6

body burdenlevel of radionuclides; this indicates

that there is probably no correlation with radiation
exposure. Hemoglobin types were considered normal. Sickling tests showed no sickling tendency in
any of the people. Glucose-6-phosphate dehydrogenase of the red cells appeared to be deficient in

the Marshallese. Studies of Gm phenotypes showed
the Marshallese to have 100% Gm'**? and nearly 100% Gm'*+', There was a complete absence
of Gm* and a high frequency of Gm-like (Gm°*).
Considerable caution must be exercised in evaluating the results of these studies on genetically
inherited characteristics because of the small num-

ber of samples tested, The data do seem to indicate

relative homogeneity of the population and closest
kinship with people of Southeast Asia. These data

also may be useful as a buse line should genetic

changes appearin later generations, possibly related
tu radiation exposure.
Results of other laboratory studies included the
following: Serum protein levels were generally on

the high side of normal; electrophoretic patterns
showed the increase in proteins was largely due
to an increase in the gamma globulin fraction. The
reason for this is not apparent. Numerous chronic
infections may be an explanation.

Sodium levels in the urine and food indicated

about the same consumption of NaCl as in Amer-

icans. The generally lower incidence of hypertension in the Marshallese might be related to the

fact that the former native dict was probably lower

in salt content than the present, more westernized
dict. It will be interesting to see whether the incidence of hypertension will later increase.
Serum cholesterol levels (1957, 1959) were

somewhat lower in the exposed population than in
the comparison or Utirik populations, but were in
the low normal range. No abnormally low readings
were noted.
Serumcreatinine levels (1957) were in the normal range with no abnormal Iev.'s noted.
Serum vitamin B,, concentrations (1958, 1959)
were generally significantly higher than American

levels. the possibility of contamination of the samples with bacteria producing vitamin B,, must be

considered, since mycloproliferative and liver discases were not seen.
Serum protein boundiodine levels (1957, 1959)
were generally slightly elevated. Evidence for thyroid dysfunction was not apparent in the people.

Glucosuria and elevated blood sugar were found

in 4 unexposedindividuals, which indicated a rather
high incidence of diabetes.

A survey for intestinal parasites (1958) showed

75% of the people to be infected with various
types. For the three major pathogens found, the

over-all infection rates were, for Entamoeba histolytica, 18.2%, for hookworm, 5.5%; and for
Trichuris trichiura, 34.3%.
Eosinophilia >5% has consistently been noted

in abouthalf the people. The fact that half the cases

with eosinophilia showed no helminthic infections
at all suggests that other factors besides parasitic
infections must be responsible. The cosinophilia
maybe related to chronic fungus and other infections, particularly of the skin.

Complementfixation studies for parainflucnza 1,

2, and 3, respiratory syncitial, psittacosis, and Q fever showed antibodies to all groups of viruscs
except that for Asian influenza, which probably
had not yet seriously involved the people of the
Marshall Islands. The antibody titers appeared to
be somewhat lower in the exposed people.

DIFFICULTIES ASSOCIATED
WITH THE EXAMINATIONS
As mentioned in previous reports, several difficulties were associated with carrying out the examinations as well as interpreting the findings.
1. The language barricr made examinationsdifficult, since very little English is spoken by the
Marshallese. However, there were sufficient English-speaking Marshallese to assist the medical team
in most instances,
2. The lack of vital stutistics or demographic
data on the Marshallese imposed a serious difficulty
in interpretation and evaluation of the medical
data. Records of births, deaths, ctc., have been
muade by the health aides or magistrates of the villages and supposedly forwarded to the district
administrator, however, such records have been
incomplete or lost in most instances, and vital
statistics are therefore inadequate. Trust Territory
officials are now attempting to assemble such data.
3. There is uncertainty on the part of some of
the Marshallese as to their cxuct ages, particularly
among the older group. This imposes certain diMculls in interpreting some of the studies to be
ouuined,

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