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Health Physics

August 2010, Volume 99, Number 2

Table 11. Lifetime Attributable Fraction (%) of projected cancers according to geographic grouping plus entire Marshall
Islands: best estimate and 90% uncertainty range in parentheses (5%—95%).

Southern latitude
atolls*
Mid-latitude
atolls?
Utrik community
Rongelap Island
and Ailinginae
community‘
Entire Marshall
Islands*

Leukemia

Thyroid

Stomach

Colon

2.2 (0.41-6.0)

12 (2.5-27)

0.47 (0.069-1.3)

8.4 (1.7—20)

25 (6.1—-45)

19 (4.3-45)
78 (39-91)

5.1 (0.96-12)

All other solid

cancers

Total

0.69 (0.23-1.4)

0.48 (0.11-1.0)

0.76 (0.16-1.8)

1.9 (0.26-5.7)

2.3 (0.73-4.8)

1.4 (0.34-2.9)

2.2 (0.50-4.8)

71 (32-86)
95 (87-97)

4.8 (0.64-14)
48 (11-73)

9.4 (3.2-19)
64 (36-78)

6.7 (1.5-14)
43 (20-54)

10 (2.4—22)
55 (28-69)

21 (6.0-39)

1.2 (0.17-3.4)

1.7 (0.59-3.4)

1.0 (0.27—2.0)

1.6 (0.41-3.4)

“Includes Kili Island where Bikini Atoll community resided.
> Includes Ujelang where Enewetak Atoll community resided.
“Does not include the U.S. military weather observers exposed to Bravo fallout on Rongerik.

might occur in the future due to accidents or intentional
actions in wartime or by terrorists. A number of important lessons can be derived from this analysis. Here, we
have confirmed that exposure to radioactive fallout,
particularly soon after detonation of a large device, can
result in high exposures and substantial increases in
cancer risk. At distances of more than a few hundred
kilometers, however, exposures and related cancer risks

are likely to be highly diminished due to dilution of the
radioactive debris in the atmosphere (depending on the
meteorological conditions) and radioactive decay during
transit. Lifestyles that are dependent on storing and
preparing food outdoors are particularly susceptible to
transmitting radioactive contamination to man. Reconstruction of radiation doses many years after exposure
can be an intensive effort and underscores the need for
dependable data of various types. The amount of data
necessary to make reliable estimates of radiation dose
and cancerrisks is significant and the collection of that
information should not be overlooked following nuclear
events, but should be, in fact, a high priority.

Acknowledgments—This work was supported by the Intra-Agency agreement between the National Institute of Allergy and Infectious Diseases and
the National Cancer Institute, NIAID agreement #Y2-Al-5077 and NCI
agreement #Y3-CO-5117. The authors express appreciation to their colleagues who assisted with companion papers in this volume, Dunstana
Melo, Payne Harris, Shawki Ibrahim, Robert Weinstock, Iulian Apostoaei,

and Brian Moroz, as well as to the numerous investigators who preceded
us in documenting and understanding the consequences of nuclear testing
in the Marshall Islands and whose work we have cited here and in the
companion papers.

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