Soe Project Title: 13. Human Health Effects from Energy Generation Medical Studies of the People of the Marshall Islands Accidentally Exposed.to Fallout Kelationship to Other Projects: (Cont d) GK-01-02-0!-1-‘a) analysis of such accidents, such as‘ for the Rasmussen report. ‘The data are also quoted in other reports such as the NCRP, ICRP, BIER, and those of the United Nations. The Safety and Environmental Protection Division of this Laboratory con~ ducts radiological personnel and environmental surveys of contaminated Marshall Islands and inhabitants. the Medical Surveys. 16. These studies are closely coordinated with Technical Progress in FY 1978: In response to requests by the people of Rongelap and Utirik, DOE agreed (February 1977) to assist the Trust Territory in an expanded health care program for the people living at Rongelap and Utirik Atolls. Accordingly during the March 1977 survey (23 years post-exposure) all Marshallese living on these atolls, who wished it, were given complete medical and laboratory examinations similar to those in the exposed group. Greater physician-patient relationship was attained by lengthening the stay on these islands. Quarterly visits were also conducted at Rongelap and Bikini, but due to misunderstandings between the Utirik people and the Resident Physician, the latter was requested not to return. Recently, however, the people have requested that he return and it is expected the quarterly visits to Utirik will be resumed. The health status of the people examined was found to be generally good. Thyroid abnormalities continued to be the only definite findings related to radiation exposure. During the past year, thyroid surgery was done on two exposed Marshallese (a 43-year-old Rongelap man and a 50-year-old Utirik man) and on one 66 year-old unexposed Rongelap man. The latter had a thyroid cancer but the two exposed people had benign lesions. There have now been 39 thyroid abnormalities (32 with surgery) among the 244 exposed Marshallese (35% of the Rongelap people and 5.8% of the Utirik people). The occurence of three thyroid cancers in the exposed Utirik population (compared with four in the Rongelap group) appears to implicate radiation exposure in the etiology but the high incidence is puzzling since it is greater than would be predicted based on Rongelap and Japanese data, and there does not appear to be any increase in benign thyroid tumors in the group compared to the much greater prevalence in the Rongelap group. Because of the uncertainty of the incidence of thyroid tumors in unexposed Marshall Islanders and in order to obtain better statistics, during the past year thyroid examlnations were included on all unexposed Rongelap and Utirik people on any of the Marshall Islands visited. It is hoped that this study will be extended to include thyroid surgery when indicated. Also in order to help solve the Utirik dilemma re-evaluation of radiation doses from fallout to the Utirik people, including the thyroid, has begun. (See Continuation Sheet) ‘6K-14