3 No gross abnormalities of bone marrow smears were reported at 6 months post exposure. Depression of peripheral blood elements in the Ailingnae and Rongerik groups was not so pronounced as in the Rongelap group. However, a slight lag in complete recovery in the Ailingnae peripheral blood count has also been noted. The persistent depression of peripheral blood elements in the exposed people makes it appear likely that there is slight residual bone marrow damage. A generalanemic tendency has been evidentin both exposed and unexposed Marshallese. PriceJones curves, on the average, showed a slight mucrocytic tendency. Serum iron levels have generally been normal, and the cause of this anemic tendency has been undetermined. Reticulocyte counts have been about the same in the exposed as in the unexposed people. Except for radiation-induced lesions of the skin, patchy epilation, and early gastrointestinal symptoms, clinical examinations have revealed no disease processes or symptoms which could be related directly to radiation effects. No prophylactic ot specific therapy ofradiation effects was ever considered necessary or given. Epidemics of chicken pox and measles ihat occurred showed no greater incidence or severity in the exposed than in the unexposed Marshallese people. During thefirst months post exposure abouthalf of the exposed group exhibited loss of weight of several pounds. This may possibly have been related to their radiation exposure, although it is difficult to rule outeffects possibly due to change of environment, At 3 years post exposure the immune response to primary and secondary tetanus antitoxin was tested and found not to be significantly different in the exposed compared to the unexposed populations. Four persons in the exposed population died of disease: (1) a 46-year-old man with a hypertensive heart disease which had been present at the time of exposure, who died 2 years after the accident; (2) a 78-year-old man who died, 3 years after ex- posure, of coronary heart disease complicating diabetes; (3) a 35-year-old man who died of acute varicella, 4 years after exposure, who had received only 69 r, having been on Ailingnae at the time of the fallout; and (4) a 60-year-old woman whodied of a cancer of the ovary at 5 years after exposure. There was no apparent relationship between any of these deaths and radiation exposure. Four deaths have occurred in the comparison population. The four deaths that have occurred in the exposed people since exposure represent a mortality rate of 7.1 per 1000 population, compared with 8.3 for the Marshall Istands as a whole. Growth and development studies on the chil- dren (height, weight, anthropometric measure- ments, radiographic studies for bone age) have revealed that slight retardation in growth and de~velopment has occurred in the exposed boys who were under 12 years of age at the time of exposure, particularly those 12 to 18 months of age at exposure. Only slight immaturity was noted in the exposed female children. It was also noted that children born of exposed parents were slightly retarded and that they had slightly lower levels of neutrophils, lymphocytes, and platelets, compared with male children of unexposed parents. It was difficult to evaluate the effects on fertility. However, a review of the birth rate of the exposed group over the past 7 years seems to indicate no - noticeable effect of their exposure onfertility. The 31 births represent a rate of 54 per 1000 population, compared with 37.3 for the Marshall Islands (1957). The 21 births over a 4-year period for the comparison population represent a rate of 72 per 1000 population. A somewhat greater incidence of miscarriages and stillbirths was noted in the ex- posed women during the first several years after exposure, but because of the paucity of vital statistics on the Marshallese and the small number of people involved, the data are not readily amenable to statistical analysis. A cardiovascular survey of the adults (1959)? showed no outstanding differences between the ex- posed and unexposed groups. The people appeared to have less hypertension on the whole than is noted in people in the continental United States. An arthritis survey (1959)* showed no great differences between the exposed and the unexposed people, and about the same incidence as is seen in American populations. Ophthalmological surveys showed no remarkable differences between the exposed and unexposed groups except possibly a slightly greater number of cases of pterygia, pingueculae, and corneal scars in the exposed group. It is not known whetherthis finding is of any significance in relation to their radiation exposure. Slit-lamp observations showed no opacities of the lens characteristic of radiation exposure. As a whole, visual and accommodation

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