IAEA-SM-224/607

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have been resected surgically. The incidence of thyroid nodularities and
estimated thyroid doses in the various age groups exposed to fall-out are depicted
in Table I. It is apparent that more than two-thirds of those individuals in the
combined Rongelap and Ailingnae groups, who were under the age of ten at the
time of exposure, and over 15% of those exposed over the age of ten have developed
thyroid lesions. Four Rongelap children were exposed in utero. One ofthese,
a boy exposed at 22—24 weeks gestation (at which time the thyroid was functional),
had benign nodules of the thyroid removed at age 20. A much smaller proportion
of the Utirik group of either age has developed thyroid abnormalities. The
occurrence of three thyroid cancers in the exposed Utirik population (compared
with four in the Rongelap group) appears to implicate radiation exposure in the
aetiology, but the high incidence is puzzling since it is greater than would be
predicted based on Rongelap and Japanese data, and there does not appearto be
any increase in benign thyroid tumours in that group compared with the much
greater prevalence in the Rongelap group.
The high incidence of thyroid nodularity in the irradiated subjectsis in
agreement with previous data linking irradiation of the gland with subsequent

development of thyroid nodules or carcinoma [6]. Since '3"I is considered much

less tumorigenic for thyroid tumours than X-rays, it is rather surprising that,
in view of the large contribution of radioiodines to the thyroid dose in the

Marshallese, the risk factor (risk/rad) is comparable with that noted following

X-ray exposure. This may berelated to the presence of more potentshortlived isotopes of iodine present in fall-out which accounted for two to three

times the dose from !74J.

Aside from the two subjects with frank hypothyroidism, there has been an
increasing suspicion of possible hypothyroidism in other cases. The evidence
supporting this conclusion is summarized in Table II. The two boys who
developed myxoedema had received an estimated thyroid dose of 1150 rads.
In addition at least five of the Rongelap population, who had appropriate testing
before surgery, had either hypothyroidism or decreased thyroid reserve [7]. In
addition a numberof subjects with sub-total thyroidectomy have shown elevation
in serum TSH concentrations and reduction in serum T, whentheir thyroid
replacement schedule was not rigorously adhered to. This is significant since in
general subtotal, thyroidectomy or lobectomyis not associated with frank
hypothyroidism, since the remaining thyroid lobe may often hypertrophy to
supply the needed thyroid hormone requirements of the individual. All the
subjects so tested and listed in Table II were irradiated at a young age, and
therefore received thyroidal dosage of about 800-1150 rads. Because of the
suspicion of possible hypothyroidism in individuals to even lower calculated
doses, a series of studies of thyroid reserve in previously unoperated exposed
Marshallese wasinitiated in 1974, and the following report summarizes the data

obtained in this study up to the present time.

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