~3As stated earlier in this letter, many facts about radiation were not known back in 1954 but the best medical judgment was used in decisions affecting the people of Utirik. Studying the same problems now, with the knowledge we have today, it appears that the doctors at that time were not aware of the degree of exposure of the thyroid due to fallout. This was especially true of the children because their thyroid is much smaller. So it is not surprising that thyroid disease was not expected in the Utirik people. Even more important is that only very recently has information become available from several sources that the thyroid gland, especially in children, is considerably more sensitive to the induction of radtatton-induced b Y twsoblect Lia tumorsthan was anticipated in the past. Taking these factors together, we can now, many years later, explain the incidence of malignant thyroid glands in the Utirik people. At this time it is impossible to predict whether more cases are to be expected in the exposed members of this population. It is, therefore, of the greatest importance that the regular medical examinations be continued in the future. By having regular medical examinations, signs of thyroid disease can be detected early and prompt treatment will avoid unnecessary suffering on the part of the Utirik people. For these reasons, I believe it is of great importance that the Chiefs of Utirik explain to their people the significance of the Lad — wand al regular medical examinations.