FALLOUT EFFECTS—CONARD & HICKING
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Internal absorption of radionuclides, Jargely
from cating and drinking contaminated food and
water, and to a lesser extent from inhalation of
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fallout, resulted in detectable radioactivity in
urine samples. However, during the first few days
when the body burdens were highest the maximurn
permissible concentrations were exceeded only
for “Sr and the radioisotopes of iodine. The dose
to the thyroid glands of the adults from the radioiodines absorbed was estimated io be about 150
to 160 rads.
Follow-Uy;
Health Status.—Medical evaluation of the health
status of the exposed people over the years since
the accident has revealed about the same incidence
of illness and disease as noted in the unexposed
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‘population with certain exceptions noted below.
General health and nutrition have continued to be
satisfactory and comparable to the unexposed
comparison population. Annual hematologic follow-up studies revealed that the levels of white
blood cells and platelets of the peripheral blood
in the exposed group never quite reached thelevels
of the unexposed comparison population (Fig 1).
Mortality and Aging.—TYhere were ten deaths in
the exposed population over the ten-year period;
this represents a mortality rate near that observed
fo: the other Marshallese people. A recent study
in which certain criteria of aging were put on a
numerical basis did not reveal any differences in
age scores between the expos.] and unexposed
groups.”
Fertility, Miscarrieges, Stillbirths, and Genetic
Effects.-fiects on fertility were not apparent
2s judged by comparison of the birth rates for the
exposed and unexposed populations. Possibly related to radiation exposure was the fact that during the first four years after exposure an increase
In miscarriages and stillbirths was noted in the
_exposed women, 41% of the births (13 in 32
births) in this group terminated in nonviable offspring compared with 21% (8 in 38 births) in the
unexposed women, No specific genetic studies have
been carried out, but no difference in incidence
of abnormalities in children of exposed compared
with those of unexposed women has been observed.
Growth and Development Studies.—Anthropometric examinations of the 42 exposed and 75 unex-
posed children have been conducted over the past
five years. Using nonparametric statistical methods, comparisons of weight, stature, and bone age
2. Gross picture of sectional thyroid gland showing
nodulcs # 14-year-old Marsiuallese girl.
group, it was not statistically significant. The eposed gins showed no significant diflecences cor
pared with unexposed gisis. The slight retardatic
of growth notedin th: boys suggests that radiatic
may be a causal facior, although possible mech
nisms are not clear. The dose to the bones from i:
ternally ahserbed isotcpcs is believed to have bec
too small to have affeci::d bone growth. These fin
ings are being publis'.-d in detail by Sutow et a
Development of T? roid Nodules.—'Thyroid no
ules were detected i: three girls nine and tr
years afer exposure; two girls were 13 and o:
was 14 years of age at the time of detection The
girls ware in the higher dose group in which the
were 25 chiklren (<18 years of are); 17 of the
were gizls, yvith 6 girls in the 10 to 15 year ran;
Of 75 unexposed comparison children, G7 were gi
and 21 of the girls were in the age range of 10
15 years. No thyroid nodules were noted in 1)
latter group. No lymph node involvement +
grossly evident, The individuals wers hospitaliz
and two hed comple thyroidectornies and {
third a parhicl thyroidectomny. Grossly, the glar
had a cobblestone eppearance with mt ple hz
nodules and were at first. thought to boooehena
Sectionsof ihe tissues wer2 reviewed by a numl
of patholngis!s, «tl of whom agreed that the mm
ules were not malignant and yesembled in me
respects adenomatoid goiter seein: wiih iodine .
ficiency, with its characteristic regenerative rat!
than neoplastic proliferation. It should be no:
that goiters are rare in the Marshall islands si:
no iodine deficiency exists (Fig 2 and 3).
3. Secten of thyroid gland shows characteristic multi
ple, diserete modules with wide variation in size anc
growth pattern. Some consist of microfollicular tissue
some of colloid cysts, while others show hyperplasi.
with papillary infoiding of epithelium.
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the wrist and knee) were made between exposed
and unexposed children of the same age groups.
Boys exposed at 1 to 5 years of age showed retardation of statural growth as well as bone age.
This was most marked in those boys exposed at
12 to 18 months of age. The average skeletal
maturation in the exposed boys was about seven
months behind their unexposed peers. Though
weight pain also appeared slightly retarded in this
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