of radiation dose to the thyroid are too low, at least in some cf the people,
by a factor of 3 or 4. This would account for the high incidence of hypothyroidism.
It would also account for a relatively low risk for thyroid cancer in the children, since such a level of radiation would be expected to
damage the thyroid so severely that cell death would, in many instances, in-

hibit cell division that might result in malignant changes (195). Since th.
dose calculations, derived from counting of a single pooled specimen of vrite
require many assumptions, an underestimate is not unlikely.
It is quite likely that the final tally of thyroid abnormalities in the
Marshallese is incomplete at this time since new lesions are still becoming
clinically evident. The mean latent period for radiation-induced thyroid
tumors may be as long as 30 years (196). Recent observations suggesting that
as many as 25 years may pass between exposure to radioiodine and the appearance of even minimal biochemical thyroid abnormalities make it clear that
long-term follow-up of the Marshallese must continue.

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