Protocol 1974

Continued

Page Five

Since only a limited number of people can be examined during the MarchApril visit, it is deemed advisable to concentrate on the Marshall
Island populations, principally the Rongelap people living at Rongelap
Island, Ebeye and Majuro.
Sampling of the Utirik population will be
carried out to the extent possible.
In order to evaluate the genetic
component, sampling of other ethnic groups would be desirable but the
logistics and time involved in a study at a distant island preclude

feasibility
Micronesian
Dr. Kasino,
diabetes in

at this time. Of
and other Pacific
a Trust Territory
the Marsnalls and

course, other studies of diabetes in
Island groups will be used for comparison.
practitioner, has a strong interest in
may assist Dr. Field in this survey. A

hematological technician (Nelson Zeditka) will also assist.
From discussions with Dr.

considered:

Field the following procedures are being

Ideally a fasting blood sugar specimen would be drawn

followed by a glucose meal and 2 hrs later another sample drawn for blood

sugar. However, only a limited numba of people can be tested in this fashion
since such samples must be obtained reasonably early in the day. At later
times the samples are subject to uncertainty regarding food consumption.
Dr.

Field believes that if sampling only after the glucose meal means

substantially larger numbers of people sampled (which seems likely), then

this procedure should be considered at Utirik and where extra numbers of
people are wanted.
He believes the resuits using the i-stick method may
tend to slightly underestimate the incidence of diabetes.
It is hoped

that urine samples for sugar test can be obtained before and after the
glucose meal, Obesity and cataract formation as related to diabetes will
be evaluated, Obesity may be further evaluated in a limited number of
cases by whole-body counting of 40K measurements to obtan lean-mass-fat
ratios on those people with positive urine sugars.
In the Rongelap

series cholesterol and triglycerides will be run on plasma samples returned
to BNL.
Samples of diet being obtained for radiochemical analysis and
iodine content may also be examined for carbohydrate, protein, fat content.
Dr.

Field is working on a questionnarie to be filled out by all subjects

in this study concerning family history of diabetes, dietary habits, etc.

Genetic Effects of Radiation: The generally negative results of the
ABCC genetic studies of first generation children Japanese exposed to the

A-bombs quelled our interest in such studies on the small Rongelap
population.
However I recently wrote Dr. James Ne@/ at the University of
Michigan who had been in charge of the ABCC studies for his opinion.
Though he agrees that it is quite unlikely that such studies in the
Marshallese will be fruitful? Since he is carrying out a battery of tests

for metabolic defects in the red cells and serum of blood in the Japanese .
children, he is willittg to carry out these same tests’ on the Marshallese

children of exposed parents and the parents and also on an equal number
of children of unexposed parents and their parents.
In addition he
recommends analysis for sex chromosome aberrations in buccal smears.
We

would obtain the smears and they would be analyzed by Dr. Arthur Bloom,
also at the U. Michigan.
Dr. Ne€f also recommends that at the time of
the blood drawing a brief physical exam for gross abnormalities also be
carried out on the children.
I will attempt to conduct this study which

Select target paragraph3