58 high incidence of diabetes. Serum assay for vitamin B,,. showedgenerally high levels; the explanation was not apparent. Radionuclide body burden evaluation in the Marshal- lese people has been complicated by several things. The people were evacuated from their island soon after the accident and did not return until 3 years later. During the 5 years since the original con- taminating event, additional weaponstests held in the area have contributedto the fission products This study ofthe internal contamination of the Marshallese has provided information (1) on the movementof Cs'*’, Zn®, and Sr® from the en- vironment to man; (2) on the rate of equilibration of these isotopes with the environment; and (3) on the discrimination factors between food and man. IMPORTANCE OF MEDICAL SURVEYS in the environment. Finally, since the diet includes The Japanese populations of Hiroshima and Nagasaki being studied by the Atomic Bomb Casualty Commission and the Marshallese population of Rongelap comprise the only large groups expected underother circumstances. tion. The two studies parallel each other but differ in certain importantrespects. The smaller number of people in the Marshallese population and the a variety of imported foods, the people are not living in a “‘closed”’ environment, and therefore may not be rapidly approaching equilibrium with the environmental fission products, as might be Body burdensof gamma-emitting fission prod- ucts (such as Cs'*’ and Zn®*) were measured in a whole-body counter and checked by radiochem- ical analysis of urine specimens. Body burdensof Sr°° were estimated from urinary excretion as determined by radiochemical analyses. Both the external dose measurements on RongelapIsland and the levels of radioactive isotopes in the food on the island indicated that some increase in Cs'*7, Zn®, and Sr*° body burdens wasto be ex- pected when the people returned there in 1957. The Cs'*’ body burden in 1958 was about0.68 uC, about 60 timesas great as in 1957, and the urinary Cs'*" level rose by a factor of 140; the mean body burden for 1959 was 0.57 wC. The mean body burden of Zn** estimated from whole-body counting data was, in 1958, after the return to Rongelap, 0.36 uC, 8 times as high as in 1957, and 0.44 pC in 1959. Thus, whereas the Cs**’ levels appear to have reached a maximum and actually to have dropped in 1959, the Zn® levels have shown a continued increase which is probably related to the long biological half-life of the latter. The Sr°” level in 1958 estimated from excretion data was 2 mpC, about 20 times as high as in 1957 before the return to Rongelap. The estimated body bur- den in 1959 increased to 6.0 mpC, about 20% of the estimated ultimate equilibrium value. Little of the body burden of the exposed group is apparently due to their initial exposure, since at presentthereis little difference between the levels of the exposed and unexposed populationsliving on Rongelap Island. When these three isotopes have reachedtheir estimated equilibrium values, _ en coy the body burdenswill still be of small significance in terms of radiation hazard. of people exposed to acute doses ofionizing radia- paucity of vital statistics makestatistical analysis of data on this group much moredifficult. How- ever, the Marshallese studies have the advantages that the dose of radiation received by the people is better known; that the findings during theearly, acute period after exposure are well documented; and that the people did not suffer from trauma, thermal burns, or marked psychic disturbance, al- though they did have the complications of beta burns andinternal absorption of radionuclides. Study of both groups has yielded valuable information on the acute effects in human beings of radiations from atomic bomb detonations. Examinations for the more subtle late effects of radiation exposure are now receiving considerable em- phasis. In the case of the Japanese, increasedinci- dence of leukemia and possibly other malignancies as well as cataracts already has been reported. In view of this finding, the next 5 years will be the critical period for the developmentof leukemia in the Marshallese. Animal experimentation has indicated the possibility thatstill other late effects may occur in the human being such as premature aging, shorteningoflife span, increase in degener- ative diseases, genetic changes, etc. Therefore, con- tinued careful examination of these populationsis extremely important in order that such effects may be documented, and therapeutic procedures instituted wherever possible, should such effects develop. In addition, in the case of the Marshal- lese, continued evaluation is indicated ofthe influenceof persisting low levels of radioactive mate- rials on Rongelap Atoll on the body burdensof radionuclides of the people living there.