PROPOSAL OF BNL MEDICAL DEPARTMENT for CONTINUING PARTICIPATION IN MARSHALL ISLAND STUDIES E. P. Cronkite, M.D. The Medical Department proposes to continue the surveillance of the Marshallese exposed on Rongelap, Ailingnae and Utirik along with the appropriate comparison populations and other Marshall Islands groups in which it may be shown that there has been a significant exposure to fallout. An essential and, in fact, integral part of the medical surveillance is the continuing study, by the Safety and Environmental Protection Division (S/EP), of body burdens, island contamination, and a continuing analysis of past, present and future exposure of the Marshallese to radiation on the above-named atolls and, in addition, those Marshallese relocated to Bikini and Eniwetok. This is essential for determination of the possible cause and effect relation of exposure to radiation. (See enclosure.) The BNL team will concentrate efforts on determination of incidence of malignant disease in comparison and exposed populations and on study of thyroid functions. The medical research literature will be continually surveyed for evidence of other diseases that may be related to exposure to radiation and appropriate special studies on the Marshallese initiated when indicated. Through the P.I. there will be a regular exchange of information with the RERF to see if any new findings on the Japanese at Hiroshima and Nagasaki indicate specific new studies on the Marshallese. Brookhaven desires to continue the present level of health care delivery through the Resident Physician and the Survey teams. As the DOI implements the Burton Bill, BNL wishes to be absolved of the responsibility for delivery of health care other than that which would be performed during surveys for humanitarian reasons. BNL further believes that the best interests of the Marshallese would be served by a close integration of the efforts of the health care providers with the medical surveillance efforts of the BNL team. It is proposed that members of the health care delivery effort accompany the BNL research group during its several annual surveys. The determination of probable relationship of disease incidence to prior exposure to radiation should not be the responsibility of the health care provider. It is proposed that the determination of the probable relationship of incidence of disease with the past exposure to radiation be evaluated annually by a review group consisting of: 1. A representative of RERF Hiroshima. 2. The BNL Survey Team. 3. A member of the Health Care Delivery Group. 4. A member of the S/EP Team. 5. A member of NRC-NAS, such as Seymour Jablon. 6. A member at large from the university community, in epidemiology. 7. Said review group to be chaired by P.I.,BNL Medical Team.