458 FALLOUT EFFECTS—CONARD & HICKING Internal absorption of radionuclides, largely from eating and drinking contaminated food and water, and to a lesser extent from inhalation of fallout, resulted in detectable radioactivity in urine samples. However, during the first few days when the body burdens were highest the maximum permissible concentrations were exceeded only for **Sr and the radioisotopes of iodine. The dose to the thyroid glands of the adults from the radio- iodines absorbed was estimated to be about 150 to 160 rads. Follow-Up Health Status.—Medical evaluation of the health status of the exposed people over the years since the accident has revealed about the same incidence of illness and disease as noted in the unexposed population with certain exceptions noted below. General health and nutrition have continued to be satisfactory and comparable to the unexposed comparison population. Annual hematologic follow-up studies revealed that the levels of white 2. Gross picture of sectional thyroid gland showing nodules in 14-year-old Marshallese girl. group, it was not statistically significant. The e posed girls showed nosignificant differences cor: pared with unexposed girls. The slight retardatic of growth noted in the bows suggests that radiatic may be a causal factor, although possible mech: nisms are not clear. The dose to the bones from »: ternally absorbed isotopes is believed to have bee too small to have affected bone growth. These fin: ings are being published in detail by Sutow et al Development of Thyroid Nodules.—Thyroid noc ules were detected in three girls nine and te blood cells and platelets of the peripheral blood in the exposed group never quite reached thelevels of the unexposed comparison population (Fig 1). years after exposure; two girls were 13 and on was 14 years of age at the time of detection. The: girls were in the higher dose group in which thei were 29 children (<18 years of age); 17 of the 2 were girls, with 6 girls in the 10 to 15 year range for the other Marshallese people. A recent study in which certain criteria of aging were put on a and 21 of the girls were in the age range of 10 i Mortality and Aging.—There were ten deaths in the exposed population over the ten-year period: this represents a mortality rate near that observed numerical basis did not reveal any differences in age scores between the exposed and unexposed groups.” Fertility, Miscarriages. Stillbirths, and Genetic Effects.—Effects on fertility were not apparent as judged by comparison of the birth rates for the exposed and unexposed populations. Possibly related to radiation exposure was the fact that dur- Of 75 unexposed comparison children, 37 were gir. 15 years. No thyroid nodules were noted in thi latter group. No lymph node involvement wa grossly evident. The individuals were hospitalize and two had complete thyroidectomies and th third a partial thyroidectomy. Grossly. the gland had a cobblestone appearance with multiple har nodules and wereat first thought to be malignant ing the first four years after exposure an increase Sections of the tissues were reviewed by a numbe of pathologists, all of whom agreed that the nod ules were not malignant and resembled in man: exposed women, 41% ficiency, with its characteristic regenerative rathe in miscarriages and stillbirths was noted in the of the births (13 in 32 respects adenomatoid goiter seen with iodine de spring compared with 21% (8 in 38 births) in the than neoplastic proliferation. It should be note that goiters are rare in the Marshall islands sinc no iodine deficiency exists (Fig 2 and 3). of abnormalities in children of exposed compared 3. Section of thyroid gland shows characteristic multiple, discrete noduies with wide variation in size and births) in this group terminated in nonviable off- unexposed women. Nospecific genetic studies have been carried out, but no difference in incidence with those of unexposed women has been observed. Growth and Development Studies.—Anthropometric examinations of the 42 exposed and 75 unexposed children have been conducted over the past five years. Using nonparametric statistical meth- ods, comparisons of weight, stature, and bone age (the latter determined from roentgenograms oi the wrist and knee) were made between exposed and unexposed children of the same age groups. foal gta! pd Boys exposed at 1 to 5 years of age showed retardation of statural growth as well as bone age. This was most marked in those boys exposed at 12 to 18 months of age. The average skeletal maturation in the exposed boys was about seven months behind their unexposed peers. Though weight gain also appeared slightly retarded in this growth pattern. Some consist of microfollicular tissue, some of colloid cysts, while others show hyperplasia with papillary infolding of epithelium.