The results support the notion that external risk coefficients are
different from internal risk coefficients following exposure to a gnixed

_ fadiation field. The total risk coefficients [3. Oxl0-? (+4.“5x10” 6) cancers
per person-rad-year at risk, 10-year latent period, and 2.3x10
(+3. sxl0-2
cancers per person-rad-year at risk, 5-year latent period] are similar to the
literature values (1,2) for this_age distribution and for external exposure+
The literature values are 2.1x10
for a lO-year latent period and 1.9xl0™

for a S-year latent period. However, if the risk is examined as a function of
age or as a function of dose, differences are encountered. For example, the
ratio of the risk coefficient for external exposure to the risk coefficient
for internal exposure, in the <10 year age group, is 2.5 (0.38 to 4.6).
In
the 10- to 18-year age group, this risk coefficient ratio is 9.40 (0.22 to
2.6).
Small group size, in this study, and the uncertainties reported in

studies on medical and fallout exposures make it difficult to establish rela-~
tive risks of thyroid cancer from internal and external radiation doses to the

thyroid. The possible synergistic effect of internal and external exposures
and the modifying factors such as high TSH levels and nonuniform irradiation
of thyroid cells complicate the biological interpretation of the risk.
In
this study, different age groups correspond to different dose levels, and very
high dose to the thyroid may be a significant modifying, pastor. Because of
the high interest in evaluating human sensitivity to
I, continued efforts
are needed to obtain data and to conduct analyses that will establish better

estimates of risk coefficients than are now available.
It is not likely that
data for the Marshallese exposures will contribute to the answer to that
important question.

ACKNOWLEDGMENT
The authors fully appreciate the efforts of John Baum, Associate Head for
Research in the Safety and Environmental Protection Division, for his review
of this manuscript.
This work was performed by members of Brookhaven National Laboratory,
Associated Universities, Incorporated, under contract No. DE-ACO2-76CHO0016

with the United States Department of Energy, and under contract No. YO1-CP-

40503 with the National Cancer Institute.

REFERENCES
1. Committee on the Biological Effects of Tonizing Radiation, The Effects on
1980,
Populations of Exposure to Low Levels of Ionizing Radiation:
National Research Council Report, National Academy Press, Nashington, DC,
1980.
2. Recommendations of the National Council on Radiation Protection and
Measurements, Induction of Thyroid Cancer by Ionizing Radiation, NCRP
Report No.80, Bethesda, MD, 1985.

3. Lessard, E.T., R.P. Miltenberger, R.A. Conard, $.V. Musolino, J.R. Naidu,
A. Moorthy, and C.J. Schopfer, Thyroid Absorbed Dose for People at
Rongelap, Utirik and Sifo on March 1, 1954, Brookhaven National Laboratory
Report, Upton, NY, BNL 51882, 1985.

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