IN CONFIDENCE MRC Department of Clinical Research University College Hospital Medical School University Street, London WCLE 6JJ MRC Medical Research Council telephone 01 - 387 9300 ext reference TO: 188 6th November 1972 The Chairman The Special Joint Committee Concerning Rongelap and Utirik Atolls Congress of Hicronesia Sir, I have pleasure in reporting to you on the medical examinations made during September 1972 by the Brookhaven U.S. National Laboratory team and their consultants, and on the subjects specified in the Memorandum of Understanding between Representative Hans “Wiliander and the consultants to your Committee. I accompanied the team from September 6th to 23rd, and either observed or took part in examinations, including that of the thyroid gland, of most of the people seen on Rongelap and Utirik, and of about 60 of the 80 people to be seen on ‘Mlajuro. I also examined microscopic sections of thyroid glands removed at operations on these people, and have studied reports of previous surveys and estimates of radiation dose. I will comment on the lines indicated in the Memorandum of Agreement but think it may be useful to the Committee if I refer first to the aims of these surveys as I observed them. It seems to me that the surveys have, and have had, three aims which are to a large extent interdependent. (a) AS a primary purpose, to detect at an early stage any radiation-induced abnormality, so that early treatment can be given, e.g. by removal of benign nodules to prevent malignant development, and of malignant nodules to prevent their spread beyond the thyroid or the neck; or to start or supervise treatment designed to prevent such changes occurring (e.g. by giving 'Synthroid”). (b) In addition, to maintain a record of the frequency of any observed thyroid or other changes, in relation to the radiation exposure of thyroid glands. When detailed examinations need to be made anyhow as under (a), this record involves no additional examination or study except of the normal frequency of changes occurring in people who have not been exposed, and of the radiation dose likely to have been received by those exposed. It is however of very considerable importance in the proper planning of radiation protection measures, to know the changes that may lO1uBesl ee / continued.