72 Bikini (see Table 41 and Appendix 12), and a gammasurveyofthe island was made by Greenhouse etal.156 (see Appendix 14). On Bikini Island almost all the gammaradiation is now due to 137Cs. The gammalevel due to natural radioactivity is considerably less on these islands than in the U.S.; this is why the average gamma dose to an inhabitant is lower in Bikini Village than in certain parts of the U.S. The people living on Bikini eat a diet consisting almost entirely of imported food, but they ingest slight amountsof radioactivity from local seafood. The newly planted coconut, pandanus, and breadfruit trees will not bear fruit in any significant quantity for some years yet. The urinary radionuclidelevel of the Bikini people is now several times as high as whenthey wereliving on Kili Island, butstill considerably below the permissible range. Thetotal estimated internal bone marrow dose in 1974 to the people living on Bikini was abouthalf that to the people living on Rongelap, but with the ex- ternal dose included, the dose to the bone marrow was aboutthe same(see Table 42). It is reassuring that analyses of urine for plutonium showlevels near backgroundin the Bikini people (see Table 37). Well water on Bikini has had lowlevels ofac- tivity (see Table 38). The dietary levels projected for Bikini when the newly planted trees bearfruit should be considerably lower than the levels based on analyses of fruit from old trees because of the ining groups have been concernedalso with general health care at the timeoftheir visits. The re- sponsibilities have beenfilled by carrying out extensive annual examinations, supplementedin re- cent years by semiannual hematology checks and quarterly visits by a resident physician. The examinations, which have been carried out with the assistance of the Trust Territory Health Services, have resulted in extensive medical histories and records for each individual and have madeit possible to diagnose and treat many diseases and illnesses at an early stage. An important aspect of the medical surveys is to maintain rapport with the people, to keep them informed of the medical findings, to explain the need for examinations, and at times to correct un- founded rumors about fallout effects. Unfortu- nately this has not always been successfully kept up because of differences in language and culture. Somestudies have been of benefit to the Mar- shall Islands as a whole, such as the surveysof the incidence of diabetes and ofparasitic infestation. In addition, a great deal of data has accumulated from studies of genetically inherited characteristics which mayprove valuable not only in determining possible genetic effects of radiation but also in anthropology. B. COMPARISON WITH OTHER HUMAN EXPOSURES soil removal procedures used at planting, but their actual evaluation must await maturity of the trees andfurther analyses.It is planned to add supplementary calcium to the diet of the Bikini people to help reduce absorption of 9°Sr. Experiments are under way to investigate the tolerance of Marshallese people for powdered milk as a source of calcium. Races other than the Caucasian are reported to have a lowertolerance for milk because of a genetic inability to digest lactose which gives directly from the bombswith little or nofallout in- symptoms, !75 ternal absorption of radioactive materials. In con- rise to abdominal discomfort, diarrhea, and other Vil. Comments and Conclusions A. THE EXAMINATIONS The primary responsibility assigned the medical team by the AEC (now ERDA)was the diagnosis and treatmentofpossible effects of radiation exposure in the Marshallese, but inevitably the exam- In contrast to other groups exposed to radiation, the Marshallese are unique in that they comprise the only human population ever exposed to acute radiation from fallout. The accident focused at- tention for the first time on the hazardsoffallout from nuclear detonations. The atomic blasts above Hiroshima and Nagasaki resulted in casualties due to penetrating gammaandneutron radition volved and therefore caused no effects due to in- trast, the Marshallese were not exposedto direct effects of the detonation but only to radioactive fallout resulting in whole-body, skin, and internal exposure. Trauma and extreme psychological disturbancesdid not contribute to the effects in the Marshallese as they did in the Japanese. The importanceof the hazard from internal absorption of radioactive iodine has been clearly demonstrated by the Marshallese experience. The 23 Japanese fishermen on the Lucky Dragon received an exposure similar to that of the Rongelap group but