CONTENTS BACKGROUND. cece cccccccccecceeeceeec cnet te ceeeeseeeeneesastaseetesesnuecsessesneetsecassaseseesetenasieeneeiaty 1 Summaryof Past Findings.....00.0...00ccccecc cscs cee eseeeeceeenereeeenerieeteeseneenteneees t Penetrating Irradiation .....0..0. lice ete resets etnies tre tenecatneraenees 1 Beta Irradiation of the Skin... eee ene ees en teeter eae cteeeecanets 2° Internal Trradiation...... ccc cece eeeee eee eceeneeneencnetenteeeciaeenseteeeeeans 3 PRESENT SURVEY2000.0. ccciccccccecc eee cectceceeeeectee sete te srs erseciesasaseaecseseeeceessacsetsteaseneessenetaecats 3 Background Material cece ccceeeeeceateceteaseeeeeesereceeeseeteneesetesscatareesteesetacceensseeeeeeens 3 Organization... cies ccc eee e nn erence tre nena eee rece teee ate 3 Difficulties Associated with the Examinations.....0...0..0ccccccsteee cece 6 Comparison Populations... ccc eee cece ence eee e etter etnaeeateeeente 6 Procedures... cee: ccevussususseesensessesssstesssanseveveseseseueuesetssestessessseenseseee 6 Findings. oo... cece ce eet ee centre nie ee rne cece e ee en DES eG ane ese teee cer ntaeenieeeieeeeaee 8 Living Conditions.......000.0ccccccecceecceceeeeeneeeseeeceseecctessneecaeenssessnsonaeetaresens 8 Interval Medical History... ice cee cence ctee cer eneereneee eres reeteneneeneesa 8 Physical Examinations ...0..00.0000 0c cscs serene etre eer ects ent esevtenneesnaeenes 9 Growth and Development Studies... ec eccccceeeeee cere esttaeeeeenenetenees 10 Ophthalmological Examinations....00...0....0cc ceccceceeeeceereeecuteenseteeeeeeneees 10 Examination of the Skin... ccc cecceee ete teerceeeeseceseevieenteerieereees 11 Laboratory Examimations...00.00000. 0c cee eeneee sere seeeeeetaeentesseeeeaeees 11 Body Burdensof Radionuclides... i ccecceccesseeseeeeeenteeteteeteseeteeteees 21 DISCUSSION 2.0.0.0...) occeceeceee tec eneceeeceaeteeeesteceeceteeseteaesecesaceaeseasesseevaeevatsnssesaesesaseessentes 28 Acute and Subacute Effects... ccc cece eceneeecneceeeenceeseeetennaeeteeaeteseeseenseees 28 Late Effects... ccc eecceneeeeeeneceeenesneeeeceeeeenaeecnseeeeseeetsaeectsectesserteseessseenas 29 Findings Common to Both Exposed and Unexposed Groups........0.0.....0005 30 Radiation Ecological Studiies.....0..0...0cccceccececceecescesceeeeseeseesessesecustseeseseeteeeeas 31 SUMMARY o.oo cececececeee sees eeasseeseeseeceevsesaceesaeeessasessecseaeeesesscavaceeveesetsesienetssneveceeeees 32 ACKNOWLEDGMENTS... .ccccccececceeeececeee cect seceereceeeetieesseeceateassetesseissseatesseetersanieneenestese 33 REFERENCES... 00.0. cecccccccececeeeeeeeee seen tececeee sete cceeeer cence eitesitciesagss sities siseetiessteeenens 34 ill