Protocol 1974

Continued

Page Four

may be importdit in cases that might develop cardiac problems.

Therefore

this group will be taken off thyroxine prophylactic treatment beginning

January 15, 2 months before the survey.
(The 23 people who have had
thyroidectomys including the 2 boys with thyroid atrophy, will not be

included in this study since it is already known that their thyroid function

is “abnormal and continued thyroid treatment is of great importance in this
group.) In order to test thyroid function in this study it is planned

to measure thyroxine (T-4 and T-3) and TSH levels on an initial blood sample
followed by administration of 10 units of TSH and another blood sample

drawn 24 hrs later for measurement of thyroxine levels and clinical
exam of the thyroid. About 10 unexposed Rongelap people will be similarly
tested.

Dictary Todine and Todine Excretion Levels:

Iodine in the diet may

be evaluated by testing the level of this element in representative meals
which will inelude local fruits and marine life.
It has always been
though: that the iodine level in their diet should be high and this will
test this assumption.
Urinary excretion of iodine, tested some years
ago, was in the low-normal range and this test will be repeated on aliquots
of 24-hr urine samples being collected for radiochemical analyses, These
studies may also be done in some of the Utirik population since their

diet is presumably less 'westernized".

There are two other thyroid studies which may require some

supplementary information:

(1)

excretion rate of iodine in children

using 1291 is in progress. Activation analysis for measurement of urinary
iodine on urines from 2 children given this isotope is being measured up
to 16 days.
This study is designed to help evaluate the thyroid dose
received by children which has been based on an excretion rate of 0.1% of
thyroid burden being excreted in the urine at 15 days after exposure
(the time of the first urine collections).
The other study (2) is an

evaluation of todoprotein levels which are unusually high in the Marshallese
people,
Jack Robbins, Ed Rall and I are particularly interested in
investipacing che environmental and genetic aspects of this finding.
Other cthnic groups are under study.
One study in progress concerns the

use of orally administered 129] with plasma collection before and at 2 and
4 days to determine possible incorporation of orally ingested iodine in the
various scrum iodine fractions.
This study is of a preliminary nature
and depending on the outcome, further sampling of the population may be
indicated,

Diabetic Study:
Diabetes in the Marshall Islands, along with cataracts,
is considered to be of unusually high incidence.
The Trust Territory
Medical Personnel at the district centers have been quite concerned about

the problem and have requested our help in any way possible.
In response
to this request, although we have not seen any connection between diabetes
and radiation exposure in the Rongelap people, we are anxious to help if
possible, We are therefore fortunate in having Dr, James Field, an expert
in this field, participate in the survey and perhaps suggest further
procedures for evaluation and therapy of this disease in the Marshalls.

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