Health Professionals and Nuclear War

‘We physicians protest the outrage of holding the entire world hostage. We protest the moral obscenity that each of us is being continually targeted for extinction. We protest the ongoing increase in overkill. We protest the expansion of the arms race to space. We protest the diversion of scarce resources from aching human needs. Dialogue without deeds brings the calamity ever closer, as snail-paced diplomacy is out-distanced by missile-propelled technology. We physicians demand deeds which will lead to the abolition of all nuclear weaponry.’

Dr. Bernard Lown, 1985, acceptance speech delivered at the Nobel Prize Award Ceremony for IPPNW


Between 1941 and 1945 the US established the ‘Manhattan Project’ at a cost of $ 2 billion (contemporary prices) to develop the world’s first nuclear weapons. These were based on the physics of nuclear fission using uranium for the Hiroshima bomb and plutonium for the Nagasaki bomb. The explosive ‘yields’ for each bomb (pictured below), exploded on August 6th and 9th 1945 respectively, were equivalent to about 16,000 and 21,000 tonnes TNT (16Kt and 21Kt).These remain the only examples of nuclear weapon use in war but graphically illustrated their horrors. About 160,000 people died instantly in the two explosions and by the end of 1945 the death toll was about a quarter of a million although we will never know precisely. Many hundred survivors subsequently developed radiation-related malignancies of which the most poignant were the childhood leukaemias, the incidence of which peaked between 1950 and 1955.

During the early 1950’s the Americans developed the first ‘fission-fusion’ (or thermonuclear) bombs in which a fission reaction is used to prime a much bigger fusion reaction between atoms of tritium and deuterium to produce helium,  neutrons and a burst of energy.

Since 1945 there have been many accidents involving nuclear weapons systems; some came alarmingly close to igniting hostilities.

Nuclear weapons tests

Up to the late 1990’s there had been about 2,000 test detonations; over 1000 were conducted by the US, about 750 by the USSR, 210 by France and 45 by the UK. Up to the late 1960’s many tests (about 700) were conducted in the atmosphere. Atmospheric testing stopped after the Partial Test Ban of 1963 came into force, being replaced by underground tests. These are now banned by the Comprehensive Test Ban of 1996 although the US has not yet ratified this as they wish to reserve the right to resume testing as and when required.

World Inventory of nuclear weapons

By the late 1980’s the world’s total inventory of nuclear weapons was about 70,000 – enough to destroy all humankind thousands of times over. Since the end of the Cold War the inventory has declined to about 17,000, but the rate of decline has stalled and there are still far too many; this poses a huge potential hazard to world health. Nuclear weapons continue to be developed and advanced by the five acknowledged nuclear powers (the US, UK, France, Russia and China) and also by Israel, India, Pakistan and North Korea.

What is the connection between physicians and nuclear war?

Health professionals first confronted the medical consequences of the use of nuclear weapons in August 1945, when teams of medical personnel struggled to care for the massive casualties in the aftermath of the atomic bombings of Hiroshima and Nagasaki.

In the late 1950s and early1960s, doctors studied the radioactive fallout from atmospheric nuclear test explosions. Examinations of the deciduous teeth of American and European children revealed heightened levels of strontium 90.  Other researchers found that after each atmospheric test, radioactive iodine 131 settled on grass on which cattle grazed, and was concentrated in the thyroid glands of children who drank the contaminated milk. Such findings fueled public protests that led to the Limited Nuclear Test Ban Treaty of 1963.

In 1962, a group of American physicians led by Dr. Bernard Lown and including Drs. Jack Geiger, David Nathan, and Victor Sidel analyzed the medical consequences of a nuclear attack. Calling themselves the “Special Study Section of Physicians for Social Responsibility,” they produced a series of papers, “The Medical Consequences of Thermonuclear War,” which were published by the New England Journal of Medicine. The articles and an accompanying editorial argued that physicians had a special responsibility to help prevent the use of nuclear weapons.

In the early 1980s, escalating threats by the US and Soviet Union that they might attempt to fight and win a nuclear war led to the formation of International Physicians for the Prevention of Nuclear War. IPPNW physicians engaged in a global education campaign about the medical effects of nuclear explosions and warned the public and the leaders of the nuclear superpowers that the medical profession would be unable to provide effective care in the aftermath of a nuclear attack.

In 1981, the American Medical Association echoed IPPNW’s assessment, stating “there is no adequate medical response to a nuclear holocaust.” Other national medical organizations, such as the British Medical Association, published detailed studies about the inadequacies of medical care after nuclear attack. The World Health Organization (WHO), the US Institute of Medicine and others added to the medical knowledge about the unique dangers of nuclear warfare. Climate scientists warned that a superpower nuclear war might cause a “nuclear winter” that could threaten the extinction of the human species.

During the 1990s, IPPNW established an International Commission to Investigate the Health and Environmental Effects of Nuclear Weapons Production and Testing and worked with the Institute for Energy and Environmental Research to document these effects. The Commission produced a series of books including Radioactive Heaven and Earth,Plutonium: The Deadly Gold of the Nuclear Age, and Nuclear Wastelands, a comprehensive study of the health and environmental impact of the global nuclear weapons production complex.

The nuclear dangers of the 21st century have led to a resurgence of physician interest in the humanitarian and environmental consequences of nuclear war in a world where nuclear weapons continue to spread. In October 2007, IPPNW and the Royal Society of Medicine co-sponsored a major conference in London to review the current state of knowledge about nuclear weapons effects. Scientific data about the global climate effects of regional nuclear war presented at that conference became the basis of an IPPNW project on “nuclear famine,”which has been used extensively to make the case for a Nuclear Weapons Convention. The climate findings and an updated summary of the medical consequences of nuclear war are available in a new IPPNW publication, Zero Is the Only Option: Four Medical and Environmental Cases for Eradicating Nuclear Weapons.

In recent years, IPPNW and its affiliates have drawn new attention to the health and environmental effects of uranium mining and processing, conducting community health surveys in India and challenging Australia’s plans to ramp up its uranium export industry.

IPPNW has also studied a nuclear danger in the medical profession’s own backyard—the use of highly enriched uranium in reactors that produce medical isotopes—and has campaigned for the conversion of those vulnerable reactors to non-weapons-grade uranium.

In October 2008, the World Medical Assembly renewed its own decade-long stance for the abolition of nuclear weapons, stating that the medical profession has a duty “to work for the elimination of nuclear weapons.” The WMA requested that all national medical associations “urge their respective governments to work towards the elimination of nuclear weapons.”[]

Red Cross physicians participated in the first relief efforts in Hiroshima and Nagasaki in 1945, and the International Committee of the Red Cross (ICRC) has called for a ban on nuclear weapons ever since. In April, 2010 the ICRC issued its strongest condemnation in more than a decade, asserting that “nuclear weapons are unique in their destructive power, in the unspeakable human suffering they cause, in the impossibility of controlling their effects in space and time, in the risks of escalation they create, and in the threat they pose to the environment, to future generations, and indeed to the survival of humanity.” []

Awarding the 1985 Nobel Peace Prize to IPPNW, the Nobel Committee honored physicians for “spreading authoritative information and…creating an awareness of the catastrophic consequences of atomic warfare. This in turn contributes to an increase in the pressure of public opposition to the proliferation of nuclear weapons.”

For more information about the International Campaign to Abolish Nuclear Weapons (ICAN), contact John Loretz, Program Director, IPPNW, 66-70 Union Square, #204, Somerville, MA 02143; 617.440.1733, ext. 280.