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that in 1959 the mean erythrocyte levels were slightly
lower in the exposed people. These blood elements
in the Ailingnae group also showed someslight
depression below the unexposed levels but not
quite so marked as seen in the Rongelap exposed
group. A general anemic tendencywas noted in
the Marshallese, both exposed and unexposed.

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Price-Jones curves, on the average, showeda slight
microcyvtic tendency. Serum zron levels were gen-

erally normal. The fact that someof the blood ele-

ments in the exposed group have not yet returned

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to the levels in the unexposed groupraises the possibility that a residual radiation effect on the bone
marrow persists, but other, not immediatelyapparent, factors may be involved.

1

Reticulocyte counts have been about the same

er a

in the exposed and unexposed people.
Bone marrow examinations on a numberofexposed individuals at 6 months and 3 years post
exposure showed no abnormalities or deficiencies
of cellular elements.
Clinical examinations revealed no disease processes or symptoms which could be attributed to

eee — —_—

radiation effects, aside from skin lesions, loss of

hair, and early symptoms. No specific therapy was
given. Epidemics of chicken pox and measles oc-

curred. The diseases encountered were no more

severe or frequent in the irradiated group than in
the unexposed group, even during the period of
greatest depression of peripheral blood elements.
At 3 years post exposure the immuneresponse
to primaryand secondary tetanus antitoxin was
tested and found notto besignificantly different
in the exposed comparedto the unexposed popu-

aan:

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lations.

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Four persons in the exposed population died of
disease: {1} a 46-year-old man with a hypertensive
heart disease which had been presentat the time
of exposure, who died 2 years after the accident;

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(2) a 78-year-old man who died, 3 years after exposure, of coronary heart disease complicating
diabetes; (3) a 36-year-old man whodied of acute
varicella, 4 years after exposure, who hadreceived
only 69 r, having been on Ailingnaeat the time of
the fallout; and (4) a 60-year-old woman whodied
of a cancer of the ovary at 5 years after exposure.

There was no apparent relationship between any

of these deaths and radiation exposure. Four

deaths have occurred in the comparison popula-

tion. The four deaths that have occurred in the
exposed people since exposure represent a mortality

Woy

rate of 8.1 per 1000 population, compared with 8.3
for the comparison population and 6.8 for the
Marshall Islands as a whole.
Certain findings were possibly related to the
radiation exposure, such as loss in weightof several
pounds in most of the people during the first
several months after exposure and suggestive evidence ofslight lag in growth and developmentof
the children based on studies of height, weight,
and bone development (but inconclusive pending
verification of more exact ages of some of the
children).
In connection with growth and development studves,
a project on the verification of accuracy of ages of
the children has not been completed and, therefore, the suggestive evidence previously presented
of possible lag in statural growth in the exposed
children must await confirmation. It was noted,

however, that in the 6-year chronological age
group, three boys and onegirlout offive boys and
twogirls in the exposed group exhibited significantly retarded skeletal maturation as judged by
x-ray examination. The birth dates of these children seemed to befairly well established.
It was difficult to evaluate the effects on fertility.
However, a review of the birth rate of the exposed
group overthe past 6 years seemsto indicate no
noticeable effect of their exposure onfertility. The
24 births represent a rate of 48 per 1000 population, compared with 37.3 for the Marshal! Islands
(1957). The 20 births over a 3-year period for the
comparison population represent a rate of 62 per
1000 population. A somewhatgreater incidence of
miscarriages and stillbirths has been noted in the ex-

posed women, but becauseof the paucity ofvital
statistics in the Marshallese and the small number
of people involved, the data are not readily amenable to statistical analysis.
A cardiovascular survey of the adults (1959) showed
no outstanding differences between the exposed
and unexposed groups. The people appearedto
have less hypertension on the whole than is noted
in people in the continental United States.
An arthritis survey (1959) showed no great differences between the exposed and the unexposed
people, and about the sameincidenceasis seen in
American populations.
Ophthalmological surveys showed no remarkable
differences between the exposed and unexposed
groups except possibly a slightly greater number
of cases of pterygii, pingueculae, and cornealscars

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