14 mm _ The PHYSICAL EXAMINATIONS - ADULTS Thepositive clinical findings in adult Rongelap and Utirik people are listed in Table 9. The general health status and incidence of physical abnormalities of the exposed Rongelap people was aboutthe sameas of the unexposed people on the island exceptfor thyroid abnormalities, which are described +: below. The varying fre- atrophy, and pigment changes. The-lesions have exhibited littl or no change during the pastseveral years. No further increase has been3secen recently in benign mob@ig@which were noted several years ago in areas of the neck that hadsustained “beta burns.” No evidence of any malignantskin changes have been.seen. OPHTHALMOLOGICAL FINDINGS, 1967 SURVEY quenciesre d from year to year on such abOphthalmological examinations were carried normalities as’ prostatic hypertrophy, cervicitis, out* in 1967 on 63 exposed people, 62 children of and arteriosclerosis probably reflect to some extent exposed parents, and 185 peopie in the comparidifferences in clinical evaluation among the exson population, a total of 310 (see Table 10). amining physicians. During the past 3 years, skin As noted in previous surveys, as compared with lesions appeared to be less prevalent, perhaps beerican populations there was an increased cause of better hygienic conditions (the importange . ence oflarge corneas and enlarged, tortuamts. of daily baths with soap and water has been and bizzare-pattemnet retinal vessels, and a lower stressed). Special ophthalmological examinations incidence of myopia,strabismus, amblvopia esowerecarried out in 1967 andslit-lamp observations phoria, retinitis pigmentosa, and congenital for enumeration of subcapsularflecks of the lens in glaucoma. 1969. These findings are described separately below. The incidenceof arcussenilis is higher in the As part of the cancer survey, x rays of the chest Marshallese than in similar age groups in the were taken every 2 years (half the group in alternate United States, which is in keeping with the genyears) on both exposed and unexposed Rongelap eral observation that the Marshallese age faster people. The roentenograms showed about equal than Caucasians. The incidence was higher in the incidence of cardiovascular findingy‘in the two exposed group (30%) than in the unexposed group groups. Two cagse with inactive tuberculouspul(13%); however, on the basis of previeusstudies. monary lesions were noted, but no evidenceof prithe differenceis probably not significant. mary or tatic pulmonary matignant lesions Although diabetés mellitus has-a moderately was seen.| Papanic yu smears were take "high incidence in the Marshallese, only one case the vaginalregion ofall women examined. vioFdiabett? retinopathy was noted. This is in keepdence offinflammatory reactions and infections -ingwith the observation that diabetes in the with trichomonas and bacteria ‘common..-:: Marshallese-éccurs largely iin oer individuals. Only one smear in an unexposed w n was sug- _ gestive of cancer of the uterus; The medical= + Theiincidenceof pix cula kn d pterygium is high in nthe Marshall f¥ands. The ince e of authorities in the Marshall Isla e-were motified —» pterygium was slightly higher in th crhsed of this case. Except for cancer 6 @yroid (described below) only one case of cancer was noted group. Abnormalities of the-rystaline lens, characduringthe 3 years,in a 71-year-old exposed woman terized below,saregreat the MarshallIslanders (3¢13) who died with bleeding.fridathegenital than in similar age in the & . ited States. tract thoughtto be due to cancér 9 uterus. In The abnormalities obgerved'e f potychro1968 one 34-year-old exposed Ailingnaé©woman matic sheott i changes; de ; Hipacitiesof all (3¢70) was found to have a hard non-tefider tumor several centimeters in diameter lateral to the . lowerleft lobe of the thyroid. She was. Bought to the United States with several other Hongelap people who were to undergo thyroid y. Surgical removal of this tumor revealed a ‘benign neurofibroma. A number. of other benig®faoft-tissue tumors were noted during the examinations. Examination of residual ‘‘beta burns,” present in about 20 cases, showed only minimalscarring, plaquecditeaved he fi the zone ofeae the granulesswere *: appeared sli RP try color” Whet#?h : esced ti¥o a *By Dr. Austin Lowrey, a member of the 1967 survey team.