EXPOSURE GROUPS The medical program examines and treats about 800 persons annually. However, the populations on which this report is based include only the exposed persons and a selected group of unexposed individuals. In December 1987, the numberof exposed persons was: Rongelap50, Ailingnae - 12, and Utirik - 112. For most purposes in this report the Rongelap and TOT TIT OT a4 Lo. L.. The content of this report is restricted to the more recent medical findings, some aspects of which bearon late effects of radiation exposure. Those features of the Marshall Islands Medical Program by which medical diagnosis and treatment are provided are discussed. For detailed information on the nature of the 1954 fallout and the acute effects suffered by the population, the readeris referred to several earlier publications (Bond, et al., 1955; Cronkite et al., 1955; Cronkite et al., 1956; Conard et al., 1957). Other reports provide reviewsof delayed effects of the exposure (Conard et al., 1980; Conard, 1984; Robbins and Adams, 1989). 00 90 — BOF 70 - Oe 60F “hee 50r 4Q- 30- 20r ne La 0555 —— RONGELAP AND AILINGNAE EXPOSED ( 86} (167) ---~ JTIRIK EXPOSED ~~ RONGELAP COMPARISON GROUP (86) 19601985 1970 197519801985 YEAR wt iL This report updates, through 1987, the medical findings on a population of Marshallese accidentally exposed to radioactive fallout in 1954. The Marshall Islands Medical Program of the Medical Department, Brookhaven National Laboratory, issues these summaries for distribution to institutions and individuals worldwide whoare concerned about the adverse medical consequences of radiation exposure in general or, in particular, the plight of the radiation-exposed Marshallese. The exposed Marshallese population originally comprised 64 persons on Rongelap Atoll whoreceived an estimated 190 rads of wholebody external gamma radiation, 18 on Ailingnae Atoll who received 110 rads, and 159 on Utirik Atoll who received 11 rads. In addition, there were 3 fetuses on Rongelap, 1 on Ailingnae, and 8 on Utirik, each of which received equivalent whole-body doses. Because of radioiodines in the fallout, the thyroid gland received an additional exposure that was muchgreater than the whole-body dose, although its magnitude was, in part, a function of age at the time of exposure (Lessardet al., 1985). Ailingnae groups are combined andreferred to as the Rongelap group, for those persons exposed on Ailingnae atoll were visiting from nearby Rongelapat the time of the fallout. Also examined was the Comparison group that dates from. 1957 when 86 unexposed people from Rongelap were selected so that the Comparison group approximated, in age and sex distribution, the exposed Rongelap group (Conardet al, 1958). Sixty persons remain in this group, againstwhich theoverall survival of the exposed population is compared (Figure 1). However, a larger unexposed group is also followed. Currently numbering 135, the age and sex distributions of its members werestatistically similar to those of the Rongelap and Utirik groups in 1982 (Adamset al., 1983). Included among the 135 are most ofthe remaining 60 individuals selected in 1957. It is this expanded unexposed population that is used for statistical comparisons of year-to-year medical events; this provides the baseline prevalences from which any unexpected consequencesof the radiation exposure can be identified. % SURVIVING INTRODUCTION 1990 Fig. 1: Percent survivors of the different exposure groups since 1964. The numberof persons in each group are given in the parentheses. THE MARSHALL ISLANDS MEDICAL PROGRAM Policies: The Marshall Islands Medical Program provides medical care twice yearly to the exposed population by visiting the islands where most now reside, namely Rongelap (and, temporarily, Mejato), Utirik, Ebeye, and Majuro.In addition, the medical team provides health care to a con-