72 Bikini (see Table 41 and Appendix 12), and a gammasurveyofthe island was made by Greenhouseet al.156 (see Appendix 14). On Bikini Island almost all the gammaradia- tion 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 ingestslight amounts of 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 when they wereliving on Kili Island, butstill con- siderably below the permissible range. The total estimated internal bone marrow dose in 1974 to the people living on Bikini was abouthalf that to the peopie living on Rongelap, but with the ex- ternal dose included, the dose to the bone marrow was about the same(see Table 42). It is reassuring that analyses of urine for plutonium show levels near backgroundin the Bikini people (see Table ining groups have been concerned also with general health care at the time oftheir visits. The responsibilities have been filled by carrying out extensive annual examinations. supplementedin recent vears by semiannual hematology checks and quarterly visits by a resident physician. The examinations, which have been carried out with the assistanceof 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 andillnesses at an early stage. An importantaspect of the medical surveys is to maintain rapport with the people, to keep them informedof the medical findings, to explain the need for examinations, and at times to correct un- founded rumors about fallout effects. Unfortunately this has not always been successfully kept up because ofdifferences in language and culture. Somestudies have been of benefit to the Marshall Islands as a whole, such as the surveys of the incidence of diabetes and of parasitic infestation. In addition, a great deal of data has accumulated from studies of genetically inherited characteristics which may prove valuable not only in determin- 37). Well water on Bikini has had low levels of ac- ing possible genetic effects of radiation butalso in anthropology. , should be considerably lower than the levels based on analyses of fruit from old trees because of the B. COMPARISON WITH OTHER HUMAN EXPOSURES actual evaluation must await maturity of the trees and further analyses. It is planned to add supple- the Marshallese are unique in that they comprise tivity (see Table 38). The dietary levels projected for Bikini when the newly planted trees bear fruit soil removal procedures used at planting, buttheir mentary calcium to the diet of the Bikini people to help reduce absorption of Sr. Experiments are under way to investigate the tolerance of Marshallese people for powdered milk as a source of calcium. Races other than the Caucasianarereported to have a lowertolerance for milk because of a genetic inability to digest lactose which gives rise to abdominal discomfort, diarrhea, and other symptoms. !75 In contrast to other groups exposed to radiation, the only human population ever exposed to acute radiation from fallout. The accident focused attention for the first time on the hazards of fallout from nuclear detonations. The atomic blasts above Hiroshima and Nagasaki resulted in casualties due to penetrating gammaand neutron radition directly from the bombswith little or no fallout involved and therefore caused no effects dueto internal absorption of radioactive materials. In contrast, the Marshallese were not exposedto direct effects of the detonation but only to radioactive exposure. Trauma and extreme psychological dis- A. THE EXAMINATIONS Marshallese as they did in the Japanese. The importance of the hazard from internal absorption of The primary responsibility assigned the medical team by the AEC (now ERDA)was the diagnosis and treatmentof possibie effects of radiation expo- sure in the Marshallese, but inevitably the exam- sotd1b4 fallout resulting in whole-body, skin, and internal Vil. Comments and Conclusions turbances did not contribute to the effects in the radioactive iodine has been clearly demonstrated by the Marshallese experience. The 23 Japanese fishermen on the Lucky Dragon recetved an exposure similar to that of the Rongelap group but