é
7.
Detailed
records
of
the
radiation
exposed
populationf
and
of
many
control persons are on file at Brookhaven National Laborktory on Long
Island.
8.
Although Brookhaven National Laboratory has primarily beBn interested
in the occurrence of radiation exposure and resultant ef ects, it has
by necessity provided limited primary through tertiary h alth care.
9.
It appears that all the exposed Marshallese and a signifi
unexposed
Marshallese
have
had
considerable
nt number of
altbration
and
interruption of their life patterns due to the nuclear we
program and subsequent investigation and follow-up.
The
migration
intermarrying
potentially
of
of
radiation
exposed
contaminated
and
individuals from
other
exposed
non-exposed
foodstuffs
atolls,
persons
(fish
to
persons,
and
other
utlization
fruits)
non-exposed groups
atolls,
b
non-exposed
current
affected islands, and uncertain exposure coverage, as well as
of
living
on
ogher factors,
makes it difficult to identify radiation affected individuals}
Additional
issues in providing health care for these people are the follwing:
1.
Any reasonable means to help the exposed populatian
to fee! no
different from the remaining Marshallese is desirable in view of
their past unique treatment, fears, and misunderstaBding.
2.
It is inherently difficult and impractical to disfinguish with
any precision in any individual case whether a partifular illness
is radiation related or not.
3.
Based
Radiation exposure monitoring is expected to contin
on
the
stated
conclusions
and
other
issues,
tie
recommendations are made with respect to known radiation expose
following
Marshallese
within a comprehensive Marshall Island health care system:
1.
The health records of each person should be availdble wherever
they are receiving primary and secondary care.
Ro tine medical
histories and physical examinations should be dir
specific
disease
complexes
known
increased frequency among radiation
or
suspected
exposed
ted towards
to
have
indi iduals
an
(e.g.
thyroid nodules).
2.
Although some continued radiation effect monitoring
Js necessary,
jt appears that the frequency and extent should be ftapered with
time.
This monitoring should be as non-disruptive asfpossible yet
still maintain good follow-up and reasonable acquisition of data.
12
4D