/administrator stationed at Kwajalein in 1978 returned to the United States in 1981. He was replaced by the Marshallese laboratory technician who had completed a clinical laboratory training course in. Honolulu underthe auspices of Brookhaven National Laboratory. Other Marshallese medical and paramedical personnel who are included on the semiannual]medicaltrips are provided by the Republic of the Marshall Islands. They are listed among the team participants on pages v-ix. In 1981-82 five reports on matters pertinent to public health were submitted to the Minister of Health, Republic of the Marshall Islands. These reports were based on data collected during the . course of the semiannual medicaltrips. The topics included the prevalence of anemia, toxoplasmosis, hyperuricemia, yaws (an analysis of serologic tests), and clinical findingsof a pedi- atric trip. This is an ongoing project. Sharing of such data obtained from the populations we serve may benefit the Marshallese people as a whole. Laboratory Support Most medical activities and all laboratory services of the Brookhaven National Laboratory medical surveys are conducted aboard a chartered U.S. Oceanographyvessel, Liktanur II. Exceptions include the examinations performed in Brookhaven National Laboratory facilities on Ebeye and pediatric examinations at Rongelap and Utirik which, forreasons of the children’s safety, are carried out in dispensaries on.shore. Laboratory support during the medical trips is provided by four technicians. Routine five- a) co ce) =) Cs) parameter blood counts are performed on a J.T. Baker 500Aelectronic particle counter andsizer. Leukocytedifferentials and phase contrast platelet counts are done concurrently. A battery of clinical tests (including serum creatinine, glucose, amylase, uric acid, and liver function tests) are carried out on a Beckmanspectrophotometer with commercially available reagent kits. Serum sodium and potassium measurements are made on a Beckman Instruments Electrolyte 2 system. Urinalysis (dipstick and Microscopic), stool examinations (for occult blood and parasites), and bacteriologic cultures (aerobic and anaerobic) with antibiotic sensitivity testing are available. Hemoglobin Aic- determinations, glucose-6-phosphate dehydrogenase testing, and erythrocyte sedimentation rates are also provided. Serum is routinely separated andfrozen for thyroid function tests and other studies which must be sent to commercial or university laboratories. Fingerstick techniques are used on young children whenever possible. An x-ray machineis available for most commonly required roentgenograms. Electrocardiograms are also available. Referral laboratories for studies mentioned in this report include: BioScience Laboratories in Honolulu (special chemistries, serologic tests), Pathologists Laboratories, Inc. (Papanicolaou smear readings), the Endocrinology Laboratory at Brigham and Women’s Hospital, Boston (thyroid function tests and prolactin assays), Protozoal Diseases Branch, Centers for Disease Control, Atlanta (toxoplasma serologies), Division of Endocrinology and Metabolism, Reese Hospital and Medical Center, Chicago (thyroglobulin levels), Hematology Laboratory at the University of California, San Francisco (erythropoietin assays), Parasitology Laboratory of the National Hansen’s Disease Center, Carville (ova and parasite identifications), and the Hematology Laboratory, University of Louisville School of Medicine (folic acid and vitamin Biz assays). Medical Findings OVERALL MORTALITY The age- and sex-matched comparison population of 86 Marshallese” selected in 1957 has been usedin the construction of survival curves. Although38 of these persons are no longer seen for annual medical examinations (26 are deceased), their status has been made available to the medical team through personal acquaintances of the individuals. Figure 1 shows the survival of the exposed and unexposed populations through 1982. Note that data collection on the comparison group began in 1957 rather than 1954. Use of the tests of Mantel® and Breslow* revealed nostatistically significant difference between the survival curves of each of the exposed groups and the comparison group. RECENT MORTALITY The following 10 deaths have been recorded since the 26-year report’: