that exposed people neither have aged faster nor appearolder than similarly aged unexposed Marshallese. No doubt the subtle changes which occur with aging would be difficult to detect overthis period of time. During the 4-year survey, data were collected in an attempt to obtain semiquanti- tative estimates of biological age by scoring the degree of certain criteria such as greving of the hair, skin looseness, skin retractility, arcus senilis, retinal arteriosclerosis, accommodation, blood pressure, etc. These data have not yet been completely analyzed. Degenerative diseases’'-*° have not been found to be increased in the exposed people. No malig- nancies have been detected. In the irradiated Japanese an increased incidence of leukemia has been noted.""-** There have been no cases of leukemia or leukemia tendency noted in the Marshallese. (No cases have showndecreasein alkaline phosphatase of neutrophils, nor have increased levels of basophils been noted.) Since the inci- dence of malignancy or leukemia would be ex- pected to be relatively low with the doseof irradiation received, and since such a small population is involved, the probabilities are good that such effects will not be observed in the Marshallese. Ophthalmological changesrelated to late effects of radiation’*"'® have not been seen. Slit-lamp observations over the past 4 years have revealed no polychromatic plaques or cataracts. Nodifferences were foundin visual acuity in the exposed and unexposed children. Genetic effects.°°°' No specific studies for genetic effects have been conducted. Of the 18 babies born to irradiated parents and living at the time of examination, none showedany abnor- malities. In view of the generally negative findings in the studies of the first-generation offspring of the irradiated Japanese,”it is unlikely that genetic studies in this group will be fruitful. Beta irradiation. Nolate effects of beta irradiation of the skin such as chronic dermatitis or premalignant changes have been found in the Marshallese. FINDINGS COMMON TO BOTH EXPOSED AND UNEXPOSED GROUPS Certain findings commonto both exposed and unexposed Rongelap people may havepossible significance in relation to their state of health and future prognosis. Clinical laboratory examina- tions have revealed a complexity of findings diff- cult to evaluate. Principal among these is the anemic tendency in the population at large. Hematocrit values of 38% or less were found in 54% of the men, and of 36% or less in 78% of the women. Also possibly related to this finding was the increase in reticulocyte counts (>>3%) in about 20% of the people noted during the 3-year exami- nation. The following have been considered as possible etiological factors: 1) Nutritional deficiency, such as lowdietary proteinsor iron deficiency. Althoughthedietis extremely limited and fish supplemented by small amountsof other meats are about the onlysource of proteins, there is no good evidence that sucha deficiency exists. In fact the blood proteins are high (average 7.8 g%). It is not known whether the diet is deficient in iron. Blood smear examinations did not reveal any obvious microcytosis of red cells. The nature of the anemic tendencywill be further investigated in the next survey by carrying out serum iron determinations and running Price-Jones curves of the red blood cells. Poor absorption or deficiency of vitamin B,, is apparently not a factor since the levels of B,. in the serum weresurprisingly high. (Experience with Diphyllobothrium latum infestation suggests that parasitism of the gastrointestinal tract should be associated with low vitamin B,, serum concentra- tions.) The relatively high values of serum vitamin B,. are puzzling, and no immediate explanation is apparent. 2) Intestinal parasitism is very prevalent, 72% of the people showing stools positive for ova and parasites. However, examination ofthese stools for occult blood showedpositive tests in only 10 people. Chronic bloodloss from this source does not seem likely; also, anemiais not usually associated with the parasites found in these people. 3) Chronic infections, particularly skin diseases and dental caries, may play an etiologicalrole in the production of the anemic tendency. The high plasmaprotein levels with high gamma globulin component maybea reflection of such infectious processes. The presence of eosinophilia in the population is another puzzling problem. (Abouthalf the people show eosinophils >5% in their differential counts with quite a few values as high as 20 and 25%.) Offhand, it might seem that the highincidenceof intestinal parasites might accountfor the high eosinophil counts. However, as pointed out, most of the types of parasites found are not wane wer mee ar epmcomtsSEBTRapeNE ea 30