AG 1 O28 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. i" = SUPE ETT an 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 SOTICE: THIS MATERIAL MA Y BE reOTECTED BY COPYRIGHT LAW {TIT oid tre ONT vats