FOREWORD
As part of the United States atmospheric nuclear weaponstesting program between 1946 an 1958, 23 nuclear
devices were detonated at the Bikini Atoll and 43 nuclear devices were detonated at the Enewa@tak Atoll. A 1954
nuclear weapons test on the Bikini Atoll, test shot code named Castle Bravo, produced a nficlear yield much
higher than anticipated. The levels and dispersion of the radioactive fallout from Castle Brav were significantly
greater than originally expected. This resulted in radioactive fallout on the inhabited atolls of Rongelap and
Utrik. The Rongelap and Utrik people were evacuated from their contaminated atolls 38 and 72 hours,
respectively, after the Castle Bravo test shot. The original population directly exposed to the f llout from Castle
Bravo consisted of 241 individuals and 12 fetuses. Absorbed dose estimates for the exposed p bpulation were in
the order of 0.11 to 1.9 Gray (11 to 190 Rad) to the whole body and from 1.9 to 200 Gray (1 0 to 20,000 Rad)
to the thyroid.
Public Law 99-239 mandated that the Government of the United States would "continue
provide special
medical care and logistical support to...the remaining population of the Rongelap and Utrik who were exposed
to radiation resulting from the 1954 Bravo test.". The Department of Energy (DOE), througlf its contract with
the Brookhaven National Laboratory Medical Department, implements this congressional mgndate.
The present DOE Marshall Islands medical surveillance program consists of two field missi s per year. The
purpose of the program is to provide medical care and treatment for radiologically related p blems for those
Marshallese who were exposed to fallout from the 1954 Castle Bravo test. As of December 1 91, the originally
exposed population consisted of 159 individuals. The medical surveillance program offer: | on a voluntary
participation basis, an annual physical examination to these individuals, as well as annual phyg cal examinations
to a comparison/control unexposed population.
The medical surveillance procedure includes a complete annual physical examination, which is based on the
criteria established by the American Cancer Society. Typical medical missions inclu d specialists in
gastroenterology, hematology, obstetrics/gynecology, endocrinology, oncology, radiology, card ‘Foes, nephrology,
pulmonology, and rheumatology.
This, the 16th report of the Marshall Islands Medical Program, disseminates information conce ning the medical
status of the 253 Marshallese exposed to the fallout from the 1954 Castle Bravo test shot.
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‘Harry J.{Pette gill, PHD.
Director
Office of International
Health Studies
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Paul 8eligmagi, M.D., M.P.H.
Deputy Assistant Secretary
for Health Studies