conditions. The activities even included such exceptional measures as the construction,

transport and use of whole-body counting, and x-ray including mammography
examinations. These are well-documented (7). In addition, state of the art medical
surveillance and care was modified when applicable to incorporate newer procedures as
they becameavailable.

The efforts to collect, study and publish information describing what occurred were
complete and admirable. Efforts to perform epidemiological research using these data
were very aggressive, considering the lack of accurate background incidence data and
other factors discussed in Section 5.5.
5.3

Primary Purposes of Medical Surveillance
The medical surveillance that began in 1955 in response to the contamination of the
Marshall Islanders from the Bravo test should have been planned for the following
primary purposes:
e

’ To assess the need for additional medical services to treat conditions caused by
deterministic doses of radiation, or by secondary infection of the primary radiation
skin damage,

e

To detect and ensure early treatment for the medical conditions that were known
or assumed to be associated with radiation,

e

To augmentthe local medical care resources in order to make the diagnosis and
treatmentof radiation-induced medical conditions possible,

e

To determine, describe and documentall medical conditions which resulted in the
exposed population over time, including the recording of mortality data including
the causes of death, when known, and

e

To record and identify any unexpected health outcomes that possibly were related
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Select target paragraph3