for atrophic skin changes.
1.4
Specific Recommendations
Continued periodic medical evaluations are recommended for the individual members of the
exposed populations through the year 2000. The value of the comparison group as originally
' established is questionable because ofits small size, the different referral practices, and other
factors that could differentially influence population’s responses to radiation. However, since all
residents are offered the yearly medical examination, they may contribute to the establishment of
background rates for various disorders.
7.4.1
The Medical Surveillance Team
The team should continue as a U.S.visiting medical team with representation from the Marshall
Islands’ Trust medical care system. Team members should include physicians, nurses, and
laboratory and x-ray technologists. Also, assisting logistics and technical personnel with the
appropriate skills and training will be needed to collect medical data and to operate the laboratory
and x-ray equipmentin thefield.
The team should visit the islands at least annually. In addition to the medical departmentof the
Marshall Islands’ government, a medical aide also should be available on-site to provide or
request medical assistance and to monitor and immediately report health events including deaths
that occur in the interim between medical team visits.
7.4.2
The Scope of the Periodic Medical Evaluations
The periodic medical evaluations performed by the team throughout the period should include
standardized examination components. Elements may be added when indicated by changes in
medical knowledge or in response to changes in observed health status of the population. For
planning purposes there is no apparentbasis to anticipate a need for changes in the standardized
examination at five year intervals. Each standardized examination should include: