12
examiners. However, even at the nadir of depres-
sion (platelets, 28 to 30 days; granulocytes, 42 to
46 days) no associated bleeding tendencyorincrease in infections was seen. Eleven individuals
had platelet counts between 35,000 and 65,000
but without evidence of bleeding. Between days
23 and 42 post exposure, 10% of the Rongelap
group developed granulocytopenia of < 1000ceils
and 42% had leukocyte counts < +4000 or absolute
granulocyte counts < 2500. During this period an
epidemic of upperrespiratory infections occurred
involving more than half the exposed population.
Theillness in the higher exposure Rongelap group
was no more severe than in the less exposed
groups, and individuals in ail groups were able to
show an upwardtrend in leukocytes during the
illness. Prophylactic treatment with antibiotics
was not instituted because it was considered wiser
to withhold them until a real need mightarise.
Antibiotics were given in certain cases where such
therapyis ordinarily indicated.
2. Effects of Skin Exposure
Beta burnsof the skin are described in detail in
the original report of the medical findings.? The
fallout was ubiquitous on Rongelap, Ailingnae,
and Rongerik. Thegritty white flakes clung to the
moist skin, got into the hair, were inhaled, and
were ingested with contaminated food and water.
Areas of the skin covered by clothing were largely
protected, and some whobathedin the lagoon
some complainedalso of burning and lachrymation of the eyes. This may have been due partly to
the caustic nature of the fallout. These symptoms
wereless evident in the American servicemen on
Rongerik and were absentin the Utirik people.
Table 6 shows the amountoffallout and theresulting skin burns for different groups.
Personnel decontamination commenced on
board the Navy ships used for evacuation, where
the people were given saltwater showers and clothing donated bythe crew. On arrival at Kwajalein
the skin was still contaminated, and decontami-
nation procedures were continued for several days.
Clothing was laundered repeatedly, and was discardedif its radiation level was not sufficiently reduced.
The first skin burns appeared about 12 to 14
days post exposure in the Rongelap people; burns
appeared somewhatlater in the Ailingnae and
Rongerik groups and wereless severe and extensive. About 90% of the Rongelap and Ailingnae
groups and 40% of the Rongerik groups developed
lesions, but none of the Uurik people. The lesions
were multiple and spotty (Figure 5) and were
characterized by superficial hyperpigmented
macules, patches, or raised plaques, which desquamated within a few days leaving thin, pink
epithelium (Figure 6). No erythema was observed
before or during developmentofthe lesions; its
may have been lacking because of insufficient dose
to dermis, or it may have been obscured by the
and children who wadedat the water’s edge unknowingly were protecting themselves since they
were later found to have fewer skin burns. However, the majority of the people on Rongelap and
Ailingnae had widespread contamination of ex-
darkness of the skin. Deeper burns with ulcera-
ably in the thousands of rads and was due mostly
to the beta component.
Mostof the people complained ofitching and
Lesions were most commononthe anterior neck,
axillae, antecubital fossae, and feet, but even the
posed surfaces of the body; the skin dose was prob-
burning of the skin for the first 24 to 48 hr, and
tion were noted in about 15% of the Rongelap
people. Epilation (Figure 7) usuaily accompanied
scalp lesions and was prevalent in >90% of the
exposed Rongelap children (Table 7); it occurred
to less degrees in adults and Ailingnae groups.
anal region in some young children was involved.
Lesions of the dorsum ofthe feet (Figure 8) were
Table 6
Skin Lesions?
Group
Rongelap
Ailingnae .
Rongerik
Utirik
20061049
Composition
64
18
23
5
157
Marshallese
Marshallese
White Americans
Negro Americans
Marshallese
Fallout observed
Skin lesions and epilation
Heavy (snowlike)
Moderate (mistlike)
Moderate(mistlike)
Extensive
Less extensive
Slight
’
None
None