“TING, The New England Hsctentific v Engdand Hh. ournal of Medicine Follictitay Or. Elmer ner, May. TS Copsriht, P96G. by the Massaclusetis Medica Socien JUNE 23, Volume 274 ES In a Marshal! Island Population Exposed in 1954 lon, Notice R.A. Coxarp, MoD. p. E. Rati. MLD. Pad. AND WW. W. Sc row, ALDLS Ubtois, Tantuinent, daache. Chi wo, Pinos, reety. Am. lousy, Banff, lation, Chi. Rochester, citi and IOSS issue uc, Denver, Vi, Stilzeray, “iirich, eproductive lay 2h. er Traming Catv. South niality, San conference, diame, San HI Less on t hosfavakia. Hh Accrvintes, ornal Medi tine O Prethalopgy, ol Colleges he ine, Palma, nal Kidney an General on Cvsue tissue of UPTON, LONG ISLAND, NEW ODULES of the thyroid gland have been discovered during the past three sears in a num- ber of people of Rongelap Island who had been aceidentally exposed to radioactive fallout in 195-4. The accident was the result of an unpredicted shift large thermonuclear device at Bikini in the Marshall Islands, which caused radioactive fallout toe be deposited on 4 inhabited Marshall Islands to the eas. Inhabitants of Rongelap AtoH, about LOO miles away, received the largest amount of fallout. The somatic effects of this radiation have been well documented in a number of medical reports and are sununarized clsewhere.!? This report concerns the recent development of thyroid abnormalities among the 82 people of Rongelap Atoll who received the Jarwest exposure to fallout radiation. Sixty-four of these people were on their home island when the detonation occurred. Eiziteen others were fishing on the nearby atoll of Ailinginaue. They sawthe blinding flash of the detonation in the early morning, followed by a white, snow-like fallout throughout that dav. The people on Ronvelap Island received the largest exposure: YORK low their return. During the vears after the accident, over 200 Rongelap people or their relatives who had not been exposed to fallout returned. ta live with the exposed people, and this group has formed an excellent comparison population, in winds after the experimental detonation of a SUMMARY OF EARLY FINDINGS The whole-body dose of radiation received proved to be sublethal. Aside from widespread anorexia, nausea and a few cases of vomiting and cliarrhea, along with irritation of the skin oceurring during the first two days, the most notable effect of the exposure was depression of the blood-forming tissues. Although the peripheral leukocyte counts were reduced to about one half to one third of the normal levels and the platelets to about one third to one eighth of the normal values during the first five or six wecks, neither infection nor bleeding clearly related to racdiation effects (except possibly menorrhagia in a few women) was observed. Recovery of peripheral blood elements was nearly complete by one vear but lagged thereafter; the mean levels remained slightly below those of the comparison population through ten vears post exposure. However, the survey at eleven veurs 175 rads of whole-body gamma radiation, thousands of rads to the skin (largely beta) from deposit of fallout material on the body and significant amounts of radionuclides absorbed by inhalation and consumption of contaminated food and water. The 18 showed levels of peripheral blood elements that ap- People on Ailinginae received less than half the ning about two wecks after exposure. The most common sites for the burns were the head. neck, axilla, antecubital fossae and dorsa of the feet. Most of the exposure of the other Rongelap people. Both groups Were evacuated two days after the accident and lived in a temporary village on a southern island in the Marshall group until [957, when the radioactive levels had subsided sufficiently on Rongelap to al*From Medical Research Cemet. Brookbaven National Laboratory. Researeh supported by the United States Atomic Mission and the Erust Perritarny of the Pacific Ustazedls. Energy Com. Sonar scientist, Medical Research Center, Brookhawen National Vasos bation, sue of July Lat onory, Upton, New York. aciety, Director of intramural research, Nationa Eustitate of Aadiritis and Metabolic Diseases, National Institutes af Health, Bethesda, Miaty banc, San Number 25 THYROID NODULES AS A LATE SEQUELA OF RADIOACTIVE FALLOUT* non Miassa- 20. 1966 §Associve pediatrician, Medical Department, Universit of Texas M.D. Anderson Hospital and “Pumor lastitute, Houston, Pexas peared to be about the same in the exposed as in the unexposed people. Radiation lesions (‘beta burns’) of the skin and spotty epilation of the head were widespread, bevin- lesions were superficial and healed without gross. visible sequelae. However, some of the lesions were deeper and resulted in pigment changes and scarring that have persisted. The hair in all cases regrewin six months and was normal in color and texture. Absorption of radionuclides in’ the fallout from inhalation and from consumption of contaminated food and water was detected by radiochemical anal- vses of urine. The highest body burdens occurred during the first two days on the Island before thes were evacuated, when thes were exposed to an envi- BEST AVAILASLE COPY