Mr. Richard D. Copaken July 23, 1980 Page 2 comprehend how this small sampling of another atoll, will provide a comparison standard, if, after "26 years of medical follow up study” of the inhabitants of Rangelap and Utirik, no standard on other atolls has yet been established. The entire problem of establishing a standard reference for normals, is further complicated by a more basic issue. Even if one were to assume the current availability of a comprehensive hematological and biochemical standard, it, in itself, may not be truly "normal" because of possible direct or indirect prior effect of radiaticn exposure om this “standard” “ poculation. - There are several other intrinsic shortcomings of the proposed sixty: 1. The proposal outlines a single screening attempt at one point in time. Since radiation induced carcinogenicity entails a lengthy latency pericd, frture interval screen- ing of the same poculation would be required to assess possible radiation related health effects. 2. No provision is made for anthropometric data collectim 3. The term “clinical stidies" as proposed, is generic ard rom-specific. If it truly implies a complete physical examination, it should be so stated. Paragraph four (indicated as "2." in the March 27 1980 propesal) should not read "The Department ofEnergy will send to Likiep a physician for the purpose of exaning the population with respect to detecting the existence of thyroid. nedules” bot should read: "The Department of Energy will sernd to and assessment. Likiep and other atolls physicians to carzy art complete physical examinaticns cn the populaticn.” 4. The progosal, as written, provides that "medical problems” (whether possibly radiation related or not) will be referred to a medical officer of the Health Services of the Govern_ Ment of the Marshall Islands ard that treatment fording will be the responsibility of the Department of the Intericr/ Trust Territory of the Pacific Islands. I find this difficult to comprehend since the medical officers of the Department of Energy and Brookhaven National Laboratory advised us at “.our April 23, 1980 meeting, that they have in the past provided requisite treatment, including stateside transport, surgery at U.S. Hospitals, etc., for even “remotely possible radiation effects".