radiation in humanbeings. and pernaps also to the designationof the program asa ‘esearch project . In spite of limitations of the program established by the mandate. the AEC recognized that it would be necessary to examine a control, unexposed population and that the physicians would treat diseases other than those caused by radiation. Later on, the AEC/DOE further expanded the program. There was never any effort by AEC/DOEorany other agencyto influence the conduct of the examinations. During their stay on the islands, the medical team routinely carried out “sick call”for anyone needing medical attention. It should be emphasized that the amount of health care that could be given by the medical team was limited not only by the mandate butalso by the time available for the examinations. . Since an unexposed population of Rongelap people were given the complete battery of examinations and tests given to the exposed people. the other unexposed people on Rongelap and Utirik eventually requested that they receive the complete examinations. Therefore, by 1972, all the people on Rongelap and Utirik were included. Following the death of a young Rongelapese in 1972 from leukemia, which was probably related to. radiation exposure, we decided that hematologicalexaminations of'the (namely, Wotje, Likiep, and Majuro) were given thyroid (neck) examinations. On arrival at these atolls. a meeting was held to tell the people that we wouid make ‘street surveys” starting at one end of the village and going down the street, asking the people to let us examine their necks. There was usually complete coopera- tion.? In 1974,a “Fallout Survivors’ Bill” (B-18) was passed by the Congress of Micronesia and later funded by the United States (B-47). Those whowereill were granted free hospitalization in the Islands and free travel, with per diem allowances. Both exposed Rongelap and Utirik people, and the unexposed contro! people could participate. When referrals to U.S. medical facilities for further treatment were necessary, the expense was borne by the Trust Territory governmentexcept for illnesses which might be related to radiation exposure, which continued to be funded by the DOE. Becauseof funding and administrative difficulties, payments were often delayed, which resulted in considerable unrest and criticism expressed at our village meetings. Later, representatives of the DOE accompanied the medical team to clarify these issues. Following my retirement, HughS. Pratt every siz” Rongelap peoplewould be’done headed the program in 1980. He wasfollowed for'a briéf-period by BP; nkite, who headed the first team in 196 : Sei Adams has ably directed the program. In 1991" ment program withthyroid |hor ne.was not'™ gTam. months. Also, webecame aware thatthe tréat: being sufficiently monitored, whith éould be serious, particularly in peoplewhohad had thy- roid surgery. In addition, it was increasingly apparent that greater continuity was necessary in the medical care of the populations being | examined. Therefore, a resident physician, Knud Knudsen, from BNL, wasstationed in the Marshall Islands at the Ebeye Hospital near Kwajalein to coordinate the medical programs at Rongelap and Utirik, and the District Center at Majuro,in collaboration with the Department of Health Services of the Trust Territory. Beginning in 1973, when thyroid nodularities were developing in the lower-dose Utirik population, we decided that more information was needed on the natura! incidence of thyroid tumors in the Marshallese people. Therefore, more than nine hundred peopleliving on atolls nit eT and Utirik 1 t 16 Jéan Howard joined Adamsin directing the pro‘~The examinations arenow.‘oaittied0Out, . twice a year. The first examination, usually in *In 1982, the Marshall Island Atomic Testing Litigation Project (Lee Angeles) supported a survey for thyroid nodules in the Marshall Islands (Hamilton, T.E.. van Belle. G., and Lo Garfo, JF., Thyroid Neoglase i Mevehall looters Exposed to Nuclear Failout. JAMA 258: 629-36, 1987). The study reported that there was an increase ofthyroid nodules in people of the northern Marshaila (other than Rongeiap and Utirik) compared with peopie in the southern atolls, which they believed was dus to exposure to fallout from the Brave accident. They claimed that the incident of nodules we fer our control pepulation was too high. If true, the risk factor for thyroid nodules in the Rongelap and Utirik people would be increased. However, when one considers the fact that the greatest damage to the thy- roid gland was from the short-lived isotopes ef iodine which decay in a matter of hours, it is hard to believe that. by the ime the fallout reached more distant atolls, the thyroid dose would have been sufficient to result in later development of nodules. We concluded from our examination of peopie on two atolls in the northern Marshalls (Likiep and Wotje), and the Rongelap and Utirik people who had not been exposed in 1954. that the inaadence of thryoid nodules in these people was simular to other world populations (A-15).