c Foe ckene ne eT ctl Batni i et bette 2 aga ee ly hedtag hes a bc = Aattdrerate licf of itching and pain. Antibiotics were used in a few cases of secondary infections, The lesions healed within a few weeks with only minimal sequelae (described below), These observations make it apparent that beta burns.of the skin having acute symptoms asociated with the lesions may be a serious consequence offallout exposure. The Marshallese could have avoided manyof the lesions ifthey had known to tike the proper precautions such as protecting the skin fro fallout and early cleansing. Pad the whole-body radiation dose been greater, the res ductor ii mauno-bematological deftases might have cesulted Gi more serious shin iifee ans can siderably conplicating the skin svanptons, 3. Effects of Internally Absorbed Radionuclides As pointed out ia Section IL A. radiochemical urine analyses beginning 15 dave after the accident indicated that the Rongelap people and to a lesser extent the other exposed groups had absorbed considerable anounts of radionuclides by inhala- Dell th ag Rea al st Soe, “hh 34 Ft ity, talignaney). Durnag the second decade following exposure, elec developed in the Rongelap people which had net becu heralded durtag the first decade, The mest diportant were the widespread development ot Uivroidd abnormalities. associated: with growth retardation ai seme children. A fatal ease olleukcaia and a posable increased incidence of Malignancies Way OF tay not have been radiation related: the nutibers are too smaall te periat ay definite conclusions. Vhese fludings are reviewed below, In thay respects Wapros ing. Mast vectorborne acute syinptoms associicd with absorbed isotopes appeared, the only caception being a possible rule of the estimated 3 imnCi of radioisotopes in the GL. tract during the first two clave in causing the carly GUL syriptans, These observations indicate that lack of carly Splonassociated with ingestion of radiouctive materialin an acute fallout siqaation docs sot pre clude development of late effects from such ingestion. Ill. Findings on Follow-Up Examinations (Late Effects) During the firse 10 scars. after the carly etlects and before the development of Uayroid abnorssialtlic, lew medical findings could be definitely as * re studies on possable lite elfeets during this period were nCgAlive (cataracts, aging. mortality, fonges- have des cloped due to racoiodine exposure to the thyroid, and near naaimuinpermissible doses of several other radiobotopes were absorbed, no a gree of growth retardation in a few children. Other A. GENERAL MEDICAL FINDINGS water? (see “Fable 3). Although serious late effects as connected with radiation expasure, such as resid. ual skin effects; an ticrease in miscarriages anil sullbirths during the fiest 3 vears; suguestive evidence ofa lag in complete recovery ofperipheral blood elements; evidence of slight chromusoime aberrations of the peripheral blood. and some de- tion and by ingestion of contaminated food and wcated with radiation exposure, The general hivalth of the exposed Marshallese appeared to be about the sune as that of the unexposed Marshall ose Comparison population, with the same types and incidence of discases. The deaths that occurred were not related to radiation exposure. In the Rongclapese a fewfindings were considered to be . seats ghee AEM2 ee 4 a ete. creer, et i a eee ee The healdh situation inthe Marshall [stands is diseases of the tropics do not occur, loppranyis rare, and tuberculosis is Dot je MC Tdaais probe, Clardic- Vascular diseases are rare (except tar diabetic gain grene of the feet), The public and personal hygiene leave much to be desired. Skin ivfections Gampetige and fungus) and intestinal infestations (aanoebac and warts) are endeaic. Tn W050 lane year after their reset Vement on Koogelip Atoll. steals were exsimined from OY exposed and PED unexposed peaple.?° Tilestation was widespread with aiany bodividuals showing multiple types os parasites, dhe main pathoyens bein Katamorha Atstedstica (louined in L854), hookwonn (5.5%), Trdariy tichnea CUED), and Giardia lamblia (7.7%). lauctlates alse ine cluded Trichunnes hooey, No significant dillerenees were noted between the incidences in thie ex: posed and unexposed populations, Recentiy pbsearras has been introduced tnt the Macshalls fiom other districts and talestation with it bas became prev. alent. Education wand cotetaat sorvedllance will be needed te overcome the pirasite problem, Eosinophilia is comunon but is tat alwarvs associ ated with helomnchic iafestations, “Diese atidies were dome be bir, Mo Cashman and Mie. KOK. Carver, Gosniina able DecaCanter, ¢ Thaatsbew, (aa.