27 in Section [V. The other physicai findings, which Table 15 have been carefully tabulated in the individualre- ports for each survey, indicate no definite pattern Composition of Pediatric Groups, 1972 Age at exposure,yTRongelap group <i0d 10-19 In utero Ailingnae group <10 Unexposed group Born 1945-1954 Born 1935-1944 of abnormalities that would differentiate the ex- No. males No. females 10 3 3 9 9 1 2 4 22 il 19 7 skeletal development (left hand and wrist) was initiated, *! and systematic documentation of anthropometric data was started. The documentation was continued during the succeeding exami- nations on subjects considered to be in the growth phase (generally through age 20). The data recorded regularly included standing height(stature), body weight, head circumference, head width, head length, chest circumference, biacromial width, and calf circumference, and sporadically included sitting height, chest width, chest depth, and buttocks circumference. (See Appendix 7.) The development of secondary sex characteristics was qualitatively assessed according to the standard criteria generally accepted in growth studies (Greulich et al.,*? Shuttleworth43). Such posed children from the unexposed comparison children. The usual spectrum of infectious and noninfectious diseases, congenital anomalies, and physiological variations has been noted in both exposed and unexposed children. 3. Growth Status Interpretation of the anthropometric data and assessment of the growth status of the exposed Rongelap children have been complicated by (a) radiation injury to the thyroid gland, (b) partial or total thyroidectomies in the children who de- veloped thyroid neoplasia, and (c) the administration of thyroid hormoneto the entire exposed Rongelap population since September 1965. If the data on the three children (Nos. 3, 5, and 63) who were obviously hypothyroid and had markedly small body measurements are excluded, comparisons of mean stature and skeletal age indicated no statistically significant difference between the exposed and unexposed children for either boys or girls. Compared with American norms, the mean skeletal ages at given chronologicalages for each group were,for unexposed girls, quite similar, but for unexposed boys, they appeared to be delayed opmentin girls; estimation of the type, pattern, by 6 to 7 months at each chronological age. Earlier preliminary comparisons had suggested that boys exposed at age <5 years were retarded etc.); and staging of the growth of penis andtestes in boys. During several examinations, photographic documentation was doneas part of the The current analysis excludes those with a specific diagnosis ofhypothyroidism. The individual growth and development curves for 13 children exposed procedures included the staging of breast devel- and amountof body hair (facial, pubic, axillary, assessment of growth status and physique. The roentgenographic evaluation of skeletal development was doneby the inspectional technique of Greulich and Pyle,*! and the American standards were used for comparison. — 2. Physical Findings The early post-exposure examinations indicated that the younger children, in general, manifested more extensive and more severe radiation injury than the older children and adults. Followingre- covery from the acuteeffects of radiation, the over- all physical status of the children appeared to be normalexceptfor the subsequent development of thyroid abnormalities, which are discussed below 200Gb} 24 in statural growth compared with unexposed boys. at age <©5 and their controls are shown in Figures 21 and 22. The effect of thyroid treatment on the two boys (Nos. 3 and 5) is evident. Several other children (Nos. 2, 19, 65, 42) had a tendency to-. ward retarded development, which may have been improved by thyroid medication. On the 4 children exposed in utero, careful examinations have resulted in no unusual physicalfindings. The growth progress of 3 of them has been similar to that of age peers (see Table 16). One boy (No. 85) has had a head circumference smaller than the average for unexposed maies and a slightly retarded pattern of skeletal maturation, buthis statural growth curve was comparable with that of unexposed males.