C. FUTURE PLANS: The negative findings on the 1978 medical examinations for the Bikini people with regard to possible radiation effects would not preclude such effects developing later due to the latent period for such effects. However, the results of the exams certainly refute the rumors circulated in the news media that the Bikini people have developed cancer and thyroid tumors as a result of living on the island. One can estimate roughly the risk of radiation effects in the 143 people who were on Bikini in 1978. Assuming that they had all been there since 1970 and received the average estimated integrated total dose of 2.6 rads for the period, based on known radiation-induced risk data, one would expect only about 0.005 total cases of leukemia to develop in that population as a result of their radiation exposure. Similar low risk estimates would apply to other possible malignancies. There would be no specific thyroid effects as noted in the Rongelap people, since the Bikini people have not been exposed to radioiodides or other isotopes which concentrate in the thyroid gland. One can therefore state that it is extremely unlikely that any radiation effects, somatic or genetic, will be detected in this group. What about the need for future medical examinations in the Bikini people now that they have been removed to noncontaminated islands? Since, as pointed out above, radiation effects are unlikely to be detected, the need for further medical examinations is not indicated based on possible radiation effects associated with such low doses. However, from our experience with the Rongelap, Utirik and Bikini people, it is clear that the psychological effects of living on contaminated islands (fear of development of radiation effects; association of nearly all ailments with radiation exposure) indicate that regular medical checkups on both Bikini and Eniwetak people who have lived or are living on contaminated islands are most desirable. The reassurance to the people by a group of doctors will do much to help them maintain a healthy mental attitude toward the problem and in addition, they will accrue benefits of more complete health care which they certainly deserve. When cancer develops in these people, which will occur as in any population, U.S. agencies may have to face court claims (such as are now showing an alarming increase in the U.S.) and the dilemma of disproving a correlation of such diseases with low dose radiation exposure will be a discouraging one. Radiation monitoring of body burdens of radionuclides in those people who have lived in Bikini should be continued for a time. Again, spectrographic analyses (whole body counts) should not be necessary for more than one year, since the present 137Cs levels should be reduced by over three biological half lives by that time, assuming no further intake of 137cs. Radiochemical urinalyses of 90sr and Pu should continue for several years. Living on an uncontaminated island should help give a definitive answer regarding possible Pu body burdens by ruling out the possibility of contamination of samples.