58 high incidenceof diabetes. Serum assay for vitamin B,, showed generally high levels; the explanation was nol apparent. Radionuclide body burden evaluation in the Marshallese people has been complicated by several things. The people were evacuated from their island soon after the accident and did not return until 3 years later. During the 5 years since the original contaminating event, additional weaponstests held in the area have contributed to the fission products in the environment. Finally, since the diet inctudes a variety of imported foods, the people are not living in a “closed” environment, and therefore may not be rapidly approaching equilibrium with the environmental fission products, as might be expected under other circumstances. Body burdens of gamma-emitting fission products (such as Cs‘ and Zn**) were measured ina whole-body counter and checked by radiochemical analysis of urine specimens. Body burdens of Sr*° were estimated from urinary excretion as determined by radiochemical analyses. Both the external dose measurements on Rongelap Island and the levels of radioactive isotopes in the food on the island indicated that some increase in Cs'"", Zn"*, and Sr”’ body burdens was to be ex- pected when the people returned there in 1957. The Cs''’ body burden in 1958 was about 0.68 uC, about 60 umes as great as in 1957, and the urinary Cs'"' level rose by a factor of 140; the mean body burden for 1959 was 0.57 wC. The mean body burden of Zn** estimated from whole-body counting data was, in 1958, alter the return to Rongelap, 0.36 wC, 8 times as high as in 1957, and 0.44 wC in 1959. Thus, whereas the Cs'”’ levels appear to have reached a maximum and actually to have dropped in 1959, the Zn* levels have shown a continued increase which is probably related to the long biological half-lite of thelatuer. The Sr°” level in 1958 estimated from excretion data was 2 mpC, about 20 times as high asin 1957 before the return to Rongelap. The estimated body burden in 1959 increased to 6.0 mpC, about 20% of the estimated ultimate equilibrium value. Little of the body burden of the exposed group is apparently due to their iniual exposure, since at present there ts litde difference between the levels of the exposed and unexposed populations living on Rongelap Island. When these three isotopes have reached their estimated equilibrium values, the body burdens will sull be of small significance in terms of radiation hazard. This study of the internal contamination of the Marshallese has provided information (1) on the movement of Cs'!", Zn”, and Sr*’ from the environment to man, (2) on the rate of equilibration of these isotopes with the environment; and (3) on the discrimination factors between food and man. IMPORTANCE OF MEDICAL SURVEYS The Japanese populations of Hiroshima and Nagasaki being studied by the Atomic Bomb Casualty Commission and the Marshallese popufauon of Rongelap comprise the only large groups of people exposed to acute doses ofionizing radiation. The two studies parallel each other but differ in certain important respects. The smaller number of people in the Marshallese population and the paucity of vital statistics make statistical analysis of data on this group much more difficult. However, the Marshuilese studies have the advantages that the dose of radiation received by the people is better known; that the findings during the early, acute period after exposure are well documented; and that the people did not suffer from trauma, thermal burns, or marked psychic disturbance, although they did have the complicationsof beta burns and internal absorption of radionuclides. Study of both groups has yielded valuable information on the acute effects in human beings of radiations from atomic bomb detonations. Examinations for the more subtle late effects of radiation exposure are now receiving considerable emphasis. In the case of the Japanese, increased incidence of leukemia and possibly other malignancies as well as cataracts already has been reported.In view of this finding, the next 5 years will be the critical period for the development of leukemia in the Marshallese. Animal experimentation has indicated the possibility that still other late effects may occur in the humanbeing such as premature aging, shorteningoflife span, increase in degeneralive diseases, genetic changes, etc. Therefore, continued careful examinationof these populations is extremely important in order that such effects may be documented, and therapeutic procedures instituted wherever possible, should such eHects develop. In addition, in the case of the Marshallese, continued evaluation is indicated of the in- fluence of persisting low levels of radioactive materials on Rongelap Atoll on the body burdensof radionuclides of the people jiving there.

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