1.4 Recommendations Based on its review of the scope and nature of the Marshall Islands accident and the low potential for furtherdevelopmentofradiogenic health outcomes, sufficient to influence current risk estimates, the ORAU team recommends a medical monitoring program aimed at early diagnosis and treatment to the benefit of individuals in the exposed population. Specific recommendations are made on the desired composition of the medical team, and the need for an evaluation program comprising standardized examinations components to which additional tests could be added to benefit the patient as indicated by the health of the patient or technical and scientific advances. Standardized examination components of an optimal monitoring program are enumerated, and standards for data collection, maintenance, preservation and quality assurance are recommended. The use of ultrasound is not recommended for routine thyroid examinations of asymptomatic patients because of the high incidence in the general populationofclinically non-significant thyroid tumors. Further attempts at biodosimetry using cytogenetic techniques currently are discouraged for this population as they are unlikely to provide useful information. 90121) on iv |