b+ use of crab meat as a food item should continue to be avoided. Otherfoods, however, are responsible for the '**Cs levels found. Summary Medical survevs were carried out on the exposed people of Rongelap Island in March 1965 and March 1966. [n 1965 the comparison population was also examined, and in 1966 the exposed popula- women duringthe past 2 years, but 3 miscarriages occurred in unexposed women. No abnormalbabies were born in the exposed group, but two (hydrocephalic and mongoloid) were born to two unexposed women. The people of Utirik Island appeared to have been in good health and reported few serious medical happenings over the past 3 years. The birth and deathrates tn this group appearedto be similar to those in the Rongelap group. tion of Utirik Island was examined. PHYSICAL FINDINGS INTERVAL MEDICAL HISTORY During the past 2 vears the Rongelap people have been generally in good health with satisfactory nutritional status. No unusual epidemics of disease occurred. Over the 2-year period 2 deaths had occurred in the Ailingnae group (originallyexposed to 69 rads). No autopsy was obtained, but children, previously noted, have continued. No leukemia or cancer (except one thyroid cancer) the deaths occurredin older people with no obvious connection with radiation exposure. One death occurred in an older woman of the comparison population. The death rate has been higherin the exposed population than in the unexposed population, which may‘in part be related to the larger percentageof older people originally in the exposed group. Birth rate has been about equal in was detected. riages or stillbirths were noted in the exposed excretion ofiodine, thyroid uptakeof radioiodine, and serum cholesterol levels were reviewed. Thyroid abnormalities during the past 3 years the exposed and unexposed groups. No miscar- v E T TT T c nee ene aper en - SE5ARA7 ON AND 2 - tt LNT loz aa FL T * caTE OF COLLECTION i TS 7 ‘ r T 3 = 90S, NN S4ELETIN LOPPECTES TC roe Doles TT a to Wy SEE pCi/g DRY As noted in previous surveys, the variety and distribution of physical abnormalities (with the exception of thyroid pathology) did not appearto be significantly different in the exposed people as compared with the unexposed population. The trends toward growth retardation in the exposed 4 + | oa - 1 Ss 'N MUSCLE CORRECTED "O DATE CF COLLECT ON t “Ts. 4 4 b if 1 io E C = > I: ' J COCONUT CRAB (BIRGUS LATRO) . KABELLE ISLET RONGELAP ATOLL \ L ! 1954 1955 1956 1957 ! Bn. i M_SCLE CORPELTES vs MARCH, 954 L 1958 1959 1960 COLLECTION a . !96! L i 1962 4 ] L 4 1963 1964 DATE Figure 71. Analyses for °"Sr, ‘Cs, and °°Co in coconut crabs of northern Rongelap Atoll since 1954. (Courtesy of E. Held, University of Washington.) THYROID FINDINGS The dosimetric calculation for radiation dose to the thyroid from internal absorption of radioactive todines from the fallout was reviewed. Early thyroid studies including protein-boundiodine determinations, iodoprotein levels, dietary iodine and urinary have increased to 18 cases, 16 with nodules and 2 with hypothyroidism. It is noteworthy that in the higher exposure group thyroid abnormalities occurred in 79% of the children exposed at < 10 years of age, as compared with no cases in the children of the Ailingnae, Utirik, or unexposed groups. Only one adult in the Ailingnae group developed a thyroid nodule. Several nodules were noted in the thyroid glands of older Utirik and unexposed adults of Rongelap. Surgery was performed in 11 cases: 9 children and 1 adult were found to have adenomatousgoiters, and | adult a mixed papillary andfollicular carcinomaofthe thyroid gland with localized metastasis. The gross and microscopic appearance ofthese lesions was described and depicted. Correlation of growth retardation in exposed children with thyroid pathology was indicated bythe recent finding of definite