CONTENTS PREFACE... ..eccceccccccccecceessceseeecaneeseesececaeeceessnaaseseeaeaaessaesstssaeanaeneeeesensecnencansnateneescneegns tose seeaeeeateaees iii FRONTISPIECE0.00.0... cece cesessceccee sees coececee see cerececescenceceseeraeeeedeasaseasieseevapescaseeene aessesecasseressneeeseeseeets x TL. BACKGROUND... ccccceccssseececeteseeeenscceseseceeecenececesteacseenesaneesesentamesdeseseaesesesaeensarsuaeeenesesasnesee 1 AL The Accident... cece cceccsescceeceneeeescescees secdcentonssenes ceases sdueateetacecneseensnse socaeereeecess 1 B. Annual Examimations. 0.0.0.0... cesses csssecessessscnnecesseccsetanscccneseceesees sesecasseesesseeesaevenses 1 C. 1970-1974 Surveys... 5 A. Dose Assessrment....0..0.0...cccecccessseseescsesescoesascucesecnesscsesasecesssenscansqsenssesceassets cesecaeacacaeeteaees 5 B. Acute Effects... ccc ececccseesncaneeneeteceee coceeneseceeceaecaesrsaceneeneaseseneteeeseaetaeeetaneressecats 10 III. Frvpines on Fottow-up EXAMINATIONS (LATE EFFECTS)...0..000.0.000ccccceseeeceesetttetctsesereenees 14 . General Medical Findings...0..0.0.0.0. ccc es esncceeseeeeseeneescsettereesinsescecneesieecatscaeecee \4 a 17 Hematological Findings... cee cccesecrcseesseessneeeeesseecsnecssesssecea snes ceeateneseneseneaseet 18 manmpon pw > TY. [nrrtacFinns... ccc ceeecccececoenseceseneseeeceensesseeessvaseeacaesseeesesnecaesens sanessesaeateenceeecsents Viral Statistics: Fertiliry and Mortality....... . Subsequent Course of Skin Lesions... cece 2h Ophthalmological Findimgs..............--ccsccccsscssssccesesesecessseeecceeesaneiecceueeesnsuteeseseueuseeneees 23 Growth and Development Studies of Exposed Children... cee 26 . Degenerative Diseases... ec ccecccessenesescvencsencscanenetssssesessssevscanesiesseceraeteeseneneatas 29 . Chromosome and Genetic Studies.... TV. THYROID FINDINGS... cee cee eeceee sca nea nacessesseeacsaesotecsneseesceeeseasssueceneenieseneaseeasenss 39 A. Early Findings... cesses cece ccsecsseseetccssesesnsecssssesesecacesaeedcocsecacatesepacaceases cnstceceeet’ 39 42 » Surgical Exploration... seers sssetsesneseesieesnserssstssssciiseitesessectisesiece 42 » Hormone Treatment... cece cccscceseeneeessceeceeescesceaeneecsesneneacaeecaescaeseeecatererteceecseetat 49 apo n B. Development of Thyroid Nodules.............. ccc cceccee eee eees ees eeseteces teen tees teen taneeeeaeeneny Studies of Thyroid Function....... lodoprotein Scudies... satceeesasstereeenseceseees 36 G. Correlation of Thyroid A Abnormalities With Radiation Exposure veeeetaecneasseecenteatecuee 57 _N. NEOPLASIA...0...0.cccceccecscscesecses sees setecnsseessceeseeesentacanseneeeseseneceaessseenseteisisenisirssestttetcttesmenenens 62 A. A Case of Acute Myelogenous Leukermia.... cece cece cee teres eneescneeeeseaeseeestenes 63 vill 98060495 sesseeeteeeceesetetststeesreeteeeettetteeeteeneete