7.
Detailed
records
of
the
radiation
exposed
population
and of many
control persons are on file at Brookhaven National Laboratory on Long
Island.
8.
Although Brookhaven National Laboratory has primarily been interested
in the occurrence of radiation exposure and resultant effects, it has
by necessity provided limited primary through tertiary health care.
9.
It appears that all the exposed Marshallese and a significant number of
unexposed
Marshallese
have
had
considerable
alteration
and
interruption of their life patterns due to the nuclear weapons testing
program and subsequent investigation and follow-up.
The
migration
intermarrying
of
of
radiation
exposed
potentially
contaminated
individuals
from
other
and
exposed
non-exposed
foodstuffs
atolls,
persons
(fish
persons,
and
non-exposed
to
atolls,
utilization
fruits)
groups
other
by
of
non-exposed
currently
living
on
affected islands, and uncertain exposure coverage, as well as other factors,
makes it difficult to identify radiation affected individuals.
Additional
issues in providing health care for these people are the following:
1.
Any reasonable means to help the exposed population to feel no
nn
different from the remaining Marshallese is desirable in view of
their past unique treatment, fears, and misunderstanding.
2.
It is
inherently difficult and impractical to distinguish with
any precision in any individual case whether a particular illness
is radiation related or not.
3.
Based
Radiation exposure monitoring is expected to continue.
on
recommendations
the
stated
conclusions
and
other
issues,
the
following
are made with respect to known radiation exposed Marshallese
within a comprehensive Marshall Island health care system:
1.
The health records of each person should be available wherever
they are receiving primary and secondary care.
Routine medical
histories and physical examinations should be directed towards
specific
disease
complexes
known
increased
frequency among radiation
or
suspected
exposed
to
have
individuals
an
(e.g.
thyroid nodules).
2.
Although some continued radiation effect monitoring is necessary,
it appears that the frequency and extent should be tapered with
time.
This monitoring should be as non-disruptive as possible yet
still maintain good follow-up and reasonable acquisition of data.
12