ET * “STATUS VERIFIED UNCLASSIFIED WAS ——7 Po OMresFe Dena.s Wd Magny, BV, ADD . | NATE CHAPTER 2 | CLINICAL OBSERVATIONS AND THERAPY | 2.4 INTRODUCTION It was known immediately that the exposed groups had received a significant amount of i penetrating radiation to the entire body, extensive contamination of the skin, and possible internal deposilion of radioactive materials. It was therefore decided that clinical observations | would be as extensive and frequent as facilities and personnel permitted in order to recognize and care for radiation effects as early as possible. Accordingly complete initial histories and physical examinations with numerous follow-up examinations were carried out. Surveys of the skin were conductedat frequent intervals and the detailed skin findings are reported in chapter 3. Extensive hematological studies were conducted, the detailed results of which are presented in chapter 4. Results of examinations for urinary excretion of radioisotopes are reportedin chapter 5, ; In addition lo periodic examinations, routine sick call was held twice daily. Medical care was available at all times ind hospital facilities were available at the Kwajalein Naval Dispensary. In view of the widespread conflicting opinions in regard to the value of various prophylactic and therapeulic measures in treatment of radiation effects, it was decided in advance that therapy would not be given arbitrarily but would ve instituted as indicated clinically for specific condilions on an individual basis, However, if severe pranulocytopenia developed (below 1000 cells/cm) the prophylactic use of antibiotics was to be considered. Whole blood transfusions were likewise to be used only in case of development of serious anemia. 2.2 SYMPTOMSANDSIGNS RELATED TORADIATION INJURY Several symptoms that developed during the first day or two after exposure probably were attributable to radiation. Itching and burning of the skin and eyes during this period occurred in over one quarter of the Ronyclap population, to a lesser extent in the Ailinginae and to a very slight extent in the Ainericans. The skin symlomatology* might have been due in part to the i | markedalkalinity of the fallout niaterial (calciuni oxide). About two thirds of the Rongelap group reported nausea during this carly period and one tenth of the group reported vomiting | t and diarrhea. Only one Ailinginac individual reported nausea, r | The people of Utirik and the Americans developed no signs or symptoms that might be related lo radiation. 1 *The symlomatology is based on questionings through an interpreter by several observers. Despite lhe repeated interrogations and the inevitable suggestion of the interrogators, the sto- ries remained remarkably consistent. 24 \ } | 4 |