64 use of crab meat as a food item should continue to be avoided. Other foods, however, are responsible for the '3’Cs levels found. Summary Medicalsurveys were carried out on the exposed people of Rongelap Island in March 1965 and March 1966. In 1965 the comparison population was also examined, and in 1966 the exposed population of Utirik Island was examined. were born in the exposed group, but two (hydro- cephalic and mongoloid) were born to two unexposed women. The people of Utirik Island appeared to have been in good health and reported few serious medical happeningsover the past 3 years. The birth and deathrates in this group appeared to be similar to those in the Rongelap group. PHYSICAL FINDINGS Asnoted in previous surveys, the variety and distribution of physical abnormalities (with the INTERVAL MEDICAL HISTORY Juring the past 2 years the Rongelap people have been generally in good health with satisfactory exception of thyroid pathology) did not appearto be significantly different in the exposed people as nutritional status. No unusual epidemics of disease compared with the unexposed population. The occurred in the Ailingnae group (originally exposed to 69 rads). No autopsy was obtained, but children, previously noted, have continued. No occurred. Over the 2-year period 2 deaths had the deaths occurred in older people with no obvious connection with radiation exposure. One death occurred in an older woman of the comparison population. The death rate has been higherin the exposed population than in the unexposed population, which mayinpart be related to the larger percentage of older people originally in the exposed group. Birth rate has been about equalin the exposed and unexposed groups. No miscar- riages or stillbirths were noted in the exposed T T T F q r T r q T ao. r OME f MIC AL a [SEPARATION AND ~\ Fg - COUNT x [ aT . cs IN MUSCLE CORRECTED TO DATE OF COLLECTION J = iO? arn 10 L COCONUT CRAB 4 r (BIRGUS LATRO) - RONGELAP ATOLL "co 1N MUSCLE KABELLE ISLET ! | 1 1954 i955 1956 1957 ° 3 4 CGRREC™ED TO MARCH, 1954 . . 7 i ‘ee + 1 L 1 L 1958 1959 1960 (96! COLLECTION DATE 1 i THYROID FINDINGS The dosimetric calculation for radiation dose to the thyroid from internal absorption of radioactive iodines from thefallout was reviewed. Early thyroid studies including protein-boundiodine determina- tions, iodoprotein levels, dietary iodine and urinary excretion of iodine, thyroid uptake of radioiodine, and serum cholesterol levels were reviewed. Thyroid abnormalities during the past 3 years higher exposure group thyroid abnormalities occurred in 79% of the children exposed at <10 4 | leukemia or cancer (except one thyroid cancer) was detected. have increased to 18 cases, 16 with nodules and 2 * DATE OF COLLECTION f 103 trends toward growth retardation in the exposed with hypothyroidism. It is noteworthy that in the 595, IN SKELETON CORRECTED TO pci/g DRY women duringthe past 2 years, but 5 miscarriages occurred in unexposed women. No abnormalbabies : 1962 1963 1964 Figure 71. Analyses for °°Sr, '°’Cs, and *°Co in coconut crabs of northern Rongelap Atoll since 1954. (Courtesy of E. Held, University of Washington.) years of age, as compared with nocases in the children of the Ailingnae, Utirik, or unexposed groups. Only one adult in the Ailingnae group developed a thyroid nodule. Several nodules were noted in the thyroid glands of older Utirik and unexposed adults of Rongelap. Surgery was performed in 11 cases: 9 children and | adult were found to have adenomatousgoiters, and | adult a mixed papillary andfollicular carcinoma ofthe thyroid gland with localized metastasis. The gross and microscopic appearanceof these lesions was described and depicted. Correlation of growth retardation in exposed children with thyroid pathol- ogy was indicated bythe recentfinding of definite