elevated alkaline phosphatase. A_ flexible sigmoidoscopy and mammography were negative, blood count was normal, and Papanicolaou smear was class I. She had carcinoma of the endometrium in 1979 which waseffectively treated by total abdominal hysterectomy. Septicemia and nonketotic hyperosmolar diabetic coma werelisted on her death certificate as the causes of death. _ Subject No. 14. This 54-year-old woman died on Ebeye in 1990. When last seen by the Brookhaven team in October 1989 she was taking glyburide for diabetes mellitus and had a fasting glucose of 208 mg/di and a HbA\Ic level of 7.4% (miidly elevated). A blood count was normal. Other problems considered earlier were bilateral cataracts, fibrocystic disease of breasts with negative mammogram in May 1989, negative Papanicolaou smear in 1988, and normalflexible sigmoidoscopy in 1987. The cause of death is unknown. Laboratory Findings: Hematology A review of “blood counts" (average concentrations of formed blood elements) of the different exposure groups during the four-year reporting period does not reveal any systematic differences among groups. In 1989 and 1990 there was a significant increase in mean platelet count in Utirik exposed women as compared to the unexposed population (Table 1). Figure 2 is a continuation graph in which hematologic data of the two exposed groupscollected since 1956 are portrayed in relation to the expanded Comparison group. Table | gives the mean values (+ /- SD) from which Fig. 2 is derived.- The individual counts are given in Appendix B. It is apparent from scanning the four graphsin Fig. 2 that there is a mild but relatively consistent - depression, generally not statistically significant different, over most of the 37 post-exposure years, of neutrophil, lymphocyte, and platelet concentrations (the latter in males only) in the Rongelap/Ailingnae group. This depression appears to be of noclinical significance. These consistently slightly lower values for all three formed blood elements over such a long period in the Rongelap group suggests the possibility of radiation related mild impairment’ of hematopoiesis. However, there is no evidence of impaired leukocytosis in response to Therefore, these differences may reflect cell compartmentalization (e.g. marginati Hematologic changes in Japanese ato survivors have been recently reviewed ( Finch, 1988). An early decline in leukoc was detected from 1947 through 1956, occurred in both exposed and unexpose and therefore was not an effect of Indeed,"no clearly established exposure d have been uncovered except in the cage of the leukemias” (Blaisdell and Amamotof 1966). Therefore, a sustained depression in [eukocyte counts, such as seen in the Rongelap grougl, was not detected amongthe exposed Japanese. Wah regard to leukocyte margination, no evidence of afradiation dose-effect in the exposed Japanese was apparent when exercise-induced leukocytosis was quantified (Belsky et al., 1972). In general, radiation has been found to alter leukocyte function in humansonly mininfally, if at: all, and, when dysfunction has been detecfed,it has been of no clinical importance. The mst recent clinical study to confirm this was carriqd out on Japanese atomic bomb survivors and included phagocytic and bactericidal activities of nfutrophils (Sasagawa et al., 1990). It was noted that for ten years after thf atomic bombings in Japan the leukocyte counts @f persons followed by the Atomic Bomb Casualty Cqmmission gradually decreased by about 35% in both the exposed and unexposed populations (Blaisdell and obtained on the Marshallese over a simpi span. Using data from the unexposed C group, the mean total leukocyte concen 1954-1958 was 8,500/ul and for 1969-1 74 it was 7,300/ul, a 14% decline. For 1985-1990 i has been 7,500/ul. A decrease in absolute | concentration, approximately 1,000/ul, simultaneously. This finding differs from Japanese, in whom it was the neutrophil. predominantly lowered. For the minimalfluctuation was seen in neutroph the three periods. The reason for th decrease in lymphocyte concentratio exposed and unexposed Marshallese is phocyte occurred hat of the that were rshallese, count for apparent in both known.