where 144 people were examined. Theship served
as a base of operations and laboratory (Figure 2).
The physical examinations at Utirik were carried
out in tents ashore (Figure 3).
Several unfavorable factors associated with the
examinations should be mentioned:
1) The language barrier made the examinations
difficult since very little English is spoken by the
Marshallese.
However, sufficient interpreters
have been available to assist the medical team.
2) The lack ofvital statestics from the Marshallese
imposes a serious difficulty in interpretation and
evaluation of the medical data. Such statistics
would be extremely helpful in evaluating the
long-term effects of radiation. In recent years
records ofbirths, deaths, etc., have been kept by
the health aids or magistrates and supposedly
forwarded to the district administrator; however,
such records have been poorly kept or lost and
thusvital statistics are practically nonexistent.
3) Another factor was the uncertainty ofexact ages
of some of the Marshallese, particularly in the
older groups, largely due to lack of written birth
records. Exceptfor the first, birthdaysarelitte
observed.
4) The medicalstatusis also complicated by
unhygtenic living conditions evidenced by the presence
of parasitic infestation, chronic skin diseases, and
extremely poor oral hygiene. Possibly dietary deficiencies also exist (this will be further evaluated
on later surveys).
5) During the course of these studies over the
past three years, difficulties have been encountered in 0btaining what could be considered as entirely adequate populations to act as comparison groupsfor the irradiated
people. Two separate comparison groups had been
used in the past, each comparableto the exposed
groupin size and closely matched for age and sex.
These groups are represented in hematological
graphs of this report as A and 8 (8, and B,). The
A population was chosen at Majuroat the time of
the initial examinations, but at six months post-
exposureit was found necessary to select another
group,the B, group, since many members of the
A group were missing (had migrated to otherislands, etc.). At the two-year examination, the B
group (8, ) was used again even though about
one-third of the group was missing. The people
in the 4 and B groups were mostly Marshallese
from the eastern chain of the Marshall Islands
andare considered to be anthropologicallyslightly
different from people of the western island chain
to which the Rongelapese understudy belong.’
At the time of the present survey,it was found
that during the preceding year the Rongelap pop-
ulation had doubled at Majuro Atoll by the influx
of other Rongelap people who had been away
from the island atthe timeofthe accident but had
since returned. This situation was mostfortunate,
since this group of people was of the samestock
(blood relatives) and was living with the population under study under the same environmental
conditions. These people provided a uniquely appropriate groupto serve as a comparison popula-
tion. Moreover, they matched reasonably weilfor
age and sex and would be available for furure examinations since they planned to return to Rongelap Islandto live. This group is represented as
C in the graphs. For the growth and development
studies, as many of the old B-group children as
could be found were examined in addition to the
Rongelap children in order to expand the number.
for comparison and furnish further longitudinal
data for yearly studies.
EXAMINATIONS
Histories were taken by a Marshallese practitioner with particular emphasis on theinterval
history during the past year.
Complete physical examinations were carried out
including examination ofthe skin with color photography and biopsies of selected lesions; ophthalmological studies includingslit-lamp observations,
visual acuity, and accommodanion; growth and
development studies in children (less than 20 years
of age) including anthropometric measurements
and x-ray examinationsof the left wrist and hand
for bone developmentstudies; audiometer examinations on all over 30 vears of age; ECG records
on all over 40 years of age; and x-ray examinatons as deemednecessary.
Hematotogical examinations included three
complete blood analyses including WBC, differential, platelet counts (phase microscopy), and
hematocrit (microhematocrit method) done at
about weekly intervals. (Only one complete blood
study was carried out on the Uurik people except
for repeat examinations on those with abnormal
counts.) In addition, sickling tests (sodium bisulfide technique) were run, and smears were obtained for reticulocyte counts, alkaline phos-