t
:

- COVINGTON & BURLING
Mr. Wallace O. Green
Page Nine
December 17, 1980

Loeffler, who has attempted to identify some of the medical
information which must be obtained in order to determine the
extent of potentially radiation related abnormalities in the
Marshall Islands, advised us that since radiation induced
carcinogenicity requires long latency periods

(10-20 years

for some solid tumors) retrospective analysis of incomplete,

nondirected medical records are clearly inadequate to

establish possible secondary deleterious effects.
Reccgnizing that the proposed surveys of health effects will of
necessity be incomplete, Dr. Loeffler is of the view that we
must attempt to provide answers at least to the following
specific questions.
I.

What evidence exists of developmental effects
associated with radiation?

This may be established by individual and population data of histories and physical examinations to include
anthropometric data (adult and pediatric).
Population
genetic studies including cytogenetic chromosoural analyses
should be conducted.
II.

What evidence exists of late somatic effects
associated with radiation?

This determination would require:
a)

Thyroid cancer and malfunction screening to include:
- History and physical examinations
- Technitium radioisotope gamma camera imaging
scanning (alternatively radioactive Iodine
scanning)
- Biochemical analyses including Thyroglobulin
determination by radioimmune assay

- T4 and TSH by radioimmune assay - standard SMAC
20 for general screening purposes (Calcium,
Phosphorus, Alkaline Phesphatase and Cholesterol

included)

~- Thyroxine Binding Globulin determination
- If indicated, in selected cases, needle aspiration
biopsy for cytological examination and possible
surgical intervention

b)

Leukemia screening to include: |

- History and physical examination
- Complete peripheral bloodcount

~
e

Select target paragraph3