FALLOUT EFFECTS—MARSHALL ISLANDERS 59 about half normal levels, but without definite clinical signs or mortality and requiring no specific therapy. Contamination of the skin resulted in widespread “beta burns” and epilation. These lesions healed and hair regrew normally within several months. These findings were not seen in people exposed on Utirik and were present in the servicemen to a lesser extent. It is noteworthy that no early effects of the internal absorption of radioiodines or other radionuclides were noted. Indeed, nearly a decade passed before effects of thyroid exposure could be documented. During the subsequent years, prior to the development of thyroid abnormali- ties, there were few findings that could be related to radiation effects (10-13). The general health of the exposed people appeared to be about the same as that of the unexposed people. Vital statistics suggested that mortality andfertility rates were about the same. During the first 4 years, there appeared to be an increase in miscarriages andstillbirths in the exposed Rongelap women, but this observation was uncertain in view of the small numbers involved. Genetic studies and examinationsof the newborn have not revealed any detectable abnor- malities that might be related to radiation exposure. A slight increase in chromo- somal aberrations in lymphocytes was noted in the exposed Rongelap people. Neoplasia (including a fatal leukemia) and thyroid abnormalities are discussed below. NEOPLASIA (NONTHYROID) A numberof benign tumors have been detected in both exposed and unexposed people in the normal range of expectancy (13). It is noteworthy thatin spite of widespread beta burnsof the skin, no chronic radiation dermatitis or skin cancers have appeared, and only a minimum amount of scarring and pigmentation can be seen. A numberof benign nevi were seen in the healed areas of neck lesions in several women,but these have not increased in recent years. , Twocases of pituitary adenomas have occurred. One was a nonfunctioning adenomain a 40-year-old exposed Rongelap woman that developed several years after removal of a thyroid carcinoma. The patient responded well to x-ray therapy. The second adenoma was a prolactin-secreting tumor recently discovered in a 27-year-old exposed Utirik woman who is now undergoing treatment. In neither case was there evidence that hypothyroidism was a promoting factor, as has been reported (38,58). Neither does it seem likely that radiation exposure was the etiological agent, since pituitary adenomas have not been reported in recent reviews to be radiation induced (52). Except for thyroid carcinomas, the documentation of possible radiation-associated malignancies in the Marshallese has been subject to uncertainties owing to the infrequency of autopsies or reporting offinal diagnoses and unsatisfactory statistics on malignancies in the Marshallese people. A number of deaths in older women were thought to be due to cancer of the female genital tract,