatment. Most of them died there.

Figure 3. The second morning after Nagasaki bombing.

……………………………….. In areas within 1 kilometer of ground zero, human bodies without any shielding, namely in open air on the roads and ground, were instantaneously squeezed by the blast wind (pressure) against walls, causing multiple fractures of skeletons and ruptures of the abdominal cavity causing escape of colons. Many people in open roads and grounds were carbonized by the direct effect of heat rays within 1.0 km from ground zero (Figure 7, Photo A). Many residential areas full of Japanese houses were crushed by the wind and burned out in which many victims were also burned to white bones (Figure 7, Photo B). The skin of people on open roads or grounds within 0.5–1.5 km were deeply flash-burned due to heavy heat rays. The skins were soon peeled off because of necrosis in the deep skin layer (For an example of a boy whose back was entirely burned, see Figure 8). With large areas of skin peeling off, people suffered severe pain and bleeding.

Figure 7. Body effects by heat rays and fire burn (1).

Figure 7. Body effects by heat rays and fire burn (1).

In three months after the bombing, these deep skin flash burns began to heal. However, with tissue being regenerated, keloid was quite often formed as shown in Figure 9. It was charcterized by marked thickening of the wounds, sometimes resembling cancerous proliferation of the skin.

Figure 9. Keloid formation after a severe flash burn by heat rays.

Thus many residential areas full of Japanese wooden houses were crushed and burned. The firestorms that continued over to next day finally flattened city areas within a 4 km radius. According to the saddest memory of some survivors, the blast wind tore off the heads of babies who were being carried on their mothers’ backs in the traditional Japanese way. Most of the mothers also died soon.

At the same time, the victims were irradiated by 100 grays (Gy)1 or more of combined gamma and neutron rays generated by nuclear fissions (Figure 6). Thus it could be possible to say that they were killed in three ways at once.

The people within 1 km of ground zero who finally survived were mostly those who were working inside a concrete building with thick walls or in a basement. Some other survivors were inside private air-raid shelters or military arsenals set in large shelters. Heat rays were effectively blocked by the walls, and radiation and blast were partially shielded before victims were exposed, thus allowing them to survive. But there were only a few hundred of these people. Many of those who survived at various proximal points were severely injured by debris and pieces of glass from damaged houses, heated and irradiated simultaneously. Many of them died within the first three months.

Struggle for Survival

Medical rescue teams perished and hospitals were all destroyed on the first day of the bombing. It therefore was impossible to find any meaningful medical aid. The situation was much severer in Hiroshima where over 90% of medical staffs, doctors, nurses, and pharmacists were dead. The Nagasaki Medical College Hospital, the largest and strongest concrete buildings in Nagasaki City, located 600 meters from ground zero, did provide fairly good shielding effects; the death rate was a relatively as low as 43%. Subsequently 900 lives in total – approximately half of the total number of professors, doctors, nurses and medical students were lost in the entire college facility including the hospital. Most of those who survived were severely injured by the blast wind and heat ray. The hospital had completely ceased to function. Within a few days, medical staffs and medical students who had survived opened first-aid stations around the margin of flattened areas.

n the late afternoon on the first day, several rescue trucks arrived carrying medical teams consisting of military doctors and nurses from Omura Navy Hospital, located 45 km north of Nagasaki City. They brought back approximately 700 severely injured victims, most of them severely burned, to the hospital and started treatment for burns and injuries consisting of bone fractures, cuts from pieces of glass, and embedding of debris and pieces of glass fragments deep in the skin. This number was very small compared to the total number of victims who suffered severe injuries, estimated to be approximately 30,000 in Nagasaki. A few hundred victims out of 700 were able to survive, thanks to intensive care at Omura Navy Hospital. They were indeed lucky people.

Several small rescue teams started their clinical activities within a few days. Some surgical operations were performed for those who had severe fractures due to the blast wind. There was no good treatment for severe skin burn, especially those cases with wide areas of skin burn. There were no stocks of drugs such as antibiotics and frozen blood plasma. Only oil and ointment were used. Even drip infusions of water and electrolytes such as salts and glucose (sugar) were not available in such small ambulatory facilities.

As a result of this lack of care, many survivors who were alive on the first and second days began to die due to severe bleeding from injuries such as severe fractures, dislocations, abdominal ruptures, thoracic punctures, and scalp and brain damage and also from dehydration and lack of adequate food supplies.

Initial Difficulty in Recognizing Radiation Effects

In the early days after the atomic bombings, many doctors had difficulty in identifying the symptoms of radiation-related ailments. There was no information about the nature of this new type of bomb. They did not even know that the bombs were nuclear and that radiation was dangerous to human beings. …………………………………………………………………………………….

