1S ° - a S\rovssacen 3° g DQ Figure 1. Map offallout area, Marshall Islands. e MAURO SS, Q Lymphocytes fell promptly and bythe third day were about 55% of the control values in adults, and slightly lower in children. There was only slight recovery by six months. At 2 years, although further recovery was evident, the mean values of these cells werestill found to be below the comparison population levels (75 to 80%). The 3-year examination showed that the lymphocytes were still somewhat below thelevel of the unexposed population. Neutrophil levels fluctuated considerably during the first few weeks butfell gradually to a low of about 50% of control values by the 6th week after exposure. Slow recovery ensued, but at 6 months they werestill slightly below the unexposed levels. However, by 1 year post-exposure they had returnedto the level of the comparison population and havesince remainedso. Platelets fell to about 30% of the unexposed values by the 4th week. By 6 months they had reached 70% of the controls; at 1 year the mean platelet count wasstill below that of the control population but higher than at the 6-month survey. Although further increases were apparentat the 2and 3-year examinations, the levels werestill belowthose of the comparison population. Changes in hematocrit were not remarkable in anyof the groups. Clinical observations revealed no diseases processes or symptoms which could beattributed to radiation effects, aside from skin lesions, loss of hair, and early symptoms. The diseases encoun- tered were no more severe or frequent in their- i radiated than in the unirradiated population, even during the period of greatest depression of peripheral blood elements. Epidemics of chicken pox, measles, upperrespiratory infections, and gastroenteritis have occurred, but apparently with no greater frequencyor severity than in the unexposed populations. Twopersons diedin the exposed population. One was a 46-yr-old man with hypertensive heart disease which had been present at the time of exposure, who died twoyearsafter the accident. The second was a 78-yr-old man whodied, three years after exposure, of coronary heart disease complicating diabetes. There was no apparentrelationship between these deaths and radiation exposure, and mortality in the exposed group did not appearto have been greater than in the unexposed population. It is difficult to evaluate the effects of exposure on fertility; however a numberof apparentlynor- mal babies have been born, and there has been no discernible fall in the birth rate. Several miscarriages developed, but the incidence does not appearto be higher than in the unexposed populations. No opacities of the lens or other eye changes have been found that could be related to radiation. Studies on height and weight and bone age seemed to showa slight degree of retardation in growth and developmentin the exposed children. However, the small numberof children involved, anda later finding that exact ages of someofthe children were in doubt, permits no definite statements to be made. BetaIrradiation of the Skin Noaccurate estimate of the radiation dose to the skin could be made. Lesions of the skin and epilation appeared about 2 weeks after exposure, largely on parts of the body not covered by clothing. About 90% of the people had these burns and a smaller number developed spotty epilation. Mostofthe lesions were superficial; they exhibited pigmentation anddry, scaly desquamation and were associated with little pain. Rapid healing and repigmentation followed. Somelesions were deeper, showed wet desquamation, and were more painful; a few became secondarily infected and had to be treated with antibiotics. Repigmentation of the lesions gradually took place in most instances, and the skin appeared normal within a few weeks. However, in about 15% of the people, deeperlesions, particularly on the dorsum ofthe feet, continued to show lack of repigmentation with varying degrees of scarring and atrophyof the skin. At 3 years 14 cases continued to show