studies were performed at 6 months, 1 year and annually for Rongelap. Initially, the Utirik people were seen every 3 years. The surveys have included careful monitoring of the 4ematopoetic system as well as the thyroid. The only death in the irradiated group due to radiation occurred in a Rongelap child exposed at 1 year who died of acute myelogenous leukemia; there have been about 50 deaths due to natural attrition. In those children exposed at less than age 1 (and the 4 in utero at Rongelap), over 90% have developed evidence of thyroid abnormalities, adenoma, carcinoma or bio- logic hypothyroidism. 6. New characteristics - in 1957, a "New control" (comparison) population was established due to the mobility of the cohort. This comparison population was closely related to the people of Rongelap and an at . tempt was made to match for age=sex. As the program has evolved there have been significant changes in the comparison popula-— tion and as or this date, there is a relatively poor fit between the experimental and comparison populations. The population of Utirik has developed an unexpectedly high increase of cancer of the thyroid which is unexplained on the basis of their acute initial exposure to radiation. The question has been raised concerning the possibility of the long term effects of low levels of radiation present on both Rongelap and Utirik following the return of the inhabi- tants. epidemiologic survey will be performed as soon as possible by an impartial group. If that survey reveals the possibility of an unusual prevalence of possibly radiation induced diseases, a full medical survey, based on the traditional medical surveys will be performed for the islands of Likiep and possibly for Wotje, Mejit and Ailuk as well. Due to the absence of adequate vital statistics, particularly prior to 1954, but continuing to the present, meaningful analysis of observed/predicted cases of possibly radiation related pathology is almost impossible to obtain. Existing health statistics when reviewed by epidemfologists familiar with the biologic and pathologic patterns prevalent in the South Pacific detect unexpected discrepancies in the Marshallese population. A more direct indication of these differences has been presented by automated biochemical analysis performed on the traditional study population. Analysis of these profiles reveals that from 95-97% of the study group (exposed and comparison) have at least one and on most occasions, multiple biochemical levels that fall outside two stand- ard deviations for comparable US values at certified research laboratories. To the best of our knowledge, no sufficient data exists to establish adequate, age-sex, specific normative curves for each of these biochemical parameters. 6. Several unique sub-populations have emerged over the last several years. These populations were the original inhabitants of the islands selected as the test site for a long series of nuclear and thermonuclear devices; specifically the atolls of Bikini and Enewetak. In 1977, following extensive restoration and decontamination procedures, the island of Bikini was declared safe for reinhabitation. However, the returning population was cautis.zed about consuming certain borderline indiginous foods and in visiting other islands with higher background radiation levels. WBC was performed sequentially and in April, 1978 it was determined that the increment of elevation would place many of the individuals above the maximum permissible dose (determined by cs!3? measured within the next year). It was therefore recommended that the population that had returned to Bikini Island (134 of approximately 600 Bikinians with land rights) would need to be repatriated to the island of Kili. The fact that this population had absorbed an unexpected amount of radiation albeit well within the maximum permissible levels has evoked a demand by this population for continued close radiologic and medical monitoring for an indeterminate period of time. We understand that on at least two occasions, statements before US Congressional committees have assured the people of Bikini cf these services. A comparable but somewhat different situation now exists for the people of Enewetak. A multi- million dollar decontamination and cehabilitation program has been undertaken by the U.S. Govern- ment over the last several years with the intent of rendering a significant portion of Enewetak Atoll habitable. The people of Enewetak were originally evacuated to Ujelang Atoll. Over the past several years, small groups of people from Enewetak have been returned to the atoll to assist in the rehabilitation. I understand these groups have been rotated periodically (about every 6 months). However, the majority of the work force on Enewetak has been US contract personnel. Careful radiologic monitoring of these workers has indicated no significant radiation risk. Next month (9/79), a major meeting will be held on Enewetak to present to the reps of the Enewetak people, current radiation situation for those islands of the atoll certified safe for habitation. In addition, they will be prcvided with other significant radiologic data concerning a number of islands in the atoll that are still considered unsafe for habitation or food gathering. It is the the recommendation of their legal counsel that the people of Enewetak on the basis of all on this information make the decision of returning to their home atoll on the basis of “informed consent”.