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Thyroid Injury and Effects eas
on Growth and Development in Marshallese Children
Accidentally Exposed to Radioactive Fallout
Wataru W. Sutow, MD‘; Robert A. Conard, MD; Keith H. Thompson
Wat Sutow wasinvolved for 25 years in the medical studies
of the people of the Marshall Islands who were exposedto radioactive fallout. He was a dedicated member of the examination teams, participating on numerous occasionsin carrying out pediatric and growth and development studies of the
exposed Marshallese children. The results of his studies have
added a great deal to our knowledgeof the effects of radiation
on children.
Wat won the respect and love of the Marshallese people
with his careful, gentle examinations and treatment of the
children. The many physicians and technicians who have
worked with him over the years developed great respect and
affection for him, and his participation in the program will
be sorely missed.
To me, Wat was a close friend and advisor, and his passing
leaves a void that will be hard to fill. —RAC
This report concernsthe late effects of fallout exposure on
the Marshallese people, particularly the effects on the thyroid
gland and growth and development of children of Rongelap
Atoll. A portion of the material and data reported hereis excerpted from the Brookhaven National Laboratory report.'

Early Effects

+ Deceased.

Wataru W. Sutow, MD, Department of Pediatrics, The University of
Texas M. D. Anderson Hospital and TumorInstitute at Houston; Robert A. Conard, MD, Medical Research Center; Keith H. Thompson, Biology Department; Brookhaven National Laboratory, Upton, New
York.
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During the weapons testing program in the Marshall Islands in 1954, an unfortunate accident occurred. Following
experimental detonation of a large thermonuclear device, an
unpredicted shift in winds caused deposition of radioactive
fallout on 250 Marshallese, 23 American servicemen, and 23
Japanese fishermen aboard their fishing vessel, the “Lucky
Dragon.” Details of the accident and exposure data can be
found in Brookhaven National Laboratory reports.*?
The inhabitants of Rongelap Atoll were exposed to the
greatest amount of fallout, those on Ailingnae Atoll to less,
and those on Utirik Atoll to the least. The exposure included
penetrating gammaradiation (whole-body exposure), deposits of radioactive fallout on the body (skin exposure), and internal absorption of radionuclides by inhalation and ingestion of contaminated food and water. The most serious
internal exposure was from radioiodines, which produced
significant doses to the thyroid gland. Table 1 lists the Marshallese populations involved, with estimated whole-body
gammadoses and thyroid doses. It should be emphasized that
the thyroid doses are rough estimates, and current reevaluation at Brookhaven National Laboratory indicates they are
probably too low.

THE CANCER RIMTLETIN. VoL 34. NO 3. 1982

Early effects of exposure (transient nausea and vomiting,
hematologic depression, development of “beta burns“ of the
skin) have been reviewed elsewhere and will not be presented here. No early deaths wereattributed to exposure. The
effects were more pronounced in the children, particularly
those exposed on Rongelap. It is noteworthyalso that no early

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