in the United States, including endocrinologists, cardiologists, hematologists, internists, surgeons, ophthalmologists, and parasitologists (see Appendix 2). The varietyof specialists indicates the diversity of the examinations conducted over the years. The BNL group has been fortunate in maintaining close liaison with the Atomic Bomb Casualty Commission in Japan, and several physicians formerly associated with it have participated in our surveys. We havealso had a close relationship with the people studying the Japanese fishermen exposed to the Bravo fallout; in 1964 exchange \ visits were arranged for Dr. Kumatori andthe author to attend surveys both of these fishermen and of the Marshallese. In May 1954, upon completion of the initial examinations (conducted at Kwajalein), the 82 Rongelap people, because of the contamination of their homeislands, were moved to Majuro Atoll, and they were examined there in September 1954 and in March 1955, 1956, and 1957. They re- turned to Rongelap, to live in a newly built vil- lage, in July 1957, after radiological surveys had showntheisland to be safe for habitation. The 157 Utirik people were taken homeafter the initial examinations, since their island was only slightly contaminated and was consideredsafe for habitation. The 28 military personnel exposed on Rongerik Atoll were taken to Tripler Army Hospitalfor further examinations. Followingtheinitial acute effects of radiation on the Rongelappeople, the examinationsover the next 9 years revealed few significant findings. An increase in miscarriages andstillbirths among the exposed women during the first 5 years was thought to be related to radiation exposure, but general health and disease incidencein the exposed people were about the sameasin the unexposed Rongelap people who had returned from otheris- lands and served as a comparison population. During this uneventful period, suggestions were made for reducing the scope or frequencyof the surveys, but these were never seriously consideredsinceit wasrealized thatlittle is known aboutthelateeffects of radiation on humans andeffects mightstill appear. In 1963 the unexpected apearance of growthretardation in some children andof thyroid abnormalities fully justified this reasoning. In 1972 a case offatal acute myelogenous leukemia developed in a 19-year-old exposed Rongelap boy, indicating the need for additional surveillance. Thesurveys therefore were expanded to include a hematological check in the exposed Rongelap people every 6 months. At that time also diffi- culties were encountered in maintaininga strict thyroid treatment program in the exposed Rongelap people, with potential serious results, particularly in the people who had had thyroid surgery. The decision was therefore madeto place a resident physician in the Marshall Islands tokeep check on the treatment program and assist the Trust Territory in general health care of the Rongelap and Utirik people. The medical findings on the Marshallese have been published in numerous BNL reports and journal articles.2-23 Someproblems have been encounteredin carrying out the medical surveys in the islands. Careful planningis required for all necessary equipment and supplies to be on handat the remotelocation, and procedures must be adapted to field conditions with properelectronic support. Sometechnical procedures such as staining of blood smears and cell cultures present problems undertropical, humid conditions. Providing adequate transportation has been a majordifficulty. While the Navy furnished LST’s and amphibiousplanes, problems were minimal, but for most of the surveys we have had to rely on cargo ships chartered by the Trust Territory, and these have sometimes proved unreliable in meeting schedules or hazardous because of faulty life-saving devices and inadequate navigational equipment. Once the survey team was lost at sea for more than a daytryingto find an island, and twice ships ran agroundonreefs. Smallboat travel in rough waters was hazardous; the trip from ship to shore was sometimes in outrigger canoes and mightresult in wet passengers and baggage. To overcomethese problems, an LCU was recently acquired for carrying out the AECsponsored radiological and medical surveys in the Marshall Islands. Other problems included the following: The language barrier hampered communication with the people, even though a limited numberofre- liable English-speaking people were usually avail- able. The lack of adequatevitalstatistics resulted in uncertainty in the exact age of many of the people; and medical records were poorly kept, particularly in the outerislands(e.g., the health aide would often give the cause of death as “too old’’). It was difficult to obtain consent for an autopsy, even at district medical centers, because of feelings against mutilation of the body after death. Someofthe subjects thought that drawing blood made them feel weak; and some questioned the