457 Medical Findings in Marshallese People Exposed to Fallout Radiation AQ 306% Results From a Ten-Year Study Robert A. Conard, MD, and Arobati Hicking Benign thyroid nodules were removed from three teenage Rongelap girls ten years after exposure from fallout. (The thyroid dose received was estimated at about 1,000 rads, largely from radiciodines absorbed.) No thyroid nodules were detected in 75 unexposed children. Other possible residual radiation effects noted in the 86 exposed Rongelapese were as follows: slight retardation of statural growth and bone. maturation in boys exposed at less than 5 years of age; greater incidence of miscarriages in exposed women during the first four years; incomplete recovery of some of the peripheral blood elements; and increased nevus-like lesions in areas of previ- ous beta radiation burns of the skin. General health and mortality has been about the same as in the comparison population. No definite radiation effects on birth rate, ‘ aging, leukemia, malignancy, or genotype have been noted. en years have passed since the people of the Marshall islands were accidentally exposed to fallout radiation’; complete reports have been pub- lished covering findings of the annual medical surveys.” The accident occurred March 1, 1954, following the detonation of a high-yield nuclear device during experiments at Bikini in the Pacific proving grounds, when an unpredicted shift in winds caused deposition of significant amounts of fallout on four inhabited atolls to the east. The Table shows the groups of people involved, the numberin each group, and the extent of the fallout and exposure. The present report summarizes the medical findings over a ten-year period of the 82 people of Rongelap Island who were exposed. Theinitial Summary of Fallout Effects findings are only briefly reviewed, greater emphasis ' being placed on the findings of more recent followup examinations. A group of relatives, away from the island at the time of the accident, returned with the exposed group to their homeisland and have served as a comparison population. Initial Findings During the first 24 to 48 hours about two thirds of the Rongelap people experienced anorexia and nausea, a few vomited and had diarrhea, and many complained of irritation of the skin and eyes. ‘These symptoms, however, subsided within a few days. Depression of lymphocytes and neutrophils to about half and the platelets to about one third the levels of the unexposed population occurred during the first six weeks following exposure, followed by gradual but incomplete recovery. The depression of blood elements was insufficient to result in infections or bleeding, and the radiation dose that they had sustained fortunately proved to be sublethal. No specific therapy was necessary. A slight loss in weight was noted in more than half of the people during the first six weeks, but the possible effects: of change of environment could not be ruled out. Beta radiation burns of the skin andepilation of the scalp were widespread, particularly in the ‘more heavily exposed group. Most of the lesions were superficial but some showed deeper ulceration. Most of them healed within a few weeks with only slight residual changes and regrowth of hair was complete by six months. T T vt Utirik 69 78 ' 14 Extent of Skin Lesions Extensive . Less extensive Slight No skin lesions or epilation osa®? exposed were 23 Japanese fishermen who received a sublethal From. the Medical Research Center, Brookhaven National Laboratory, Upton, NY (Dr. Conard), and the Department of Medical Services, Trust Territory of the Pacific Islands, Saipan, Mariana Islands (Mr. Hicking). Reprint requests to Brookhaven National Laboratory, Upton, NY 11973 (Dr. Conard). JAMA, May 10, 1965 e Vol 192, No 6 a (31-59 DAYS) T T - oe v (31-59 OAYS) a8 8 Dose (Rads) 175 T } 1 t 7 oT TF (26-30 DAYS) 8 Rongerik Gamma CUMULATIVE PERCENT Ailingnae Fallout Observed Heavy (snow-like) 18 Marshallese Moderate (mist-like) 28 Americans Moderate (mist-like} 157 Marshallese None Composition 64 Marshailese nN oOo oOo ——t Group* Rongelap T * EXPOSED, TEN YEARS POST EXPOSURE 4 CONTROL , * EXPOSED, TIME OF MAXIMUM DEPRESSION Estimated 4 L 1 1d J. 20 40 60 80 NEUTS x1075 i nde. 1. 4.0 20 LYMPHS x 1073 L 0 1 1 i i woke 20 «4 60 PLATELETS x 107‘ 1. Cumulative percent distribution curves of neutro- phils, lymphocytes, and platelets. 113