3 Reports have been published on the medical findings of surveys made at the following times after exposure: initial examination,! 6 months,” doing a complete survey only in alternate years. In 1969 the Utirik population wasalso examined, for the first time since 1966. The physicians and 7 years,8 8 years,9 9 and 10 years,!° and 11 and are listed on thetitle page and are shownin Figure 1 year,? 2 years,‘ 3 years,5 4 years,® 5 and 6 years,’ 12 years.11 A more completelist of reports, including outside publications, on the results of medical surveys of the Marshallese exposed to fallout, and including a section on someof the radiation ecological studies of these islands published largely by the University of Washington group, appears in BNL 50029.14 BACKGROUND Several difficulties were encountered in carrying out the examinations. The language barrier wasone,since very few of the Marshallese speak English, but usually some Marshallese were available who spoke enough English to serve asinterpreters when necessary. Thelack of vitalstatistics and demographic data on the Marshallese imposes serious limitations in interpretation and evaluation of the medical data. Trust Territory officials are attempting to improveregistration of such data. The uncertainty on the part of manyof the Marshalleseas to their own ages is a problem,especially in the growth and developmentstudies amongthe children andin the agingstudies. Duringthefirst 2 years two separate groups of Marshallese people were used for comparison purposes, but they were unstable, with a largeattrition rate. At the time of the 3-year survey the Rongelap population at Majuro Atoll was found to have doubled during the preceding 12 months because of the influx of relatives who had come back from otherislands to live with their own people. Those people had been away from Rongelapat the time of the accident and therefore were unexposed. The group matched reasonably well with the exposed group for age and sex. This group has gradually increased and is now more than twice the size of the exposed group. Table 2 shows the various Marshallese populations that have been examined since 1954. ORGANIZATION OF THE 1967-69 SURVEYS In 1967 and 1969 complete surveys were made of all of the comparison population as well as the exposed people. In 1968 only the exposed group was examined, in line with our policy of technicians participating in the different surveys 2. These included, in addition to those from the United States, a sizable number of Micronesian medical personnel. The examinations were carried out at Majuro, Ebeye, and Rongelap, since a number of Roneglap people drift back and forth between these three islands, and at Utirik (see Table 3). The medical teams traveled to Kwajalein in the Marshalls by commercial plane and from there to the variousislands by Micronesian cargo ship (Figure 3). Most of the supplies and medical equipmenthadto be carried with the team except for a considerable amountof permanent equipment, including two examination trailers, established at Rongelap. Table 4 shows the numbers of people examined during the 1967-1969 surveys. Findings GENERAL MEDICAL STATUS Duringthe past 3 years some improvementhas been noted in the general health of the Rongelap people. This may be partly due to general improvementin sanitation and hygenic measures. Garbagedisposal appears to have reduced thefly population,and children are using the outhouses rather than the beach for defecation. The people have more moneyto purchase such items as kerosene refrigerators, automatic washing machines, and new plastic water cisterns. Gastronenteritis and respiratory infections werestill fairly frequent, but skin lesions due to fungus and impetigo appeared somewhatreduced. Fish poisoningstill occurs sporadically among families who happen to eat a poisonous fish and will probably continue to do so, since the poisonousfish are very difficult to identify and may shift from one species to anotherat times. A rather serious epidemic of Hong Konginfluenza occurred among the Rongelap people in 1968 and may have been responsible for the deaths of a 58-year-old exposed woman and of an unexposed boy whodied of meningitis complicating the influenza. In June 1968 a few cases of infectious hepatitis occurred, and also a mild measles outbreak among the youngerchildren. In August 1968 four patients were brought