CHAPTER 2 CLINICAL EXAMINATION 2.1 PREVIOUS FINDINGS Within hours of exposure ta radiation, approximately two-thirds of the Rongelap people felt nauseated and one-tenth of the group had vomiting and diarrhea. One Ailinginae individual reported nausea. Itching and burning of the skin and eyes during this period occurred in over one-quarter of the Rongelap residents and in a smaller number of the Ailinginae population. With the exception of skin lesions and epilation reported in Chap. 3, there were no further symptoms nor findings on physical examination that could be attributed with certainty to radia- tion exposure. All individuals were normally active throughout the period of observation. The various clinical conditions encountered in the highest exposed Rongelap and Ailinginae groups were not remarkably different in type or extent from those seen in the least exposed Utirik group. Although a numberof individuals were markedly neutropenic, no infections attributable to neutropenia per se were observed. No external evidence of hemorrhage wag observed,al- though platelet counts in 20 per cent of the Rongelap groupfell to 90,000/mm’or lowerat the time of maximum depression. Antibiot.cs were used in a few individuals where inticated for incidental infections. However, no prophylactic or therapeutic drugs were necessary or given because of whole-body radiation exposure alone. 2.2 PROCEDURES The following procedures were carried out routinely on both exposed and control groups: (1) brief past history,* (2) complete interval history, (3) skin examination (including biopsies and photographs in selected cases), (4) complete physical examination (including ophthalmo—< scopic, rectal, and pelvic examinations), (5) chest X-ray, and (6) hematological studies (in- cluding bone marrow aspirations in selected cases}. Serology was done on scme of the exposed individuals. Special measurements were taken on children to provide a base line for future growth and developmentstudies. 2.3 CLINICAL FINDINGS Past histories revealed litt'e of note, with the exception of a high incidence of yaws (exposed group, 23; control group, 17) and gonorrhea (exposed group, 21; control group, 19). One * Interval and past histories were taken by Dr. John Jaman, a Gilbertese physician who spoke excellent English as vetl as Marshallese. English-speaking Marshallese nurses aided in the physical examinations. 11