in the United States, including endocrinologist, cardiologists, hematologists, internists, surgeons, ophthalmologists, and parasitologists (see Appen- dix 2). The variety of specialists indicates the diver- sity of the examinations conducted over the years. The BNLgrouphas been fortunate in maintaining a close liaison with the Atomic Bomb Cas- ualty Commission in Japan, and several physicians formerly associated with it have participated in our surveys. We havealso had a close relationship with the people studying the Japanese fishermen exposed to the Bravo fallout; in 1964 exchange visits were arranged for Dr. Kumatori and the author to attend surveys both of these fishermen and of the Marshailese. In May 1954, upon completionofthe initial ex- aminations (conducted at Kwajalein), the 82 Rongelap people, because of the contamination of their homeislands, were moved to Majuro Atoll, and they were examined there in September1954 and in March 1955, 1956, and 1957. They re- turned to Rongelap,to live in a newly built village, in July 1957, after radiological surveys had showntheisland to be safe for habitation. The 157 Utirik people were taken homeafter the initial examinations, since their island was only slightly contaminated and was considered safe for habitation. The 28 military personnel exposed on Rongerik Atoll were taken to Tripler Army Hospital for further examinations. Followingtheinitial acute effects of radiation on the Rongelap people, the examinations over the next 9 years revealed few significant findings. Anincrease in miscarriages and stillbirths among the exposed women during the first 5 years was thoughtto be related to radiation exposure, but general health and disease incidencein the exposed people every 6 months. At that time also difficulties were encountered in maintaining strict thyroid treatment program in the exposed Rongelap people, with potential serious results, particularly in the people who had had thyroid surgery. The decision was therefore made to place - a resident physician in the Marshail Islands to keep check on the treatment program and assist the Trust Territory in general health care of the Rongelap and Utirik people. _ The medical findings on the Marshallese have been published in numerous BNL reports and journal articles.2-23 Someproblems have been encounteredin carrying out the medical surveys in the islands. Careful planningis required for all necessary equipment and supplies to be on hand at the remotelocation, and procedures must be adapted to field condidons with proper electronic support. Some tech- nical procedures such as staining of blood smears and cell cultures present problems undertropical, humid conditions. Providing adequate transportation has been a major difficulty. While the Navy furnished LST’s and amphibious planes, problems were minimal, but for most of the surveys we have had to rely on cargo ships chartered by the Trust Territory, and these have sometimes proved unreliable in meeting schedules or hazardous because of faulty life-saving devices and inadequate navigational equipment. Once the survey team was lost at sea for more than a daytryingto find an island, and twice ships ran aground on reefs, Smailboat travel in rough waters was hazardous; the trip from ship to shore was sometimes in outrigger canoes and might result in wet passengers and baggage. To overcomethese problems, an LCU was recently acquired for carrying out the AEC- people were about the sameas in the unexposed sponsored radiological and medical surveys in the MarshallIslands. Other problems included the following: The for reducing the scope or frequency of the surveys, but these were neverseriously considered since it .the people, even though a limited numberof reliable English-speaking people were usually available. The lack of adequatevital statistics resulted in uncertainty in the exact age of manyof the people; and medical records were poorly kept, particularly in the outerislands (e.g., the health aide would often give the cause of death as “too Rongelap people who had returned from otherislands and served as a comparison population. During this uneventful period, suggestions were made was realized thatlittle is known about thelateeffects of radiation on humans andeffects mightstill appear. In 1963 the unexpected apearance of growth retardation in somechildren andof thyroid abnormalities fully justified this reasoning. In 1972 a case of fatal acute myelogenous leukemia developed in a 19-year-old exposed Rongelap boy, indicating the need for additional surveillance. The surveys therefore were expanded to include a hematological check in the exposed Rongelap 500b092 language barrier hampered communication with old”). It was difficult to obtain consentfor an au- topsy, even at district medical centers, because of feelings against mutilation of the body after death. Someof the subjects thought that drawing blood made them feel weak; and some questioned the