cous membranes from improperly prepared arrow: rout Jour is not uncommon, Both have erroncously been associated with radiation elfccis in the minds of the Rongelap people. Diabetes mellivus is a major problemand is discussed separately in Section TEL. G. A prograin is under way to build newdispensaries on the outer islands. On Ebeye a new hospi tal building has provided improved conditions lor health care. Lt is against this general back ground that our examinations tke place. We are privileged to get generous help fronthe local healed authorities in our task, and conversely when we are an the scene we Cannot avoid getting invelycd in problernis out. side the scape of Lillout complications, Major physical findings during the past 3 years are listed in “Fable 8, B. VITAL STATISTICS: FERTILITY AND MORTALITY Vhe number of five births duriy the last 5-vear period was 37 among the exposed and 69 among the unex posed, Calculated as live births per vear per 1000 population these numbers give a birthrate of Pil for the exposed and 106 for the unespascd. Ta addition, (here were LO miscariiages amang the exposceb and 1 among the unes posed, so dat, in both qroups, ane premnaney out of five cuded in nicarciaae, Uhis is approximately the same free queneyos observed in the past (sce Viable 9), Lewal abortions are net performed ithe Mare shiall Usbands, and there is no reason to believe that any ofthe pregnaney terminations on recard were provoked. Family plaaning has net been practiced inh the past although ti is stowly gaining ground, We therelore believe that the leriliiy and fetus Viability indicated by these statis ics are the natue ralones. and, aldiough the exposed females showed aN apparent increase in miscarriages during the first > vears, there is no evidence sudgesting that the histary of esposure to radiation bas had any permanent clfect on cither. The people who have died ace listed by vear in Table 10, with their age and: probable caus of death (such death certificates ay aie available are hot alwaws specilig). The overall mortility rate for the 20-sear periad is ~b2 per L000 per vear for the exposcd Rongelap group and — 35 for the anexposed: for the hist d-vear period the rates are ~Y andl ~ 21 respeetively. These ditlcrences are hot statinically significant; ta such small groupes Table It Mortality, Utirik (Av. age at death: 6123) Year bob 157 Subject Nu, TB 1057 Age & wx Year aM 57 F 63M Subject Age Na. & ex 1905 218) o7 M 1965 22d 63 F 1905 2 TLE 14657 2 63 F yD W255 56M 1058 wd NE 147 2181 7K AM hoo 2he2 u7 M La7 2202 “OF 954 227 TaN Tm? way T9F yo Ta JEU SyuT 4N1 61F 18 | Seeadd 2tul wit 2M TUM Badd lk 19aG 2116 Ou J1ho i JF ith Mf 14d 1 theads my 2141 2259 219] a7 F JF oF taal NG TEN td T34 8OM 1G] 2yuu 4OF 1070 275 YK 63M Vad Tod Jyh Ti t3 NE 65 F buT] 971 W238 Th oe M 2F 1d 2192 uiF 63 MM [72 rH 2178 37M Lad JU3A 51 F Los 21a o7 F 174 2201 as F ons 14653 rad 2104 TF IG7U Lor. 73M 57 MM observed over such short periods, differences this large or larver could occur by chance ( <U.05). Even so, had the trend been in the opposite dircetion, we would have had reason to be concerned; a an cxample, we ary keeping a carchul watch on the BpPpAarent increase in maligasncies (see Section V’). The mortality rate among the exposed Cririk people was ~ 13 for the 20-vear period and ~ 14 lor the last 5 vears. The deaths are sted in Table TE, bat causes are not given because of insullicient hata. Reeent misconceptions make it necessary to clarify comparisons with district-wide statistics. The vital statistics of the Trast Territory have improved greatly over the 20 vears covered bythese reports, bur thes are still tat published in suthicient detail to permit valid comparisons with ours, Vhe age distributions are tou ditverent: district- wide the median age is 1G vears, whereas in our group itis benweren $0 and 40, Vhe ditference between the mortality ia the general population (+7 per [000 per vear) and thaton our groups (> 3) reflects this ditference un age distrabution andi is not related ty the history of exposure. A similar ef lect can be seen on the birthrate (~40 per 1000 per vear distriet-wide and ~~ EIU in our groups).