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: