different from the incidences in other world populations, which suggests that
there is nothing unusual in the environment of the Marshall Islands that might
predispose to thyroid abnormalities.
The numbers of thyroid abnormalities detected in the various exposed
Marshallese groups were roughly related to the calculated thyroid doses in the
groups, i.e., greatest in the Rongelap, less in the Ailingnae, and least in
the Utirik group, as indicated in Table 1 and Figure 3. However, because of
the small numbers of people involved and uncertainties of the doses received,
the data do not lend themselves to dose-response analysis.

Numerous animal studies have shown the association between radiation ex~
posure and the later development of thyroid neoplasia (143-145,198,199).
There are increasing reports of the development of thyroid abnormalities in
children many years after therapeutic irradiation r of the head and neck (with

thyroid exposure) (146-171,200-203).

The incidence of thyroid tumors was

increased in the survivors of the atomic bombings of Japan (84-86,172). Reports of tumorigenic effects of radioiodines are more limited in man (173180), and 131y has considerably less effect than x-radiation and- other penetrating radiations in this regard. The few studies of late thyroid effects
following diagnostic use of 131) have indicated generally negative findings
(175,176).*
Besides the Marshallese exposed in 1954, the only other people that may
possibly have had a similar type of exposure were those residing in the
Nevada-Utah area during the Nevada testing program. Children living in this
area were later examined for thyroid abnormalities. The thyroid dose in these

children has been estimated at about 18 rem (maximum 120 rem) (181).

amount of short-lived iodine isotopes involved is not known.

The

No increase in

the incidence of thyroid abnormalities was detected in these children compared
with unexposed children in Arizona, also examined in that study.
Several points should be made regarding the thyroid dose estimates in

the Marshallese children.

Table 9 (see also Appendix IV, Table 4) shows that

radiation risk estimates for the development of thyroid nodularities or carcinoma in the Marshallese approximate those for populations exposed to xradiation and for Japanese atomic bomb survivors. The internal absorption of
radioiodines before evacuation of the Marshallese from their home islands was

a wost important source of radiation exposure to the thyroid gland.

On the

basis of known facts regarding risk, the estimated doses of gamma radiation

‘alone would not have been sufficient to induce the observed findings. It is
known that !511 is considerably less effective in producing thyroid abnormalities than x-radiation (183-185,187), and, since it has been demonstrated that
the shorter-lived isotopes of iodine are more destructive to the thyroid than
131; (188-192) because of greater penetration of their beta rays and faster

dose rate, it seems likely that their presence played an important role in thyroid injury and may partly account for the unexpectedly higher risk estimates
than would be expected from 131y alone. However, several points should be repeated. The dose estimates in the Marshallese are only approximate, and

*Doses from diagnostic use of i31y vary from about 10 to 200 rads (194).

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