20
gevity in the exposed Japanese people are notyet

available.
Degenerative diseases. An increase in degenerative
diseases has been reported to occurin irradiated
animals as evidence of premature aging.'”’* No
such increase in degenerative diseases has been
noted in exposed Marshallese compared with unexposed populations. Again, lack ofvital statistics
hampersevaluation.
Carcinogenesis and leukemia. Increased incidence
of cancer in animals has been noted even with low
doses of radiation.'*:?* Increased incidence of
leukemia has been reported ‘n the exposed Japanese populations.**'?* In the exposed Marshallese
no cancer (or leukemia) has been seen. Base-line
studies have been carried out during the past two
years for alkaline phosphatase levels of the neutrophils, and no consistent decrease of this enzyme
indicative ofearly leukemia has been seen in anyin-

dividuals. In addition, no increase in basophils in

the peripheral blood (based on counts of 4000
white cells) has been noted. Decrease in alkaline
phosphatase activity of neutrophils and increase
in basophils were noted in Japanese cases that
later developed full-blown leukemia.?*"6
In view of reports of thyroid malignancy and
leukemia in individuals who as young children
had received moderate doses of irradiation over
the thymic region,*” the thyroid andits function
are being studied in the Marshallese. Theestimated dose of 300 rep to the thyroid from iodine131 and gammaradiationis in the lower rangesreported to have resulted in malignancy. During
the present survey, the exposed and unexposed
people were screened for cholesterol levels of the
sera. No abnormally highlevels indicative ofthyroid hypofunction were noted. (During the next
surveyit is planned to determine protein-bound
iodine levels in all children.)
The incidence of leukemia and malignancy
would be expectedto be relatively low with the
dose of radiation received by these people, and a
significant numberof cases would be seen only in
a large population; therefore, the probabilities are
good that such effects will not be observed in the
Marshallese.
Ophthalmologicaleffects: Visual acuity. In exposed
teen-aged Japanese children, slight loss of visual
acuity has been noted nine years after exposure.'*
No differences were found in visual acuity in the

exposed and the unexposed Marshallese children.

Opactties ofthe lens. Radiation induced cataracts
and polychromatic plaques of the lens have been
observed in exposed humanbeings.”*?* Careful
slit-lamp observations revealed no such changes
in the Marshallese. Even if such changes do develop,it is probably too early to expect them yet.
Genetic effects. Radiation induced mutations of
the germ plasm in animals produce abnormalities
in the offspring.***? However, extensive studies by
Neelet al.* in the first generation children of exposed Japanese people have failed to show any
significant abnormalities. In the case of the Marshallese, no anomalies have been obse~vedin the

13 babies born since the event. Unfortunately the
productof the miscarriage and the two deadinfants were not examined.

There are several factors which, offhand, would

seem to makegenetic studies in the Marshallese
likely to be fruitful: 1) The people live together as
a unit and thus are easily available from year to
year for study. 2) They appear to be a rather
homogenousrace anthropologically, having lived
in the Marshall Islands for about 2000 years with
little outside intercourse. Intermarriage for such
a period of time tends to produce genetic homogeneity. Height, skin color, and featuresare fairly
uniform. 3) Consanguinous marriages are prevalent (first-cousin marriages on the maternalside
only are indeed in good taste) and have produced
a backlog of “bad” genes as evidenced by the high
incidence of congenital anomalies. Radiation induced mutations wouldbelikely to be reinforced
by such marriages.

In spite of these factors, the small numbers of

people involved in this study (compared to the
large numbers in the Japanese studies) makeit

unlikely that these studies will be fruitful.
Superficial Irradiation of the Skin

Thus far there has been noindication of any
premalignant or malignant change grossly or
microscopically in any of the residual areas of
scarring atrophy and pigmentaberrationsresulting from the beta burns. The complaint in some
individuals of further epilation during the past
year was not substantiated by physical examination. The residual skin lesions are being kept under close surveillance for possible malignant
changes. Exposureto tropical sunlight, trauma,
andhigh incidence of skin infections may enhance

such changes.

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