The criteria certifying atomic bomb disease adopted by the Japanese government are very different from the actual state of the survivors. The criteria are based on epidemiological research by the Radiation Effects Research Foundation, the successor to the Atomic Bomb Casualty Commission (ABCC). The ABCC studied only the effects of primary radiation from the atomic bombing on the survivors of Hiroshima and Nagasaki, and ignored the damage from residual radiation. Analysis of the incidence of acute radiation disease, the rate of chromosomal aberrations, and the relative risks of chronic disease among the survivors, shows that the effects of residual radiation from fallout exceeds that of primary radiation in the area more than 1.5-1.7 km distant from the hypocentre of the Hiroshima bombing. The effects of internal exposure due to intake of tiny radioactive particles are more severe than those of external exposure, explaining the difference between the official criteria and the actual state of the survivors.