16 None waspositive for malignantcells. It was noted Table 4 that the secretions were scanty in most of the Majuro were all 6 years of age or older. All nonexposed children of exposed parents were <6 years old, Of the 88 nonexposed Rongelap children. 38 were <6 years of age. The incidence of various physical findingsis summarized in Table 5. Adenopathywas defined for the purposes of this tabulation as the presence of (a) nodes 0.5 cm or larger in all areas (cervical, axillary, and inguinal), or (b) nodes 1.0 cm or larger in the axillary regions, or (c) nodes 2.0 cm or larger in either the cervical or inguinalareas. The term “active chronic tmpetigo” includesseveral types of superficial skin infections. Manyof these lesions probably represented secondaryinfections of lacerations and abrasions. The incidencesof otitis media and adenopathywererelated to age, both being more common in younger children. Clinically active chronic impetigo was also found more often in the vounger children; 2 3 24 67 0 8 13 13 0) 88 13 110 25 20 155 however,its incidence was higher in the exposed children (although the group wasolder) than in nonexposed Rongelap children of comparable ages. Its incidence was also higher among the nonexposed Majuro children, who wereall in the older group. As in 1959, the pattern of physicalfindings seemed unrelated to exposureto radiation. Growth and Development During the past several surveys considerable effort has been expended to establish as firmlyas possible the accuracyof the date of birth for each child. The medical surveyrecords providedreliable written data for children born after March 1954 and for some born immediately before the fallout, For the other children, however, the task of determining birth dates proved to be difficult, frustrating, and unsatisfactory. The reconstruction of the birth chronology was based on an intensive study and evaluation of very frequently contradictory information derived from the following sources: 1. Dates of birth as reported byparents. 2. Dates of birth as recorded occasionallyin the village ledgers used for various purposes. 3. Limited number ofbirth certificates on file at the court house on Majuro. 4, Birth order of children within each family unit. . Ranking of childhood population in terms of age byparents. 6. Ranking of childhood population in terms of age by children. . Correlation with memorable environmental events. eer 19 weet 26 4 — 2 2 Seapine Tangs “antigen eenee A ee ree tion. The exposed and nonexposed group at Total 2 0 einaelpiieem—e imme During the 1961 survey, 155 children were examined (Table 4). All exposed subjects in the pediatric age group (<20 years) were seen except for two (No. 67 and No. 76) who had movedto other atolls. Fhe increase in number of nonexposed children of exposed parents represents new babies born since the previous survey. Newbabies also increased the total of nonexposed Rongelap controls, even though a numberof children either became old enoughto be transferred to the adult study or were lost to the study because of migra- Control Rongelap series Majuroseries 22 2 fone 1 ean PEDIATRIC EXAMINATIONS Exposed Exposed ii utere Nonexposed (exposed parents) Knees se, ~ Rectal examinations were carried out on all adults, and proctoscopic examinations when indicated. Several cases of prostatic enlargement were noted, but no evidence of malignancy was apparent. An ulcerating lesion was noted in a 66-yearold female in the exposed group (No. 30) in the upper rectum, Scrapings from this area indicated that it was an inflammatory lesion and not malignant. at at at Rongelap Majuro Kwajalein Total qr Appendix 6. Children Examined ~~! women, and the smears were consequently somewhat dry. Inflammatoryreaction with the presence of blood in the smears was common. Endocervical atypia was noted in a numberofcases. Theresults of these examinationsare reported in