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