2 part of the control group used for the growth and development studies of the exposed children. The accumulation of data from these surveysis becoming increasingly voluminous. Since conditions have not been favorable for performance of extensive statistical analyses or use of electronic computing procedures to store and manipulate the data, the annual survey reports published by this Laboratory are made as complete as possible. This report, therefore, includes a considerable amount of raw data, much of it in appendices, so that others may have an opportunity to make further calculations if desired. Summary of Past Findings Reports have been published on the findings of surveys made at the following times after exposure: initial examination,: 6 months,” 1 year,’ 2 years,‘ 3 years,® 4 years,* 5 and 6 years,’ and 7 years.® The followingis a brief summary ofthe find- ings previously reported. Duringthefirst 24 to 48 hr after exposure, about 24 of the Rongelap people experienced anorexia and nausea. A few vomited and had diarrhea. Manyalso experienced itching and burning of the skin, and a few complained of lachrymation and burning of the eyes. Following this, the people remained asymptomatic until about 2 weeks after the accident, when cutaneous lesions and loss of hair developed, due largely to beta irradiation of the skin. It was apparent when the people werefirst examined, a few days after exposure, that the lymphocytes were considerably depressed and that significant doses of radiation had probably been received. In addition to the whole-body dose of radiation and the beta irradiation of the skin, radio- chemical analyses of the urine showed that measurable amounts of radioactive material had also been absorbed internally. The effects of the radia- tion can best be summarized under three headings according to the mode of exposure: penetrating irradiation, skin irradiation, and internal irradiation. PENETRATING RADIATION One of the earliest findings indicative of significant exposure in these people was loweringoflevels of leukocytes and platelets of the peripheral blood. This was most marked in the 64 people on Ronge- lap who had received 175 r, and was less marked in the other groups receiving less exposure. The hemopoietic depression was roughly proportional to the dose of radiation received. Even in the 157 Utirik people who received only an estimated 14 r, it was possible to distinguish slight platelet depression in the group as a whole. The smaller group on Ailingnae and Rongerik showed peripheral blood levels between those of the high and low exposure groups. The chronological records of blood findings in the Rongelap and Ailingnae groups are pre- sented in Table 10 and in Appendices 1 and 2. Lymphopenia of abouthalf the level of the comparison Marshallese population was evident when the Rongelap people were first examined on their arrival at Kwajalein 3 days after exposure. This depressed level was maintained steadily with only slight increase noted by one year. In the following year, mean counts approached the levels of the comparison population but have since generally remainedslightly below. Neutrophil levels fluctuated considerably during the first month; possibly this was related to the prevalence of beta burns of the skin during that period. Neutrophil depression became evident by 5 and 6 weeks post exposure with levels reaching about half that of the comparison population. This degree of neutropenia was insufficient to result in any apparent increased infectious processes, and indeed it was noted that neutrophilic leukocytosis was possible in people showing casual infections at this time. Neutrophil levels recovered more rapidly than lymphocyte levels and reached near control levels by one year. Subsequent annua! surveys have revealed that recovery does not appear to be complete, particularly in younger and older age groups. Platelet counts showedless fluctuation than other blood counts and fairly consistently showed increasing depression, reaching levels of about 30% that of the comparison population by the 4th week. A spurt of recovery to about 75% of comparison levels occurred during the following few weeks, which was followed by slower recovery but with mean levels never reaching higher than 85 to 90% that of the comparison population during the 7 years post exposure. Erythropoietic depression has not been a consistent finding as with the leukocytes and thrombocytes. Slight depression of red blood counts, hematocrits, and hemoglobin have been noted at times.

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