TITLE Human Health Effects from Energy Generation: BUDGET AND REPORTING CODE Medical Studies of the People of the Marshall Isiands Accidentally Exposed to Fallout CONTRACTOR NAME CODE Associated Universities, Inc. 20e. DATE PREPARED HA-02-01-01 BNL WP NUMBER 03/31/80 TASK NO. REV. NO. 0 Approach cont. Fiscal control will be exercised in the form of monthly comparison of actual costs incurred against corresponding line items in the budget. Substantive progress shall be monitored through a periodic review of accomplishments conducted by the Contract Task Manager. 20£. Technical Progress. Technical Progress in BY-3 (FY 1979). In response to requests by the people of Rongelap and Utirik, the Department of Energy agreed in February 1977 to assist the Trust Territory in an expanded health care program for the people living at Rongelap and Utirik Atolls. Accordingly, during the January - February 1979 survey (25 years post-exposure), all Marshallese living on these atolls, who wished it, were given complete medical and laboratory examinations similar to those in the exposed group. Greater physician-patient relationship was attained by lengthening the stay on the islands, which necessitated doubling the size of the medical team by releasing one team after 2 1/2 weeks to return to the United States and utilizing a second team for the second half of the survey. A 2nd survey covering 4 weeks in May and June concentrated primarily on pediatric evaluations and sick call plus a reevaluation of those thyroid nodules found on previous surveys. On the final three days of that survey Dr. Brown Dobyns, thyroid surgeon, flew out to Kwajalein and the entire team evaluated the 14 prospective surgical candidates. All were cleared for transfer to Brookhaven National Laboratory for medical evaluation and then on to Cleveland Western Reserve for definitive surgery. The group was divided into nine patients who underwent surgery in early July, and a group of five who underwent surgery in September. A third survey was conducted in September and October covering a five week period. This survey was directed towards the treatment of dental and ophthalmologic problems and the treatment of intestinal parasites on the major islands. Thyroid abnormalities continue to be the only definitive findings related to radiation exposure. During the past year, thyroid surgery was done on seven of the exposed group and five of the unexposed comparison group. [In addition, Surgery was performed on two Marshallese from Wotje Atoll who were not in the long term study groups; one of these lesions turned out to be a carcinoma. There have now been 48 thyroid abnormalities (41 with surgery) among the 246 exposed Marshallese (4i% of the Rongelap people and 8% of the Utirik people). The occurrence of three thyroid cancers in the exposed Utirik population (compared with four in the Rongelap group) appears to indicate radiation exposure in the etiology, but the high incidence is puzzling since it is greater than would be predicted based on Rongelap and Japanese data and there does not appear to have been any increase in benign thyroid tumors in the Utirik group compared to the greater prevalence in the Rongelap group. Because of the uncertainty of the incidence of thyroid tumors in unexposed Marshall Islanders and in order to obtain better statistics, thyroid examinations were included for all unexposed Rongelap and Utirik people on any of the Marshall Islands visited. This study has been extended to include thyroid surgery when indicated. Also, in order to help solve HA~o> 255 [045221