i] dliation, but the caustic nature of the fallout may have contributed, The GAL symptoms in the Rangelap people consted of anoresia and nausea (in about pwor thirds of thea) and toa lesser extent of vomiting wad diarrhea (in one-teath of (hear), Only a few inthe Ailingnae group complained of these symp. toa, and ne one in the Rongerik and Utirik groups. ‘The gama exposure is thought to have bern sufficient to account for the GE ssniptonas, but the ingested radioactive material (estimated atabour SanCip may have contibuted, The GI. svinplowns were mate prevalent inthe Rongelap children (see “Fable ip Uhese svenptonis Listed only alas bwordiys ans bad hargely dosppearcd by the tiie the people arrived at Re ajaleina, b. Depression of Blood Elements. “Vhe carly hematological findings anal the Hadings in sate sequent years are presentcd a tabular form in Appendix 6 and graphicallyin Section PC, Phe carly findings are sumanarized bere and the later ones in Section TLC, One of the earliest findings in the Marshallese 14 rads, it was possible to distinguish slight platelet depresion inthe group as a whole. The smaller groups on Ailingnae and Rongerik showed peripheral bload levels between thuse of the high and low exposure groups, The hematolagical depression was thought io be due entirely to gamma radiation, since it was not considered likely that the dose from internally absorbed radionuchdes contributed toit significantly. The hematological depression was greater in the children, particularly those exposed at <5 years of age (see Table 5). Vhe changes are chuimerated belowin more detail. dampheprnia Wo about hall the level of the com. pariou Miushallose populahon was evident when the Rosgclip peaple were first examined 3 days after exposure. Juchildien <3 vears of age the Isanphocvies dropped ta 29% of the level of the comparison children but showeda slight rise dur- ing the following weeks. The lymphocvte levels showed a slight increase by one vear. Veutrapdil levels showed considerable fluctuation during the first month, possibly related to the prevalence of beta burns of the skin during that 197 Wik people who received only an estimated period, Neutrophil depression became evident by to 6 weeks post exposure, the level dropping ta about half the control level in adults andslightly lower in children aged <4 (Table 5). Neutrophils recovered more sapidly than Iwinphocytes and reached near control levels by one vear. arly plateat counts showed less fluctuation than other blood counts and decreased to about Table 4 of recovery to about 73% of control levels occurred Rdicative of significant exposure teas laweriag of leukocvte and platcler fevels in the peripheral blood. “Vhis was most marked ia the 64 people on Re vsanedisg> ws leer bined received 175 rads and bess so Lother groups rooriviig lows exposure. “Phe hen peactic depression was roughly proportional to the ganna dose of cadiadiou received, Even in the during the next few weeks, fallawed by slower Nustanee cate Vaneau in Wea lage Citeaape? recovery with mean levels never exceeding 40 ta fiwcibera an, Aur ateapesaie, v6 No Nptinttat Vinitiag a) Dt Ls | wh i it i Meson Bleed Cares at Peak Depress an a HMessuelays ( teens Percent af coated Age Do Nettroplils vote tof Lov traphenss tes Platelets aa a fyb 4 tO eee eee 4° of control levels during the first vear. The platelet count is probably the most sansitive index af the severity of radiation exposure in the subFeedrsad raurnager, fa trofendic depression has not been a consistent finding, and radiation ctlects on these cells have net been demonstrable by peripheral blood count, “Par lelee + Awe <0 SO of control levels by the fourth week, A spurt Morpholopiwal changes, Ducing the period when HCUlrepenia Was iast severe, same people were found ta hase peculiar manos tie leukuoevies that were thought to be darge leaaphoevtes. These cells were not found: subsequently, although an ov. casional binucleated IWwinphoeste was acen, «. Clinical Findings. “Vhe developiient of significant depression of peripheral blood leukocytes aod platelets during the first G weeks was cause for considerable apprehension among the medical