AOL AS THE DOE MEDICAL PROGRAM IN THE MARSHALL ISLANDS Following the accidental exposure to radioactive fallout (March 1, 1954) of 244 Marshall Islanders and 28 American servicemen, the AEC (now DOE) initiated a regular medical examination and treatment program for radiation effects in the exposed Marshallese which has been under the direction of Brookhaven National Laboratory since 1956. The examinations have been carried out with the cooperation and participation of medical personnel from the Trust Territory. The examinations have been on an annual basis for the Rongelap people and every three years for the Utirik people until six years ago when all of the people have been examined annually and, in addition, quarterly medical visits to Rongelap and Utirik have been made whenever possible by a Resident Physician in the islands (a BNL physician). A group of 150 unexposed Marshallese serve as a control group and are examined the same as the exposed groups. The medical findings are summarized below in section I and in section II are outlined the various measures taken by AEC/DOE to aid the exposed people. I. Summary of medical findings and treatment: Early Effects The fallout accident in 1954 resulted in exposure of the Marshallese on Rongelap, Ailingnae and Utirik atolls to fallout radiation before they were evacuated by about 2 days. Whole-body exposure from penetrating gamma radiation gave an estimated 175 rads to the 64 people living on Rongelap, 69 rads to the 18 people on Ailingnae (these were Rongelap people on a fishing trip to this nearby atoll during the fallout) and 14 rads to 157 people living on Utirik atoll. In addition, there was internal absorption of radionuclides from inhalation and ingestion of contaminated food and water and fallout deposited on the body caused significant skin exposure in the Rongelap and Ailingnae groups The radiation to the skin was spotty and superficial and the dose, though indeterminate, was probably greater than 1000 rads. Except for radioisotopes of Iodine, the radionuclides absorbed from the fallout are not believed to have resulted in significant internal exposure. The magnitude of the dose to the thyroid glands from radioactive iodines was not appreciated until later when thyroid nodules unexpectedly developed and reevaluation of the dose showed that the early estimates had to be revised upward, particularly in the children. (It was estimated adults on Rongelap had total thyroid doses of 335 rads and young children 700-1400 rads.) PF = 0 | wwe) crt The Rongelap and Ailingnae people were the only ones to develop acute effects of exposure (transient nausea and vomiting, hemopoietic depression and widespread beta skin burns and epilation, but with no detectible acute effects related to internal absorption of radionuclides). The low dose Utirik group showed only statistically a slight depression in platelets without clinical signs of exposure. There were no deaths associated with the acute exposure of the Marshallese and, except for the skin burns, no treatment was necessary. Blood levels returned to near normal by one year and beta burns healed and hair regrew within a year with only a mild scarring and residua in about 15 people.