18 beings with a remarkable reserve margin of safety in protecting against infection. Even at the lowest shallese was most probably dueto the penetrating dose of gamma irradiation. Certainly external half their normal values, there was no detectable evidence of increased susceptibility to infection or increased tendency to bleeding. Indeed, at no time during the past three years has there been any increased incidence of diseases, infectious or noninfectious, in the exposed population compared with the unexposed groups. These people the bones, and the internal adsorption of boneseeking isotopes is not believed to have been large enough to have contributed significantly. The Marshallese children probably received slightly higher dose than did the adults becauseoftheir shorter stature and thinner bodies in field of radiation producedbythe fallout. Even so, the dose of penetrating radiation received was prob- ebb of hematopoietic depression, when the leukocytes and platelets in the Marshallese were about have sustained epidemics of measles, chicken pox, upperrespiratory infections, and gastroenteritis, apparently without any greater incidence or severity of these diseases compared with unexposed groups. A limited study of immuneresponses at three years post-exposure showed thatthe antibody response to tetanus toxoid antigenic stimulus was notsignificantly different in the exposed and unexposed people. However, had this type of study been carried out soon after irradiation,it is possible that some degree of impairmentof antbedy production might have been demonstrated. Metabolic effects: Weight changes. A possible effect of penetrating radiation noted duringthe first few months after exposure was fairly constant weight loss of several pounds in manyof the people, both adults and children. This occurred despite thefact that their appetites were good andtheir food consumption was greater than had beentheir custom. It is not known whetherthis weight loss represented an effect of radiation on metabolism or whetherit was related to the change in environ- ment. Growth and development. It is difficult to evaluate the effects of the radiation exposure on growth and development because of the small numbers of children involved. The lag in growth and developmentas evidenced by differences in weight and height of the 4 to 10-year age group of exposed children was slight, and definite statements cannot be made at this time about the significance of these differences. However, the bone development studies seem to indicate a slight degree of retardation in the exposed group. Lag in growth and development was observed in the Japanese children exposed to the atomic bombs at Hiroshima and Nagasaki.'? It was uncertain whether psychic and physical traumaor economic conditions might be responsible in the Japanese children. Theslight effect on growth and developmentin the Mar- beta radiation would not contribute to the dose to ably too small to have produceda direct effect on the epiphyses. It would seem morelikely that arrest of bone maturation might be from some nonspecific or indirect metabolic effect or possibly hormonaleffect resulting from the radiation. Irradiation of the thyroid gland may have depressed thyroid hormonesecretion and thus delayed bone growth. Further studies of thyroid activity are planned. In utero effects and effects on pregnancy. Four women were pregnantat the time of exposure, two in the first, one in the second, and onein the third tri- mester. These pregnancies progressed uneventfully to normal-term deliveries. The babies all appeared normal in every way, and no microencephaly was presentas has been reported in some babies irradiated zn utero in Japan.'*** Since the event, nine other normal births have taken place. One miscarriage and two infant deaths have occurred, butthis incidence does not seem greater than that in unexposed Marshallese people based on limited numbers of observations. Fertility. It is entirely possible that a temporary loss of fertility may have occurred shortly after exposure in someof the people. However, careful investigation of the possible effects of the radiation exposure onfertility has not been possible. Comparison ofthe frequency of pregnancies in the ex- posed and unexposed groups does notindicate any detectable effect of radiation exposure on fertility. As pointed out, however,satisfactory vital statistics are lacking, and the numbers ofindividuals are too small to reach any definite conclusions. In a limited medical survey of the Central Pacific Islands carried out by the U.S. Navy in 1949 and 1950,'* limited statistics on pregnancies in the Marshallese were reported. Pregnancies among the exposed Rongelap women during the past three years are within the range 18 to 32 per 1000 population reported in the above survey.

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