—_—_a COMPARATIVE ANALYSIS OF THE TRADITIONAL nae cae ~“4 - 1978) BNL MEDICAL PROGRAM AND REQUIRED REVISIONS IN LICHT OF ACTUAL AND PROJECTED EXPANSION EXPANDED CHARACTERISTICS TRADITIONAL CHARACTERLSTICS 1. Directed toward early detection treatment, and prévention of radiation induced Crag _197F 1. Same 2. Recent developments in 1978 and 1979 have opened the possibility that islands other than thom disctase, 2. Islands involved have included Rongelap, Alingna2, Rongerik and Utirik. designated in the traditional study may have received variable amounts of radiation, producing a wide spectrum of long term low level radiation of variable intensity. Recently obtained information from the papers of the USS Renshaw seem to indicate that on March 5-6, 1954 that there was a signif- deant increase in background radiation at least on the island of Likiep (7 300mr/hr measured from the water of the cistern of the Catholic school. 3. Populations under study have included: a. 64 Rongelap - 175 BR b. 18 Alingnae - 69 R 4 in utero c. 158 Utivik - 14 R 4. Rongelap received 175 R of gamma radiation; Alingnae received an unknown amount (approx. 69 R). Twenty-eight servicemen received ;an unknown amount on Rongerik; 158 people on Utirik received 14 R. In addition, all of these islands received an unknown amount of short-lived radio-nuclides - predominantly qiodine. 5. The exposed populations were evacuated .ia' a period of 48-72 hours, to Kwajalein, where ‘they were cared for by a team of radiation specialists from the AEC and other nuciear labs. Following an exteasive medical and radiologic ‘evaluation of the exposed population, an age-sex matched cohort was established for the people of Rongelay. No cohort was established for Utirik. The »veopis of Utirik were returned to their island 3 months post-exposure; the people of Rongelap, 3 years post-exposure. Follow up 3. The Secretary of State of the newly formed Marshall Island government, Mr. Anton deBrum _ states that as a child on Likiep at the time of the Bravo test on 3/1/54, he noted a particulate type of fallout. He remembers the visit of the Renshaw and states that a number of the people of the island underwent personal dosimetry at the time of the visit. He states he can remember the Geiger Muller counter clicking rapidly during the counting of the feet of many of the inhabitants being surveyed. During the ensuing 25 years, Mr. deBrum states he has noted a "very high" incidence of thyroid and congenital abnormalities in the people of Likiep. 4&4. In 1970, Dr. R. A. Conard (then director of the BNL Marshall Island Study) visited Likiep and attempted to performa complete survey of the island aimed at detecting the presence of thyroid nodules by palpation of ail available inhabitants. During this survey 135 people were examined and 5 nodules were detected. Of the three major populated islands in the atoll, one was surveyed. In 1977, a simiiar sutvey was carried out on Wotje. Two of the four inhabited islands in the atoll were visited. The visits to Likiep and Wotje were designed to determine the presence of palpable thyroid nodules in an “unexposed" population. Current data indicate that this population might in fact have had a higher than ambient radiation exposure. 5. The inhabitants of all islands other than Rongelap, Utirik, Alingnae and Rongerik have been reassured repeatedly that they have not been exposed to “significant'"' radiation. Recently, Mr. deBrum designed and circulated a medical questionaire to determine from a number of the people of Likiep and some surrounding atolls the prevalence of “thyroid” and “congenital” abnormalities since 1954. We have no solid information on the size of the population sampled. However, the survey has revealed an unusually high prevalence of “positive” results. The questionnaires have been completed by individuals and in many cases, hy health care personnei. Interpretation of these questionnaires in their present format is impossible from an epidemiologic standpoint, however the questionnaires do raise the possibility of an unexpected incidence of the aforementioned diseases in Likiep. This information has been presented to US - Department of Interior and US - Department of Energy and assurances have been made to the Marshall Islands gov't. that a carcful and scientifically valid