Japan trip shows students the humanity behind data

Remember the stories behind the data for peace, for the survivors, and for all humankind. If there’s one thing the students traveling to Hiroshima, Japan with Dr. Amanda Phipps have learned, it is this.

In late November, Amanda Phipps, an assistant professor of epidemiology, and three University of Washington School of Public Health graduate research assistants met with colleagues at the Radiation Effects Research Foundation (RERF) for the second time since the UW/RERF Partnership was re-established in January 2018.

The partnership, originally established by Dr. Scott Davis, former chair and professor emeritus of the University of Washington Department of Epidemiology, supports investigative and educational efforts focused on the health effects of atomic bomb radiation and to improving the quantity and quality of U.S. research scientists with expertise in radiation epidemiology.

During this nearly weekly-long trip, Phipps and her team met and, for some, reconnected with the Japan-based researchers. Their goal was to brainstorm ideas and define research projects for the students to work on. The trip itself also served as an opportunity for students to understand the stories of the people behind the data they would be analyzing.

The stories of the past

The immediate devastation and long-term health impacts on survivors of the Hiroshima and Nagasaki atomic bombings, which ended World War II, led health researchers in Japan and the United States to work together to understand how the radiation exposure of the atomic bombs can have tragic, long-term effects for survivors. Starting with the Atomic Bomb Casualty Commission established in 1947, the U.S. and Japanese collaboration performed extensive health studies on survivors. The commission was later reorganized into the RERF, which continues population-based research on the survivors and their kin.

To help students understand the devastation of the bombings and the health issues that occurred in survivors and their children, Phipps took the students to the Hiroshima Memorial Peace Park, which was built on an open field created by the explosion.

“It’s important to remember the context of the datasets we’re analyzing and to recognize the devastation the atomic bombs had on Japan at the time they were dropped and for many years following the event,” said Phipps. “It reminds us of the humanity in our work.”

Brandie Bockwoldt, an Epi MPH student, remembers one of the first virtual displays she encountered in the museum. “You saw what the city was like before the bomb. It then shows the bomb being dropped, exploding, and how the blast and fires spread to cause all the damage. Last, you saw what remained after the blast,” Bockwoldt said. “It was eye-opening to see how fast a perfectly normal day in Hiroshima changed and the magnitude of the devastation.”

Matthew Dekker, also an Epi MPH student, said this part of the visit helped him realize that their work as student-epidemiologists has an impact.

“Our work doesn’t exist in a vacuum,” he said. “We are operating within social and political systems in which what we do often have an impact outside of the strictly scientific realm. I’d be hard pressed to think of a setting in which this is more apparent than working on atomic bomb survivor research which has tremendous implications symbolically, as well as epidemiologically.”

Bringing light to the data sets

Throughout the week, the students participated in educational sessions and discussed their future projects with the Japan-based RERF team. This not only gave them some exposure to designing a research study, but it also helped them to understand the Japan-based research team’s values and priorities in their work—something that’s hard to communicate and grasp from a distance.

“The process of talking through our topics with the researchers there was incredibly valuable,” said Dekker. “I think a lot of our training as developing epidemiologists is just learning to think like one, and there’s maybe no better exercise than sitting with a bunch of knowledgeable researchers and having them kindly poke holes in your thinking.”

For his research project, Dekker will look at the role that smoking and alcohol consumption may have played in atomic bomb survivors developing various cancers.

Bockwoldt has been working with the RERF since the partnership with the UW was reestablished. Her first project has been looking at gastrointestinal cancer survival among atomic bomb survivors. Now in the analysis phase of this project, Bockwoldt took advantage of this visit to get feedback on her work and to start a proposal for a second project.

“It was great to have their insight on both projects because they know the data and internal processes it takes to get data,” Bockwoldt said. “They pointed out which projects would be feasible, what data is available, and which outcomes and exposures had enough data collected to perform in a meaningful study. This helped me identify my second research project.”

Bockwoldt says this planning and brainstorming phase with the RERF researchers helped her see and participate in the study design process for the first time. Her second project will look at the relationship between cardiovascular disease mortality and stress indicators associated with the bombings.

“The tragic legacy of the atomic bombs and the gracious contributions of the A-bomb survivors have taught the scientific community volumes about long-term health effects of radiation exposure,” Phipps said. “Thankfully, there is no other study like this in the world. That’s why it’s so important to that we continue to learn all we can from these data.”

Radiation epidemiology’s future

Until recently, the threat of atomic bombs had lulled after the fall of the Soviet Union in the early 1990s. As this threat subsided, so did government funding for radiation epidemiology.

“There has been a sort of graying of radiation epidemiology researchers as atomic bomb threats subsided after the Cold War,” said Phipps. “But, radiation exposure may still be a threat to humans through small-dose exposure, such as CT scans and X-rays. We’ve also seen a resurgence in this field as space travel becomes more accessible to the public.

The need for radiation epidemiologists is growing. At the Conference for Health and Radiation over the summer, the UW RERF team were surprised to find a large NASA presence.

“Astronauts are exposed to large amounts of radiation while in space,” said Bockwoldt. “NASA is very interested in the health impacts radiation imposes as the interest to explore more of space and to potentially send people to other planets grows.”

With more research in radiation epidemiology, organizations sending people to space will have a better understanding of how to estimate a ‘safe’ amount of time to be out there. For example, past research has found that women are more vulnerable to radiation in space than men, which is why female astronauts spend less time on space missions than men. Radiation epidemiology can also help identify the need for new technologies that may reduce the amount of radiation exposure and the heaths risk associated with it.

This renewed interest in radiation exposure is exciting, but there’s still a lot we don’t know about radiation exposure Phipps said, which makes their work all the more relevant and important to learn from the past for the future.