Mr. Richard D. Copaken July 23, 1980 Page 3 5. 4, TSH and HIG determinations are not proposed as general 6. As proposed, the Department of Fnergy will be responsible screening parameters, but “as indicated to follow thyroid carcinoma". The implication is that only individuals with the established diagnosis of a carcinama of the thyroid or Suspected thyroid carcinoma on clinical grounds, will be biochemically tested; this is unacceptable. for the preparation, handling and transportaton of bio- chemical analyses of the collected samples. Should hanrdiing, transportation and analysis be rather carried out, by an independent major laboratory? As you are aware, currently, such arrangenents are being finalized and cost analyses are being prepared. Having outlined sane of my objections to the proposed Likiep study, I think that with appropriate modification, it nevertheless, should be instituted with the clear understanding that it would represent an initial phase of screening and data collection in preparation for com pliance with Public Law 96-205. The preliminary conclusions gleaned from the proposed study could, ard should, be used to direct further plaming and implementation of om- prehensive health care to the people of each Marshall Islands atoll that was exposed to radiation — which I gather from Dr. Wachholz' comments in our meeting of April 23, 1980, includes the entire population of the Marshall Islands. Since such care has been clearly mandated by Congress and the President, the proposed Likiep screening study could well be used as an initial step.