gray hair as has been reported in human beings (32, 37, and 38).

In the Japanese bomb casu-

alties (30) and the Japanese fishermen (11) the regrown hair was also normal in color, texture, and abundance.

The nature of the bluish-brown transverse bands of pigmentation that developed beneath
the nails is not known. Since it occurred in the majority of the more heavily exposed Mar-

shallese groups and in all five of the American Negroes, but none of the white Americans, it

appeared to be a response peculiar to dark~skinned races. The phenomenon was apparently produced by whole-body radiation with dosage as low as 75 r since this was the estimated dose the
American Negroes received in the absence of significant contamination of the hands. Sutton
(39) has reported a case of similar fingernail pigmentation which developed in a negress, follow
ing 150 r of soft X-irradiation to the hands.
Certain conclusions may be drawn from this experience concerning the hazard of radioactive
fallout in regard to the skin. (1) Serious contamination of personnel with fallout may occur
many miles from the site of detonation of a nuclear device;

(2) Beta radiation of the skin

may result in extensive epilation and skin lesions even though the dose of whole-body penetrating radiation received may be sublethal; (3) Just as the dose of whole—body radiation can

be decreased by early evacuation so can skin irradiation be reduced by prompt personnel decontamination. One can conceive of a situation following fallout where early evacuation from a
field of radiation mght result in a minimal whole-body dose of radiation, but due to delayed

decontamination of the skin. for various reasons, serious skin exposure might occur.

The re-

verse situation might occur if decontamination were possible early, but evacuations were de-

layed and adequate shelter against penetrating radiation were not available;

of prompt decontamination cannot be overemphasized.

(4) The importance

The earlier the fallout occurs the more

radioactive is the material and the higher the dose rate.

Therefore, prompt decontamination

is exceedingly important when fallout occurs within several hours after the detonation.

Diffi-

culty encountered in decontamination of the hair may necessitate cutting off the hair or shaving

the head if contamination is great; (5) Warm weather would tend to aggravate the hazard since
increased perspiration would tend to concentrate the material and cause it to stick, and less
clothing would increase exposure and; (6) Simple preventive measures may completely eliminate
or greatly reduce the hazard of skin irradiation. Recognition of the powdery, ash-like material as radioactive fallout should not be difficult. Preventive measures center around avoidance
of the deposit of fallout on the skin. Taking shelter or keeping indoors during the fallout
are obvious safety measures and covering as much of the body as possible with clothing, even a
single layer, will provide marked protection.

SUMMARY
Radioactive fallout from an experimental thermonuclear detmation resulted in accidental
exposure of 239 Marshallese people, and 28 American servicemen. Whole-body exposure to penetrating radiation, beta radiation of the skin, and a small amount of internal absorption of

radioactive materials occurred. Beta lesions of the skin, epilation and nail pigmentation are
described. This report covers the results of examinations immediately after the accident, again
at 6 months and at | year after the accident. During the first 24 to 48 hours, itching and
burning sensations of the skin occurred lasting only a, day or two. Lesions began developing 2
and 3 weeks later on exposed parts of the body in roughly the following order: scalp with epilation, neck, axillae, antecubital fossae, feet, limbs and trunk.

No primary or secondary ery-

thema was observed. The majority of lesions were superficial and occurred in about 90 percent
of the higher exposure groups. They were characterized by pigmentation which was accompanied
by mild itching and burning sensations of the skin, followed by dry desquamation leaving de-

pigmented areas which gradually repignented to normal color. Some 20 percent of the lesions
in the highest exposure group were deeper and were characterized by pain, wet desquamation and

ulceration. Some of these deeper lesions showed persisting aberrations in pigmentation and
some degree of atrophy. There has been no breakdown of the skin noted in any lesions after

438

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