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