0.40 for the Utirik and Comparison group,
indicating nostatistically significant differences.
Causes of Recent Mortality:
The number of deaths occurring in 1988
through 1991 is as follows: Rongelap - 1: Utirik 3: expanded Comparison group- 10 (see p. 1 for
the description of this group). The clinical events
surrounding the deaths are described below.
100
TYPrprrrprerrprr rrp
rrr
pr
ree
pr rrr
yp rr
rrp
err
80 -
4
+
Bor
Q 70F
4
4
>
ee tee
= er
& sop
2 40 ~=—— RONGELAPANDAILINGNAE EXPOSED(86)
30k ------ UTIRIK EXPOSED
a9 RONGELAP COMPARISON GROUP
:
7
4
w
(167)
—(86}
4
10r
4
go bttetitbrristiiisntisii tigitiriitbiii itis
1955
Fig.1:
1960
1965
1970
1975
YEAR
1980
1985
1990 1995
Percent survivors of the different exposure groups
since 1954. The numberof persons initially in each
group is shown in parentheses.
Rongelap:
Subject No. 1. Advanced complications of
diabetes mellitus were the cause of death in
December 1991 of this 58-year-old man. He had
been referred to the Straub Clinic in Honolulu a
month earlier for a scheduled colonoscopy
because of a history of colonic adenomatous
polyps. At that time no evidence of malignant
disease was uncovered, and chronic renal failure
was felt to explain the anemia, abnormal mental
status, and neuropathy that had been developing
in recent years.
Utirik:
Subject No. 2. The death certificate of this 54-
year-old woman lists "sepsis" and “diabetic
gangrene/cellulitis (left) foot" as her cause of
death in April 1991. She had diabetes mellitus
with retinopathy and probably nephropathy, and
she was last seen by the medical team in March
1990. At that time she had a guaiac-positive stool
felt to be due to hemorrhoids. Her mammogram
was “negative” and her Papanicolaou smear was
normal, An alpha-fetoprotein level was normal (she
was known to be hepatitis B surface antigenpositive), and a chest x-ray showed only pectus
excavatum.
Subject No. 3. This 52-year-old man,a cigarette
smoker, died in 1990; death certificate cause of
death: malignant lymphoma with marked gastric
involvement. When last seen by the Brookhaven
medical team (April 1989) the patient had
borderline hypertension requiring no therapy. No
lymphadenopathy or splenomegaly was noted. He
had symptomsconsistent with esophageal reflux, for
which he was given antacids. His blood count,
urinalysis, stool guaiac and electrocardiogram were
normal. A chest x-ray had been normal in 1988,
and a flexible sigmoidoscopy was normal in 1987.
His serum was known to be positive for hepatitis B
surface antigen, but the alpha-fetoprotein level was
normal in 1988 (2.5 ng/ml). The death certificate
diagnosis was made onclinical grounds. No tissue
diagnosis was possible. The patient died while
departing Majuro to have an evaluation in Honolulu
for his dysphagia and weightloss.
Subject No. 4. This 80-year-old woman died on
Utirik in 1988; in recent years she had become
severely incapacitated with shortness of breath and
arthritis of the shoulder.
A medical team
cardiologist diagnosed mitral regurgitation
(secondary to ruptured chordae tendineae) and mild
aortic stenosis/insufficiency. She was on digoxin
and hydralazine for this. The joint problem, which
was due to a shoulder injury at an early age and
subsequent degenerative changes, was handled with
acetaminophen. Her blood count when seen in
March 1988 was normal except for a mild anemia
(hemoglobin: 10.1 g/dl), present since 1984
(hemoglobin: 10.6 g/dl). Serum creatinine was
normal in 1987, as was a Papanicolaou smear.
Because of restricted mobility her medical exams
were done in her home. She was unchanged
clinically when last seen in September 1988. The
cause of death is unknown.
Comparison population:
Subject No. 5. This 67-year-old man died on
Ebeye in 1988.
When last examined by the
Brookhaven team (1985) his medical problems
included marked obesity and chronic renal failure of