Medical teams almost always included an equal complement of Micronesians
trained as medical practitioners, nurses, health aides, and technologists.
These participants were especially valuable in obtaining accurate interval
“histories, which were primarily directed toward detecting conditions with
higher probabilities of radiation association, such as thyroid enlargement or

dysfunction or development of neoplasia in other organ system.
Family and social histories were also obtained to establish pedigrees, periods of residence
on various islands, and smoking and drinking habits, and to supplement demographic data obtained by other means.
Thorough general physical examinations were administered by the medical
staff with special attention directed to examination of the thyroid, skin, female breasts, and other sites of potential oncogenesis.
Preprinted examina~
tion protocol forms ensured uniformity and completeness.
Questionable findings were evaluated by consultation with other staff physicians.
Positive thyroid findings were always confirmed by a consulting thyroidologist before more

extended evaluations and/or surgery were performed in the United States (see
Section IX.B).

Patients 40 years of age or older received standard 12-lead electrocar-

diograms annually (Hewlitt-Packard 1500), a 14x17=-inch P-A chest x ray bi-

annually (or more frequently if indicated by smoking history and/or signs or
symptoms of pulmonary pathology), and annual stool examinations for occult

blood (Ames Hemocult).

Urine was tested for pH, sugar, acetone, blood, and

protein with Ames Labstiks.

Blood for hematologic and endocrine evaluations

was drawn and processed as described in Section III.B. Two-hour postprandial
blood sugars were measured annually in known diabetics and periodically in the

entire study group, and glucose tolerance tests were periodically administered
(see Section VII).
Other biochemical assays, such as those for serum enzyme
activity and electrolyte and metabolite concentrations, were performed at ir-

regular intervals or as clinically indicated in certain individuals.

Dental examinations have been limited essentially to extractions and
Fluoride prophylaxis.
Periodic ophthalmologic examinations have included
slit-lamp inspection for cataracts but not refractions (1).

The pediatric study groups consisted of all children exposed to radia-

tion in March 1954 and a comparison population selected from unexposed
Rongelap children in 1957 who were matched as closely as possible for age and

sex. Attrition in the control group due to death or emigration was compensated by periodic addition of unexposed individuals. Children born to parents
in the adult study groups were also examined routinely as a separate study

group.

The initial composition of these groups is summarized in Table 2.

Rongelap children in each group were examined, generally on an annual basis,
by the medical team, which included a pediatrician each year since 1958, except for the four years 1960, 1964, 1967, and 1973.
In earlier years, the
children on Utirik were not seen as frequently as those on Rongelap, but major
efforts to examine them were mounted in 1957, 1959, 1966, 1969, 1972, and each
year since 1974, when examinations were performed at least annually on all
study groups whether they were residing at Rongelap, Utirik, Majuro, or Ebeye.

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