maintaining a euthyroid state in the operated cases and has been important in
correcting growth retardation in the children.
aio
=
P

prey Sues

EgdoknddutertticectSeveralYeatsago the

Ailingnae group were also included in the treatment program. Serious consideration must now be given to including the exposed Utirik group also. A few in
this group with thyroid nodules have been placed on Synthroid therapy.
_ The development of three cases of thyroid cancer in the Utirik group was
unexpected. One wonders if something is unusual in the Utirik situation since
the heidence is higher than expected for cancer based on risk/rad for Rongelap and
Japanese data without increase in benign nodules which are usually increased. to

a greater extent from radiation. This points to the fact that we badly need
more data on the general incidence of thyroid tumors in the Marshallese people.

Therefore on this survey a continuation of the study of such tumors in other

exposed Rongelap and Utirik people is planned. Followup will include observations
with a trial period of Synthroid suppressive treatment, followed by surgery if
indicated. During the past several years, with the development of more sensitive

tests of thyroid function (RAI for T4, TSH, T3, TSH and TRH stimulation tests)

extensive examinations of the exposed Rongelap people have indicated that some of
the exposed Rongelap people who have shown no evidence of thyroid nodules and who
appear clinically euthyroid have reduced thyroid function. Further such tests
will be carried out on this survey. This finding may portend trouble ahead in
some of this group. These people with biochemical hypothyroidism will be
included for compensation.
Examinations

The forthcoming survey will include examinations of all people living on
Rongelap and Utirik, including children and exposed and control Rongelap and
Utirik people living on Majuro and Ebeye.. In addition a thyroid survey of
unexposed Rongelap and Utirik people living at Majuro and Ebeye will be included.

Potential 1979Exams (by Age + Sex)

Males
14-25

>25-40

Females
>40

14-25

>25-40

>4n

Rong. exp, children of Rong. exp

24

16

15

24

22

12

Utirik exp, children of Utirik exp.

26

32

15

16

35

31

Rong. unexp, children of Rong. unexp.

4l

36

31

38

43

38

Utirik unexp

children of Uritik unexp.

30

10

13

28

3

10

Totals:

121

94

74

106

109

91

,

Grand Total:

905956

595

Select target paragraph3