28
units for populations at large) based on analysis

of a small sample of bones from the Rongelap man
who died in April 1958, if this sample is representative. Since children may havelevels higher
than those of adults bya factor of 10, their values
maybe as high as about '4 of the stated maximum
permissible concentration (30 to 40 puC Sr”).
However, this estimate is based on bones of American children and. since consumption of milk by

the Marshallese children is practically nil compared with that by American children, this extra-

polation may not be valid. Based on urine analy-

ses for Sr*" excretion, the average 1958 level was

3.42 ppC Sr’’/l urine, or about half the level found
during the first month post-exposure (6.2 puC
Sr°’/l urine). Itis not known whether the body

burdens of Sr*" in the Rongelap people have yet

attained equilibrium with their environment, and

this point will be carefully followed in future

studies.

Although the rapid rise of the Ebeye people’s

values toward those of the other Rongelapresi-

dents suggests that equilibrium values have been

approached, the daily excretion rates indicate that
equilibrium with the environmental values cannot
be assumed. In anyevent, the increase in activity

between the 1957 and 1958 surveys andthesimilarity of the results for the exposed and unexposed
groupsindicate that mostof the radioactivity seen
is the result, not of the initial contamination, but

of more recent ingestion of food containing radionuclides. It is known from other studies**-** that
the soil and food plants on Rongelap contain low
levels of fallout products. Eating of land crabs has
been proscribed becauseoftheir relatively high
Sr“° content. Among other foods the pandanus
fruit shows the highest Sr*’ content, but this fruit
represents a relatively small part of the diet. Other
plant foods such as coconuts and breadfruit have
relatively low levels of Sr*® activity. These plants

also contain lowlevels of Cs'**.
Calculations of the radiation dose rates on the
basis of existing data are subject to much uncer-

tainty, but have been attempted because of the
great interest in this facet of the problem. Using
the assumptions accepted in the United Nations
report,’® the 3.8 wyC of Sr*°/g calcium found in

the one subject autopsied corresponds to a dose

rate of 9.5 mr/year to the bone, and a doserate of

only 3.8 mr/year to the bone marrow.Similarcalculations for Cs*** and Zn"? give a total of about
120 mr/year from the knowninternally deposited

radioisotopes. This is to be compared with the

dose rate from natural sources,'*® of which 44
mr/yearare attributed to K'°, radium, and meso-

thorium distributed internally and 134 mr/year
to cosmic rays and local external gamma sources.
From local external gamma sources the Rongelap
people as measured in March 1958 werereceiving
about 250 mr/year and in August 1958, 500 mr
year. (The latter increase was due to slight addi-

tional short-lived fallout from a then currenttest
series and the integrated dose for the year might
be expected to be <(500 mr.)

Discussion
ACUTE AND SUBACUTE EFFECTS

Theresults of the medical survey on the Rongelap people 4 years after exposure to fallout show
that the people have largely recovered from the
acute and subacuteeffects of their exposure and
are making satisfactory readjustmentto their repatriation on Rongelap Atoll.
The acute effects of radiation that were observed early in these people were indicative of
significant exposure. Findings unquestionably
related to their exposure were early gastrointestinal symptomsandsignificant depression of the
peripheral blood elements commensurate with the
calculated dose of 175 r penetrating gammaradiation, beta burnsof the skin and epilation from skin
irradiation, and the acquisition of a low level body
burden of radionuclides. In addition certain other
findings were possibly related to their exposure
such as (1) loss in weight of several pounds in most
of the people during thefirst several monthsafter
exposure and (2) suggestive evidenceof a slight
lag in growth and developmentof exposedchildren duringthe first 3 years based on studies of
height and weight and bone development. (A reevaluation of these studies is necessaryin viewof
uncertainty in ages of someofthe children.)
Other acute and subacute effects of whole-body
irradiation which have been reported to occur
have not been observed in the Marshallese. (1)
Fertility, based on comparison of frequency of

pregnancies, did not appearto be affected: (2)
no deleterious effects were noted on the course of
pregnancies; and (3) the four in utero irradiated
babies appeared normal. It should bereiterated
that completely negative statements cannot be

made based onthese findings because of the pau-

Select target paragraph3