B. Issues 1. It is medically impossible to distinguish in any par ticular individual whether a disease complex or symptom is radia tion related or not. Epidemiological studies over time on groups of people can establish increased incidences of particular pro lems, but this evidence is not particularly helpful in decidin specific causation in any individual. The peoples of Bikini, Enewetok, Rongelap and Utiri are now liv- ing on approximately one half of the 26 atolls/islan s in the Marshalls. This migration and resulting intermarryi g is rapidly spreading those individuals with "direct" radiation ffects through- out the Marshalls. e large pop- With the groups resident among ulations on Majuro and Ebeye, well over 75% of the tal Marshail- ese population has people from the four affected at Ts living among them. pretation This means that even the narrowest int of P. L. 96-205 will require health care to be provi ed far beyond the four atolls themselves. Preferential treatment for those individuals with " irect" effects will tend to continue the arguments of those not in uded that they were also affected. ople on ships The anecdotal stories of in the fallout area who should be included, as well s other groups, already abound. ese numer- It appears that the refutation of ous claims may require considerable energy and cost in the future, if the advantage of inclusion is significant. The indirect effects are also a matter of considerab te discussion. Foodstuffs from affected atolls are shipped elsewhe » fish and other sealife may carry radiation from one area to other, sec- ond and third generation offspring of affected peop may have