EFFECTS OF NUCLEAR WAR _ | 431 Recovery of the blood-forming tissues is judged virtually complete based on studies of the peripheral blood counts. A possible exception is seen in the blood platelets which are slightly below the levels in the unexposed group but still within the normal range. There is no evidence of any untoward effect associated with this finding. The beta burns of the skin healed rapidly during the first few months after exposure. In 12 cases there remain slight scarring of the skin and pigment changes at the formersite of deeper burns, However, no evidence of any cancerous change in these acars is noted. In those that lost hair, regrowth of normal hair was complete by 6 months after exposure. Very little is known about late effects of radiation in human beings. Increased incidence of leukemia in the exposed Japanese people has been noted and, in animal studies, the following late effects of radiation may result: Life shortening, premature aging, increase in degenerative diseases, increased incidence of malignancies, opacities of the lens of the eyes, and genetic changes. The Marshallese have been examined for evidence of such changes, but none have been seen. Radlation-induced leukemia is known to appear relatively soon after exposure and other types of malignancy at later times. Therefore, con- tinued examination are essential in order to detect and, if possible, treat such effects should they develop. : : The radioactive fission products that had been absorbed internally by the Rongelap people were never sufficient in amount to result in acute effects. These radioactive materials were excreted rapidly during the first 6 months after exposure. The island of Rongelap remains slightly radioactively contaminated, but careful surveys showed the island to be safe for habitation by the summer of 1957 when the people were returned to Rongelap. Studies of the body burdens of radioactive materials in these people is an important part of the medical surveys. A 21-ton steel room with very sensitive radiation-detecting equipment has been used in the past two annual surveys at Rongelap to determine the body burdens of radionucleides. In addition numerous urine samples have been analyzed for radioactivity. The results of these studies show that there has been an increase in body burdens, principally of cesium 137, zine 65, and strontiam 90 since their return to Rongelap. About the same levels of these isotopes have been noted im those exposed and unexposed. During the first 8 months after their return to Rongelap their body burden of cesium 137 are estimated to have increased by factors up to 100 (resulting in a mean body burden of 0.68 yc); sinc 65 is estimated to have shown a concomitant increase (mean body burden of 0.86 xc) ; strontium 90 showed about a twentyfold increase rate of excretion In the urine. Only one sample of boneis available for estimating the body burden of strontium 90. This is from a Rongelap man who died in April 1958 (9 months after his return to Rongelap) which showed 3.6 yue/Sr™/gm Ca (strontium units). On the basis of North American data, it is expected that the values for children would be higher. Based on preliminary analysis of data from the most recent survey (8 to 20 months after their return to Rongelap), it appears that the people have begun to attain equilibrium with their lightly contaminated environment. The cesium 137 levels appear to be alightly lower than the year before, while the zine 65 has increased slightly. The strontium 90 analyses, unfortunatley, are not available yet. The body burdens estimated above are far below the maximum permissible levels; cesium 137 is about 2 percent of the MPL, and sinc 65 is 1 percent of the MPL. . : In summary, a medical survey of the Marshallese people in March 1959, 5 years after exposure to faliout radiation, showed that the people had recovered from the acute effects of their radiation exposure and appeared to be generally in good health. The following specific statements can be made in regard to their radiation health status: . : 1. No illnesses or diseases were found that could be directly associated with acute radiation effecta. 2. One case of cancer and three deaths have occurred, but with no direct relation to radiation effects. 8 Fertility does not appear to have been affected. The incidence of miscarriages and stillbirths appears to be somewhat higher than in the unexposed Marshallese, but a deficiency of vital statistics precludes definite conclusions as to whether or not this is a radiation effect. 4. Suggestive evidence of slight lag in growth and development of exposed children noted previously is being reevaluated on the basis of better age data obtained during the past survey.