eral forms of radioactive iodine in producing
thyroid injury was more fully appreciated and
accounted for the increased thyroid abnormalities noted (see Table 1).
Several years after exposure, a trend toward
retardation of growth was noted in some of the
exposed Rongelap children,particularly in boys
exposed when they were less thanfive years old
(A-22,24). At ten years old, two boys, exposed at
one year of age, became markedly stunted. In
fact, they were shorter than their brothers who
were a year younger. At this time, they exhibited clinical signs of severe loss of thyroid function. It was not immediately apparent that the
growth retardation wasrelated to thyroid maifunction since the thyroid hormonelevels were

normal. Soon after, a more refined test of thy-

roid hormones showed that a form of protein in
the blood, peculiar to the Marshallese people,
had caused spurious readings of thyroid hormone levels. The hormonelevels were depressed
and were responsible for the growth retardation.
Nine years after exposure, thyroid nodules

were detected in a 12-year-old Marshallese girl

and the following year two other exposed children developed nodules of the gland. Tumors of

population. Recurrence of non-cancerous
tumors in two individuals following surgery has
required a second operation. Table 3 lists the
number andtypes of thyroid tumors diagnosed
at surgery.
The time of development of thyroid tumors
was related to the amountof radiation to the
gland.i.e., the greater the amountofradiation,
the earlier the development of the tumor.

Wefound later that the exposed Rongelap

people generally showed reduced thyroid function, even those that had not had thyroid surgery (A-36); also, the degree of reduction in ©
those that had had surgery was greater than
would be expected from the amountof thyroid
gland which was removed (A-19). One exposed
Utirik man, who had not had thyroid surgery,
had slight reduction of thyroid function. A
treatment program giving thyroid hormoneto
Rongelap people, although not strictly adhered
to, apparently prevented clinical effects of this
reduced function. However, it was apparent
that serious effects of loss of thyroid function
could develop, and the importanceof maintaining a strict program of thyroid treatment was

the thyroid gland,'! both benign and malignant,

continued to develop in adults as weil as children, particularly in the exposed Rongelap
group, to a lesser extent in the exposed
Ailingnae, and, later, a slight increase was

noted.in the lessear-expesedUtirikgroup. The —
incidance ofthyroré.turmees4s (he dhéxpoad

/

group westhesame as in Scherrdpopila
tionss About one-thirtofthe expoaddeTin

pee:

people haye developedthyroidabhéttha ies5
(see.Table 2); Thegreatest tattdencewastn”°=

children exposed attess than 10‘yearsof'age,
which is due to their smaller and more active
thyroid glands. Two of the three Rongelap children exposed in utero later developed benign
thyroid tumors, suggesting that radioiodines
transferred from the motherto the fetus were
partly responsible for development of the thy-

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roid tumors.*? The incidence of thyroid abnor-

malities in the Utirik population has been
slightly higher than that seen in the unexposed

‘lhe term “thyroid tumor” is used hareto include adenomatous

nodules, adenomas and cancer.
Reeentiy, a thyroid tumor wasfoundiin a Utirik man (one of
eight) exposed in ucero. It is jess certain that bus tumor was
related to the mother's exposure.

Two Rongelap boys with growth retardation due
to radiation effects on their thyroid glands.
23

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