Protocol 1974

Continued

Page Four

may be important in cases that might develop cardiac problems.
Therefore
this group will be taken off thyroxine prophylactic treatment beginning
January 15, 2 months before the survey.
(The 23 people who have had
thyroidectomys including the 2 boys with thyroid atrophy, will not be
included in this study since it is already known that their thyroid function
is “spnormal and continued thyroid treatment is of great importance in this
group.) In order to test thyroid function in this study it is planned
to measure thyroxine (T-4 and T-3) and TSH levels on an initial blood sample
followed by administration of 10 units of TSH and another blood sample
drawn 24 hrs later for measurement of thyroxine levels and clinical
exam of the thyroid. About 10 unexposed Rongelap people will be similarly
tested.

Dietary Iodine and Iodine Excretion Levels:

Iodine

in the diet may

be evaluated by testing the level of this element in representative meals

which will include local fruits and marine life. It has always been
thought that the iodine level in their diet should be high and this will
test this assumption.
Urinary excretion of iodine, tested some years
ago, was in the low-normal range and this test will be repeated on aliquots
of 24-hr urine samples being collected for radiochemical analyses.

These

studies may also be done in some of the Utirik population since their

diet is presumably less "westernized",

There are two other thyroid studies which may require some
supplementary information:
(1) excretion rate of iodine in children
using 129] is in progress. Activation analysis for measurement of urinary
iodine on urines from 2 children given this isotope is being measured up

to 16 days. This study is designed to help evaluate the thyroid dose
received by children which has been based on an excretion rate of 0.1% of
thyroid burden being excreted in the urine at 15 days after exposure
(the time of the first urine collections).
The other study (2) is an
evaluation of iodoprotein levels which are unusually high in the Marshallese
people.
Jack Robbins, Ed Rall and I are particularly interested in
investigating the environmental and genetic aspects of this finding.
Other ethnic groups are under study.
One study in progress concerns the
use of orally administered 1297 with plasma collection before and at 2 and
4 days to determine possible incorporation of orally ingested iodine in the
various serum iodine fractions.
This study is of a preliminary nature
and depending on the outcome, further sampling of the population may be
indicated,
Diabetic Study:

Diabetes in the Marshall Islands, along with cataracts,

is considered to be of unusually high incidence.

The Trust Territory

Medical Personnel at the district centers have been quite concerned about
the problem and have requested our help in any way possible.
In response
to this request, although we have not seen any connection between diabetes

and radiation exposure in the Rongelap people, we are anxious to help if
possible,

We are therefore fortunate in having Dr. James Field, an expert

in this field, participate in the survey and perhaps suggest further
procedures for evaluation and therapy of this disease in the Marshalls.

Select target paragraph3