and hand for hone development studies); studies
of aging criteria; spectal examinations of the skin
with color photography of selected lesions: ophthalmological studies including slit-lamp observations, visual acuity, and accommodation, audiometric examinations; cardiovascular survey; and
x-ray examinations as deemed necessary.
In 1959, 96 exposed people, including their
children, and [66 unexposed people were examined on Rongelap.
Cardiovascular Survey. In view of the possible
association oflate effects of radiation with cardiovascular disease, the following cardiovascular survey was carried out.
1. Climeal Aistanes recorded present and past
health and illnesses, especially cadiac and pulmonary symptoms.
2. Physical examinations included the usual observations in the cardiovascular system in regard to
the rhythm and rate of the heart; the nature of the
heart sounds and murmurs,if present; the size and
shape of the heart by clinical indications, changes
in the arterial walls as observed by inspection of
the retinal arteries and by palpation of the radial,
brachial, and dorsalis pedis arteries; and the appearance ofthe veins.
3. Instrumental procedures: Systolic and dtastolic
hlood pressures were obtained with the cuff-type
aeronoid sphygmomanometer. Oscillometry readings were obtained from both legs at calf level by
the Collins type of oscillometer. The highest of the
readings obtained at different pressure levels was
used as a single reading for each subject. Electracardiograms were taken on people 20 years of age
and over (84 unexposed and 38 exposed individuals), The electrocardiograms were taken bv a
Sanborn Direct Writing apparatus which had
been specially shock mountedfor field use.* In almost all subjects the electrocardiograms were
taken with [2 leads, to include three standard bipolar limb leads, three augmented unipolarlimb
leads, and six unipolar or V chest feads in accord
with the standard 1 2-lead procedure recommended
by the American Heart Association. The technical quality of the electrocardiogram was in most
instances relatively good, but there were two
handicaps. The electric power for the instruments
was obtained from a generator on the LST by running a cable ashore to outlets in the various build*We are most grateful to the Medical Equipment Research
Department, U.S. Army, Fort Totten, N.Y... for use of this instrument on a permanent loan basis.
ings used for the medical examinations. Induction
currents often caused interference, and groundin:
of the instruments at times was difficult. Ther:
werc also technical variations because of variabl:
line voitage and amperage. X-rayfilms of the ches:
were taken on selected subjects when indicated!
The number taken was kept to a minimum t
avoid additional radiation of the exposed people
even though the dose involved was extremels
small. The Alms were used chiefly for the study o!
the lungs and, to some extent, for measurement «!
heart size and shape. Chest films were obtained on
11 subjects in the unexposed group and 7 in th
exposed group.
It should be pointed out that there was ne
standardized basal or adjusted level of physical
activity, such as resting for one hour before takinu
the tests. The patients were seen in the course ol
the usual examination, as might occur tn the outpatient department of a hospital.
Arthritis Survey.
During the course of other
studies on the Rongelap population, it was possible to obtatn information on the prevalence ol
arthritis and allied phenomena. Since little is
known of the prevalence of these diseases in tropical populations, any such data would be a contribution to the “geographic pathology” of the
arthritides’ besides being of interest in connection
with the possible adverse inHuenceofradiation exposure on degenerative diseases.
X-rays of the hands and wrists were graded for
osteoarthritis on a scale of 1+ to ¢+ by the
method of Kellgren and Laurence” as modified bs
Blumberg et al.” The same x-rays were used to
detect any cases of rheumatoid arthritis, other
arthritides, or bony abnormalities.* A small ali-
quot of serum(0.3 to 0.5 ml) was used to determine the presence of “rheumatoid factor” by the
bentonite flocculation test of Bozicevich et al.'" In
this test, a titer of '42 or greater is considered positive, 46 doubtful, and any titer below 15 nega-
tive.* A joint examination on each of the Rongelapese was performed by the medical examiners.
and any individual with significant joint findings
was re-examined by one of the physicians experienced in the diagnosis ofjoint disease. Treatment
of the joint disease was undertaken whereindicated.
“We are indebted to the following personnel of the Nationa!
Institutes of Health: Drs. R.L. Black, f. J. Bunim. and E.G 1.
Bywaters for reviewing the x-rays: and Dr. K. Bloch for perfurming the bentonite flocculationtest.
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