INTRODUCTION Ailingnae groups are combined and referred to as the Rongelap group, for those persons This report updates. through 1987. the medi- exposed on Ailingnae atoll were visiting from cal findings on a population of Marshailese nearby Rongelap at the time of the fallout. Also examined was the Comparison group that dates from 1957 when 86 unexposed people from accidentally exposed to radioactive fallout in 1954. The Marshall Islands Medical Program of the Medical Department, Brookhaven National Rongelap were selected so that the Comparison group approximated, in age and sex distribu- Laboratory, issues these summaries for distri- bution to institutions and individuals worldwide who are concerned about the adverse medical consequences of radiation exposure in generai or, in particular, the plight of the radiation-exposed Marshallese. tion.the exposed Rongelap group (Conard etal, 1958). Sixty persons remain in this group, against which the overall survival of the exposed population is compared (Figure 1). However, a larger unexposed group is also followed. Cur- The exposed Marshallese population origi- rently numbering 135, the age and sex distributions of its memberswerestatistically similar to those of the Rongelap and Utirik groupsin 1982 (Adams et al.. 1983). Included among the 135 nally comprised 64 persons on Rongelap Atoll whoreceived an estimated 190 rads of wholebody external gammaradiation. 180n Ailingnae © Atoll who received 110 rads. and 159 on Utirik Atoll who received 11 rads. In addition. there were 3 fetuses on Rongelap,1 on Ailingnae, and 8 on Utirik. each of which received equivalent whole-body doses. Because of radioiodines in the fallout, the thyroid gland received an additional exposure that was much greater than the whole-body dose, although its magnitude was. in part. a function of age at the time of exposure are mostof the remaining 60 individuals selected in 1957. It is this expanded unexposed population that is used for statistical comparisons of year-to-vear medical events: this provides the baseline prevalences from which anv unexpected consequencesof the radiation exposure can be identified. The content of this report is restricted to the more recent medical findings, some aspects of which bear on late effects of radiation exposure. Those features of the Marshall Islands Medical Program by which medical diagnosis and treatment are provided are discussed. For detailed information on the nature of the 1954 fallout and the acute effects suffered by the population. the readerIs referred to several earlier publications (Bond, et al., 1955; Cronkite et al. 1955: Cronkite et al.. 1956: Conard et al., 1957). Other reports provide reviewsof delayed effects of the exposure (Conard et al., 1980; Conard, 1984: Robbins and Adams, 1989). EXPOSURE GROUPS The medical program examines and treats about 800 persons annually. However, the populations on which this report is based inciude only the exposed persons and a selected group of unexposed individuais. In December 1987. the numberof exposed persons was: Rongelap- 50, Ailingnae - 12, and Utirik - 112. For most purposes in this report the Rongelap and 2084u 101 “ee GURVAIVENG (Lessard et al.. 1985). —— -ONGELAP AND AILINGNAE EXPOSED +-— LIRIK EXPOSED - =INGELAF “TMPARISON GROUP - © 385 U0 235 270 “EAR ~ 96) 67) 26) 275 730 - 25 290 Fig. 1: Percent survivors of the different exposure groups since 1964. The numberof persons in each group are given in the parentheses. THE MARSHALL ISLANDS MEDICAL PROGRAM Policies: The Marshall Islands Medical Program provides medical care twice yearly to the exposed population by visiting the islands where most nowreside, namely Rongelap (and, temporarily, Mejato), Utirik. Ebeye, and Majuro. In addition, the medical team provides health care to acon-