mee war lh. ny also experiskin, and a few burning of the mained asvrmpr the accident, hair developed, e skin. [t was St cxamined, a e¢ Ivmphecvtes hat significant en received. In f radiation and jochemical ant measurable wa also been abe radiation can zadings accordtrating irradiaradiation. ‘ON zative ofsignifi‘as lowering of 8) 8 years post exposure. Erythropoetuc depression has not been a consistent finding as with the leukocytes and thrombocytes. Slight depression of red blood counts, hema- and Ailingnae groups are presented in Figures 20, 27, and 32 and in Appendices 1 and 2, and in the Uurik group in Appendix 3. Lymphopenia of about half the level of the com- the Rongelap people were first examined on their Lepowure, about enced anorexia 4 diarrhea. In cries of nausea 4 marked in the other groups receiving less exposure. The hemopoietic depression was roughly proportional to the dose of radiation received. Even in the 157 Utirik people who received only an estimated 14 rads, it was possible to distinguish slight platelet depression in the group as a whole. The smaller group on Ailingnae and Rongerik showed peripherai blood levels between those of the high and low exposure groups. The chrono- parison Marshallese population was evident when 87-136 801-1058 2258-2278 eee weeks, which was followed by slower recovery but logicai records of blood findings in the Rongelap 1-86 | -86 401-428 2101-2257 N Ff levels of leukocytes and platelets of the per. pheral blood. This was most marked in the 64 people on Rongelap who had received 175 rads, and was les 700-817 1000-1082 $01 -900 801-970 BO1- 1058 SVMF aL arrival at Kwajalein 3 days after exposure. In children << 5 vears of age the lymphocytes dropped to 25% of the levels in the comparison children, but showed a slight rise during the following weeks. The depressed level! was maintained with only slight increase noted by one year. In thefollowing year, mean counts approachedthelevels of the comparison population and have generaily remained slightly below. Neutrophil levels fuctuated considerably during with mean levels never reaching higher than 90 to 95% that of the comparison population during the tocrits, and hemoglobin has been noted at times. No gross abnormalities of bone marrow sinears were reported at 6 months post exposure. At 8 years, examination of 9 bone marrow aspirations from exposed people showed a reduced myeloid-erythroid ratio wth abnormalities of the erythroid and myeloid precursors in 5 cases. Depression of peripheral blood elements in the Ailingnae and Rongenk groups was not so pro- nounced as in the Rongelap group. However, a slight lag in complete recovery in the Ailingnae peripheral blood count has also been noted. The persistent depression of peripheral blood elements in the exposed people makes it appear likely that thereis slight residual bone marrow damage. A general anemic tendency has been evident in both exposed and unexposed Marshallese. PriceJones curves, on the average, showed slight microcytic tendency. Serum iron levels have gen- eraily been normal, and the cause of this anemic prevalence of beta burns of the skin during that tendency has been undetermined. Retrculocyt: counts have been about the same in the exposed as in the uncxposed people. 5 and 6 weeks post exposure with levels reaching patchy epilation, and early gastrointestinal symp- the first month: possibly this was related to the period. Neutrophil depression became evident by about half that of the comparison population in the adults and slightly lower in the children <5 vears of age. This degree of neutropenia was insuffi- cient lo result in ans apparent mcreased infectious processes. and indeed 11 was noted that neutro- philic leukocytosis was possible in people showing casual infecnions at this time. Neutrophil levels re- covered more rapidiy than lymphocvte levets and reached car control levels by ane year, Subsequent annual surveys have revealed that recovery does not appear to be complete, particularly in vounger and older age groups. Platelet counts showed less huctuation than other bloed counts and fairiy consistentiv showed increasing depression, reaching leveis of about 30% that of the compartson population by the 4th week. A spurt of recovery to about 75% of com- parison ievels occurred during the following few Except for radiation-induced lesions of the skin, toms, ci:icai examinations have revealed no disease processes or symptoms which could be related directly to radiation effects. No prophylactic or specific therapy of radiation effects was ever con- sidered necessary or grven. Epidemics of chicken pox and measles that occurred showed no greater incidence or severity in the exposed than in the unexposed Marshallese peopie. During the first months post exposure about half of the exposed group exhibited (oss of weight of sev- eral pounds. This may possibly have been related to their radiation exposure, although itis difficult to rule out effects possibly due to change of environment. At 3 years post exposure the :mmune response to pnmary and secondarytetanus antitoxin was tested and found noi to be significantly different in the exposed compared to the unexposed populations.