Chapter X — The Marshallese Experience Related to Other Radiation Accidents _ The Rongelap people (who were nearestto Bikini) were not evacuated before thescheduled detonationas they had beenbeforeOperation Crossroads, and, in the subsequent confusion, evacuation was delayed. Because there was no radio communication with the island the: -« Marshallese were unaware of the.danger of the fallout and took no protective measuresto reduce their exposure. Their houses offeredlittle protection. They ingested food and water contaminated with the fallout and did not wash the fallout from their bodies nor change cloth- ing. In contrast, the American servicemen on Rongerik atoll were aware of the fallout and its dangers and took protective measures which reduced their exposure. The medical findings in the Marshallese are applicable to accidents involving nuclear power reactors where fallout has been shown to be a serious problem. The worst radiation reactor accident occurred at Chernobyl in Russia in 1986. Earlier, there were reactor accidents at Windscale in England (1957) and at the Three Mile Island plant in Pennsylvania (1979). These accidents were less serious, involving much less “4 90081495 sau ©Ae An ® oe at detectable in other countries of Northern — dren, who are most sensitive to such effects. A large numberofpeople, including 80,000 children (A-68), are believed to have received sig- nificant thyroid exposure and are being. examined regularly. Thusfar, no thyroid tumors have been reported but, based on the findings in the Marshallese people, I believe that thyroid abnormalities will eventually develop (A-59-62): There are reports of an increase in leykemia in.the exposedchildren (B-101,102). The Marshallese experience has shown that certain prophylactic measures are heipful in people receiving significant radiation exposure . .to the thyroid from fallout. These measures include early surgical removal of thyroid tumors and use of thyroid hormone. Consideration should also be given to the pro- phylactic use of stable iodine (potassium iodide tablets) to people at risk of such exposure to reduce the absorption of radioactive iodine by the thyroid gland. ok fallout, particularly the large numberofchil- _ mental in saving lives (A-60). Of concern is the large numberof people exposed to radioactive Le where extensive supportive care was instru- et le oe OU Europe and, toa slight extent, in the United States (A-59-62). Inadequate emergencyplanning resuited in uncoordinated emergency action. One hundredand thirty- five thousand people were evacuated from a 30-kilometer area around the pliant. There were 31 deaths from acute effects of people exposed at the reactor site. Over 200 people were treated in hospitals een ae more distant. This powerful detonation, greater than expected, deposited large amounts of incinerated coral dust mixed with radioactive elements in areas east of Bikini. Fortunately, because of their distance from the detonation site, the amounts of fallout on the inhabitants of the islands were too small to cause acute lethal effects. The radiation exposure of the Marshallese was due entirely to fallout. The people on Rongelap Atoll, where the heaviest fallout occurred, lived in the southern isiands of the atoll and sustained a sublethal!dose ofradiation. Had theylived on islands 10 to 15 miles further north, undoubtedly there would have been deaths due to the exposure. ac extensive fallout, with few, if any, detectable effects in the populations surrounding these plants (A-62). At Chernobyl, humanerrors resulted in melting of the reactor core which breached the shielding, sending a plume of radioactive material downwind over a considerable area of Western Russia; the plume was a Before the Bravo accident, there had been some failout from other tests, but it was not until this accident that the importanceof the fallout hazard becamefully appreciated. Some features of the accident and its consequences were unique in comparison with what might oceur in other geographical areas. The detonation occurred on a tiny, isolated coral atoll with only sparsely inhabited islands 100 miles or