INTRODUCTION 2.0.0... cece cc cece ce cece cece tte e rete cece aneeeveeens 1
HEALTH EFFECTS OF IONIZING RADIATION .......-.-- cee ceveeeeceee
3.1
32
3
Overview 2.0... ccc ccc cc cece rece tne ences meee rene nccccceces 3
Deterministic Effects .......... cc cece ccc ec cere eee e eee n erence cenes 4
3.2.1 Factors Influencing the Clinical Expression of
Radiation Injury .......... ccc ccc c ee ence eee r eet e een cnccees 4
33
3.4
3.2.2 Early Clinical Features of Acute Radiation Injury ...............-- 6
3.2.3 Delayed Clinical Features ........... 0c cee cece reece eee neeecees 9
Stochastic Effects. ........ 0... c cece cece cece ce een eee n ones esenes 11
3.3.1 Heritable Genetic Effects ........ 0. cece cece cece cece ee ceenes 11
33.2 Somatic Effects ..... 0... . ccc cee c cece cee e cnet e ener eeenes 11
3.3.3 Risk Estimates ......... 0. cece ccc cece cece cece cee n ee eeenee 12
Psychological Effects ....... 20... ccc cece rece ete cece ence nneees 13
THE INCIDENT AND ITS IMPLICATIONS FOR RADIOLOGICAL HEALTH ..
15
4.1
The Incident ........... ccc ccc wcrc cece e cece tence eenceeee
15
Radiation Dose Estimates ........... 0. cc cee cece reece cece ceneeens
19
42
43
4.4
45
Radiological Exposures ........ 0... cc cece reece eensewe e cere eeoes
4.2.1 Chronology of the Acute Exposures .......... ccc cece cece ceece
42.2 Types of Acute Exposures ......... 0.2... cece cece eee e cee eeees
423 Potential for Protracted Exposures ............. 00 ccceeccceeces
The Exposed Population ........... 0... cece eee cece cece reece neces
4.4.1
4.4.2
4.43
4.4.4
External Whole-Body Doses from the Plume .............-.2000External Radiation Doses to the Skin from the Fall-out
Contamination ......... 2. eee cece eee nec c cece eer eeeees
Internal Radiation Doses ............. cece eee cece eee eeceees
Additional Absorbed Doses During Rehabilitation ................
Early Medical Findings
19
21
21
24
............. cece cece cece eee e cence nec eeee 25
45.1 Acute Systemic Effects ...... 0.0... ccc cee cece eee e cence
45.2 Acute Local Lesions ......... 0... cee eee eee eeeeeee eeee
45.3 Other Early Health Effects .............eee e eee e cece ee eeee
45.4 Association Between the Early Medical Findings
and the Radiation Exposure ............. 0 cece eee cece terete en enes
45.5
15
15
16
17
17
Association Between Subsequent Health Experience of the Marshallese
25
25
26
27
and Their Radiation Exposure in 1954 ............ cece eee eens 27
THE RESPONSE1954-1992 2.2... cece ccc cece cece cece tee e reese ences 29
5.1
5.2
5.3
5.4
Follow-Up 1954-1992 2.0... ccc cece cece erect cece tense eeens
5.1.1 Actions 2.0... . cece cece cece eee ee eee een eee eeeaee
5.12 Findings ....... 0... cece cece eee eee eee e ween eenstee.
What Should Have Been Done .......... 0... cece cece ee cee eee eeee
29
29
30
30
Factors Limiting Epidemiological Studies of Exposed Marshall Islands
Population. 0... cece ccc cece cee eee eee eee tree eee e tenes
32
Primary Purposes of Medical Surveillance .......... 0... ee ee ete eeeees 31
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