« * AZVINGTON & BURLING Mr. Wallace O. Green April 21, 1980 Page Three Marshall Islands sought the assistance of Dr. Robert]IG. Loeffler to attempt to identify the medical informat]jon which must be obtained in order o determine the ext@nt of potentially radiation related 2. ormalities in the nq@rthern Marshall Islands. Since no definitive radiation measurements available either for the fallout experienced by the in question as a consequence of the weapons testing body dose exposure on these atolls, fare ? olls for 7 the only meaningfpl assessment of the risk factor created by the exposurefof the people of the northern atolls is the current and recufrent determination of somatic effects in the potentially affected population. Furthermore, Dr. Loeffler advised us that since radiation induced carcinogenicity requires long laten¢y periods (10-20 years for some solid tumors) retrospective analysis of incomplete, nondirected medical records a¥e clearly inadequate to establish possible secondary deJeterious effects. - Recognizing that the proposed surveys of health effects will of necessity be incomplete, Dr. Ldeffler is of the view that we must attempt to provide answerg at least to the following specific questions. T. What evidence exists of developmental effects associated with radiation? This may be established by individual and popula-— tion data of histories and physical examinations to inglude anthropometric Gata (adult and pediatric). Population]genetic studies including cytogenetic chromosoural analyses shguld be conducted. It. What evidence exists of late somatic effects associated with radiation? This determination would require: a) Thyroid cancer and malfunction screening to iftclude: - History and physical examinations - Technitium radioisotope gamma camera imagin scanning (alternatively radioactive Iodine scanning) - Biochemical analyses including Thvroglobyuli determination by radioimmune assay