FALL-OUT RADIATION—CONARD ET AL. Vol. 164. No. 11 Internal Irradiation.—Radiochemical analysis of nu- merousurine samples from the exposed persons showed some degree of interna] absorption of radioactive materials, probably as a result of eating and drinking contaminated food and water. Calculations of the body burden of these materials, however. showed that the concentration was too low to cause anyserious effect. Analysis of urine samples six months after exposure showed that there was only barely detectable radioactivity remaining in somecases. These studies revealed that, other than the occur- rence of skin lesions, loss of hair, and early symptoms. there had been no other symptoms ordisease processes encountered that could be attributed to radiation effects, There had been no deaths. The diseases encountered had been no more severe or frequent than in the nonirradiated population. This was true even during the period when the greatest depression of the peripheral blood elements occurred. It was difficult to evaluate the effects on fertility. A number of apparently normal babies had been born, however, and further pregnancies had occurred. Ophthalmoscopic examinations andslit-lamp observations were made initially and at one vear after the exposure. No opacity of the lens or other eve changes were found that could be attributed to radiation. Present Findings The present survey two years after exposure in- cluded examination of the exposed Marshallese (64 Rongelap and 18 Ailingnae people, along with 10 babies born to these people since the event) and, in addition, a control group of 57 unexposed Marshallese from Rita village on Majuro who werepreviously examined at the time of the six-month survey. In addi- tion, control data on blood from another group of 127 unexposed Marshallese from Majuro, obtained at the time of the initial survey, was also used for comparison of hematological findings. History During Interval and Clinical Findings.—Both the control and exposed groups had been in good general health during the previous 12 months. An epidemic of chickenpox, with no reported complications, involved a large percentage of both populations in the interim between the one-year and two-year examinations. One case of uncomplicated measles occurred in the Rongelap group during the year. In this period. five childbirths were reported among the Rongelap people and onein the control group. These infants have developed normally and are free of any apparent abnormalities. Five Rongelap women and three women in the control group currently have un- complicated pregnancies. One child and an adult in the exposed group wereseriously ill during the past year and, recently after this survey (May 13, 1956), one death. which will be discussed below, occurred among the Rongelap people. Physical examination revealed that the people of both the exposed and control groups appeared to be generally in good health and with good nutritional status. Clinical abnormalities were not anusual and were about equally distributed between the two groups. With the exception of the residua of skin lesions, none of the findings in the exposed groups could be attributed to the effects of irradiation. A 77rs oy i wi fd | am eb a. Me Poof te ay 1193 year-old man gave a history of paresis of the right upper andleft lower extremities of nine months’ duration, with gradual improvement in strength and function during the previous few months. Clinical findings substantiated a diagnosis of cerebrovascular accident. An 11-vear-old boy had been hospitalized about a year previously with acute rheumatic carditis and cardiac decompensation. (This disease, though uncommon. does occur in the Marshall Islands.) The diagnosis of rheumatic heart disease with mitral stenosis and insufficiency was substantiated, and, at the time of examination, the boy was fully active without evidence of decompensation. On May18. 1956, a 46-year-old Rongelap man died suddenlyafter an illness of about one hour. The patient had been quite well until his present illness, except for two short illnesses, which occurred a year ago and four months previously, and were characterized by pyrexia (102-104 F [38.9-40 C]) headaches and bodyaches. general malaise, and a slight cough. In addition, he had complained occasionally of vague abdominal pain, but there were no associated physical findings present. Previous physical examinations had given essentially negative results except for hyper- tension (blood pressure 148/104 mm. Hg), which was present on the first examination, a few days after the radiation exposure occurred (2 years previously ). The condition no doubt antedated the exposure. The present illness was characterized by acute onset of dyspnea, and the patient complained of abdominal pain. He died before he could be brought to the hospital. Autopsy and microscopic examination of tissues re- vealed myocardial hypertrophy (left side) and _pericordial effusion with pulmonary and hepatic congestion; benign nephrosclerosis; and coronary artery arteri- osclerosis. A diagnosis of hypertensive heart disease with congestive failure seemed justified. There was no apparent causal relationship with radiation effects. particularly since hypertension was undoubtedly present at the time of the radiation exposure. Growth and Development: Growth and development, based on height and weight changes, were compared in nine males, between the ages of 3 and 15 years, and in nine females, between the ages of 5 and 19 years, from the exposed and control groups. Unfortunately, control data were only available from the six-month and the present survey for compariscn, and the numbers werelimited due to the inability to locate some of the previously matched control children, The irradiated male children, compared to matched controls at both six months and twoyears, showed a mean deficiency of 2.1 in. (5.33 cm.) in height and 6.5 Ib. (2.9 kg.) at six months after exposure and 7.2 lb. (3.4 kg.) at two years. There was no real difference in the female children. Even though slight differences were noted between the irradiated and control male children, it is not possible to attach any significance to these differences because of the small number of children involved and uncertainties concerning the racial homogeneity of the two populations. Greulich and co-workers,’ in surveys of Japanese children who survived the atomic bombings at Hiroshima and Nagasaki, noted retardation of growth and development in the exposed male children, when com-

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