Late Effects of Atomic Bombings: 1948–2018

About 270,000 victims of Hiroshima and Nagasaki finally recovered their health. They had to start their new daily life with a serious shortage of food and other necessities. After spending three years of recovery with relatively good health, hibakusha encountered the first malignant disease: leukemia. It is classified as the earliest occurring malignant disease due to atomic-bomb radiation because it was clearly distinguished from the disorders caused by ARS. Therefore, leukemia was the first malignant disease derived from cells injured by initial radiation exposure; the cells then transformed to malignant leukemia cells. This earliest delayed, or “late”, effect was followed by many kinds of cancer of various organs. Thus, the late effect spans an extremely long period.

First Malignant Disease Observed as the Earliest Late Effect of Atomic Bombings


In 1949, doctors in Hiroshima and Nagasaki began to recognize a gradual increase in the number of hibakusha patients, including children, suffering from leukemia. The excess annual rate of leukemia continued to rise until 1955 and then continued at an elevated level for more than 10 years (Figure 12) (Gunz and Henderson 1974). Acute and chronic types of leukemia both were observed. 

 These leukemias were later analyzed in detail when the first dosimetry system (DS65) became available. A clear radiation-dose dependency was revealed as a curve that elevated exponentially (called quadratic) from 100 millisieverts (mSv) at around 2.0 km from ground zero to more than 4 Gy at around 1.0 km (Figure 13 on original). Dose is thus inversely proportional to the square of the distance. Total leukemia incidence was four to five times higher than the control group of Nagasaki citizens not exposed to the bombing (Preston et al. 1996).

……………………………. People who were children under the age of 10 at the time of the bombings are now in their seventies. Some of them suffer from MDS. The increase in MDS among childhood survivors indicates that the massive irradiation of the whole body injured blood cells in bone marrow, and that these cells have survived more than 70 years in the bodies of hibakusha, and finally resulted in leukemia-inducing gene abnormality. MDS patients occasionally develop acute leukemia 3–5 years after the first diagnosis, and mostly die. Therefore, it can be said that atomic bomb is still killing some hibakusha even after more than a half century……………………..

Intermediate to Life-long Delayed Effects of Exposure to Atomic-bomb Radiation


Around 1960, the incidence of solid cancers began to rise gradually. The elevated cancer incidence lasted for a long time (Ozasa 2016). It peaked around the year 2000 and remained at that level until now. The types of cancer that appeared include lung, breast, thyroid, stomach, colon, liver, skin, and bladder. ……………………………………….

In-utero Radiation Exposure


In both Hiroshima and Nagasaki, many pregnant women were exposed to various doses of radiation. Miscarriages and malformation of newborn babies were frequently observed, but there were no good statistics showing radiation-dose effect. Some mothers who were in the early prenatal period at the time of the bombing sometimes bore babies who had a small head. The babies later became mentally disabled. There were 62 such babies recorded among 1,470 (Otake and Schull 1998). The larger the dose to the mother’s uterus was, the higher the incidence of microcephalic babies, suggesting high-dose radiation interrupted brain development. This is the most obvious phenomenon observed among fetuses exposed to radiation in utero.


In-utero exposed babies were later found to have an increased risk of cancer development during their early adulthood. The follow-up study is now ongoing (Izumi et al. 2003)……………………………………………………………..

Summary of Hibakusha Life, 1945–2018

Can Homo Sapiens Gain the Ethical Wisdom to End the Nuclear Weapon Age and Survive?

The consequences of the atomic bombings linger on. First generation hibakusha population will cease to exist probably around 2045. If genetic transmission of radiation-related diseases to the second generation of hibakusha would be proved in the future, atomic bombs will continue to affect those descendants forever. The year 2045 will mark the 100th annniversary of the Hiroshima and Nagasaki nuclear bombings and of the nuclear weapon age. If we human beings fail to eradicate nuclear weapons before the first century ends, what should we do? This is the question that all hibakusha have posed in their 70-year struggle for survival all the time after bombings.

Summary of Hibakusha Life, 1945–2018

Can Homo Sapiens Gain the Ethical Wisdom to End the Nuclear Weapon Age and Survive?

The consequences of the atomic bombings linger on. First generation hibakusha population will cease to exist probably around 2045. If genetic transmission of radiation-related diseases to the second generation of hibakusha would be proved in the future, atomic bombs will continue to affect those descendants forever. The year 2045 will mark the 100th annniversary of the Hiroshima and Nagasaki nuclear bombings and of the nuclear weapon age. If we human beings fail to eradicate nuclear weapons before the first century ends, what should we do? This is the question that all hibakusha have posed in their 70-year struggle for survival all the time after bombings…………………………………………………………………………..more

August 11, 2022 - Posted by | Uncategorized

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