33 Two deaths occurred in the exposed and onein the unexposed groupsince the last survey. The deaths in the exposed group did not appear to be related to radiation exposure. Diseases, infectious and noninfectious, were as commonin the exposed as in the unexposed people. Nutrition appeared good except for slight hemeralopia in several children ascribed to vitamin A deficiency. The birth rate was about the samein the exposed as in the unexposed group, andthe babies appeared normal. Nolate effects of exposure were noted. Shortening of life span has not been observed. The death rate has been about the samein the exposed as in the unexposed population. Premature aging of the irradiated group has not been grossly visible. No radiation opacities of the lens or differences in visual acuity have been noted. No malignancies have been observed, and the incidence of degenerative diseases was about the sameas in the unexposed group examined. Genetic studies have not been carried out, but no difference in the inci- dence of congenital abnormalities has been noted in the first-generation children of the exposed compared with the unexposed populations. The only residualeffects of beta irradiation of the skin were seen in 12 cases which showed vary- ing degrees of pigment abberation,scarring, and atrophyat the site of deeper burns. In no case was there evidence of chronic radiation dermatitis or premalignant or malignant changein thelesions. The return of the Rongelapese to their island (which has a persisting low level of radioactive contamination)is reflected in a rise in their body burdens andincreased urinary excretion of certain radionuclides. Estimates of these body burdens of radionuclides were determined by gammaspectroscopy and by radiochemical analyses of urine samples. These estimates showed that the body burden of Cs'*" had increased by a factor of 100 and of Sr®° by a factor of 10, with someincrease in Zn* also, since the return to Rongelap. However, the levels were well below the accepted maximum permissible levels. Analysis of bone samples on one of the men whodied showed 3.7 Sr®? units/g calcium. Further detailed studies on the radiation ecological aspects of these surveys, including examinationsof the food and human metabolism of these isotopes, is in progress and will be an importantpart of future investigations. The survey team devoted considerable attention to other medical studies in the Marshallese not directly related to radiation effects but possibly having some bearing on prognosis. Findings in these studies were commonto both the exposed and unexposed populations. An extensive intestinal parasite survey showed that the people were infected with many types of protozoa and helminths, although this finding did not entirely account for the generally higher incidence of eosinophilia. Among other findings that need further explanation are the general anemic tendency, the high plasmaprotein levels with increased gamma globulin, and the high levels of serum protein-bound iodines and vitamin B,,. It is hoped that some of these problems will be solved in future surveys. Another group of investigations concerned the anthropological background of the Marshallese based onstudies of genetically determined traits. Amongthese were determinations of various blood groups and of hemoglobin and haptoglobin types. These studies are shedding some light on the origin of these people and on the homogeneity of the population being investigated. Their blood groups resemble most closely those of people from Southeast Asia and Indonesia, and the population appears to be relatively homogenous. Acknowledgments Because of the broad scope of the studies carried out in this survey and the complexity of the operation, the cooperation and coordination of many persons and agencies were necessary to carry out the mission successfully. The authors are deeply grateful to many individuals, too numerous to name,for their invaluable assistance and coopera- tion. Manyofficials of the Atomic Energy Commission, particularly Dr. Charles L. Dunham, Dr. H.D. Bruner, and manyoftheir staff of the Division of Biology and Medicine,as in the past. have been most helpful in the coordination of arrangements with the Departmentof Defense, Department of the Interior, Department of State, and other govermental agencies. At Brookhaven National Laboratory the high degree of interdepartmental! cooperation made possible the designing and constructionofthesteel room, the assembling andtesting of complexelectronic equipment needed for the gammaspectroscopy, andthe ordering, packing, and shipping of equipmentfor the survey. We are particularly

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