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-6From this and other evidence, it appears that iodine-13] is|consid-~
erably less effective than comparable doses of externally applied X-rays
in producing thyroid cancer. The magnitude of this difference cd4nnot be
stated since not-a single confirmed case ascribable to iodine-13] is known.
In making a comparison it must be kept in mind that X-rays are ofdinarily
delivered at a high dose rate in a single sitting or in a few divided doses;
and the thyroid as well as the blood vessels supplying it and thq adjoining
tissues are wmiformly exposed, In addition the age of the patierts treated
and their clinical conditions are rarely the same in the two typds of treat-

ment,

If the radiation were administered at the same low dose rdte for both

iodine-131 and X-ray, the ostensible difference might not be as

6.

great.

Reactor Accident

In a reactor accident, radioactive iodine was released to the
environment! , and control measures were instituted to prevent human thyzpid doses
from exceeding 20 rads. No increase in the incidence of thyroid freoplasia
in this area has been reported, but it must be remembered that the
complete
effects of this episode will not be known for many years.
7.

Total Radiation Doses in Childhood Cancer of the Thyroid
Although thyroid cancer occurs in children who are not knownjto have

been exposed to artificially produced radiation, some history of

K-ray ex-

posure has been obtained by several workers in well over half the] cases
in which careful inquiry has been made. The X-ray doses received|by most
of these subjects are difficult to determine, but by tracing the fecords
of radiologists it appears that the smallest doses associated with subsequent cancer range from about 100 r measured in air upwards. Only a very
small number at these low levels have been reported.
8.

/

Thyroid Abnormalities in a Marshallese Population Exposed to
Radioactive Fallout

The development of thyroid nodules and hypothyroidism has begn noted
in a number of Marshallese people of Rongelap Is}and in the Pacific who
had been exposed to radioactive fallout in 1954.9 This developmegt is
believed to be a late effect of irradiation of the thyroid gland grom
intermal absorption of radioiodines and from external gamma radiafion at
the time of the fallout. A total of 64 Rongelap people (54 living in
1966) received a whole body dose of gamma radiation of 175 rads, qxtensive

direct irradiation of the skin from deposition of fallout thereon fand in-

ternal absorption of radionuclides in the fallout. Eighteen othe
Rongelap people (14 living in 1966) received a lesser exposure of Jabout
70 rads of gamma radiation along with a smaller dose to the skin
and
internal absorption of less amounts of radioelements. A total of [157
individuals on the island of Utirik received a whole body gamma ddse of
approximately 14 rads.

%conard, R. A., Rall, J. E., and Sutow, W. W.: Thyroid Nodules aq a Late
Sequela of Radioactive Fallout.

New England J. Med. 274:1392-1399, 6/23/66.

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