.
,
we oF ae Be ee ee
The Medical Research Center
acrositohy
COLLECTION
BOX No.
NL Reeneds
,
Reprinted from The Journal of the American Medical Association
July 13, 1957, Vol. 164
Copyright 1957. by American Medical Association
Brookhaven National WLahorate:+
RSHALLESE TWO YEARS AFYGRBrEXPOSNRE york
FQ|RALL-OUT RADIATION ©
OF
Robert A. Conard, M.D., Upton, N. Y., Lieut. Charles E. Huggins (MC), U.S.N.R.
annon. M.D., Boston, Col. Austen Lowrey (MC), U.S. Army
HO 1824
and
Lieut. John B. Richards (MC), U.S.N.R.
_ This report concerns the medical follow-up survey
of 82 Marshallese people two years after exposure to
fall-out radiation. On Rongelap island. 64 people and,
on Ailingnae, 18 people were exposed to the radiation
on March 1, 1954, after an experimental detonation of
a nuclear device some 100 miles away. Initial and
follow-up studies on these people six months and one
vear after exposure have been reported. The following
is a brief summary of previous findings, which can be
found in detail in the previous reports.’
Background
During thefirst 24 to 48 hours after exposure, about
two-thirds of the persons in the Rongelap group experienced anorexia and nausea, and a few vomited and
had diarrhea. At this time many also experienced itching and burning of the skin and a few complained of
lachrimation and burning of the eyes. After this, the
people remained symptom-free except for symptoms
associated with skinlesions resulting from betairradiations of the skin. beginning about two weeks after the
accident. The effects of the irradiation can best be
summarized according to the mode of irradiation
under three headings: (1) penetrating irradiation,
(2) skin irradiation, and (3) internalirradiation.
Penetrating Irradiation —The Rongelap people received an estimated whole-body dose of 175 r and the
Ailingnae people 69 r of gamma radiation. Depression
of peripheral blood elements occurred as follows in
the Rongelap people: Lymphocyte levels fell promptly and by the third day were 55% of control values and
in the children 25% of control values. These cells remainedat this level, with only slight recovery by six
months, At one year, there was further recovery, but
thev were still below control levels, Neutrophil levels
fluctuated considerably during the first few weeks, but
they fell gradually to a low of about 50% of control
values by the sixth week after exposure, Recovery was
slow. At six months, counts were still below control
levels, but by one year they had returned to the level
found in the control population. Platelet levels fel] to
about 30% of the control values by the fourth week.
By six months, the levels were still depressed to 70%
of control levels, and at one year the meanplatelet
count was still below that in the control population,
but it was slightly higher than at the six-month survey.
The depression of blood elementsin the Ailingnae group
was similar to that in the Rongelap group except
that it was less marked. Changes in the hematocrit
had not been remarkable in either of the two groups.
From the Medical Department, Brookhaven National Laboratory (Dr. Conard), Naval Medical Research Institute,
Bethesda, Md. (Lieutenants Huggins and Richards), and
Walter Reed Army Hospital, Washington, D. C. (Colonel
Lowrey).
* Detonation of a nuclear device in 1954 resulted
in the exposure of 82 people to fall-out radiation
consisting of a whole-body dose of gamma radiation, beta radiation to the skin from radioactive material in contact with the surface, and internal radia-
tion from radionuclides absorbed from food and
drink. Gastrointestinal symptoms occurred during the
first 24 to 48 hours after exposure and then subsided. Irritation of skin and conjunctiva was seen
during the same period. No subsequent abnormalities
were seen in the eyes, but the skin manifested epilation and spotty lesions beginning about two weeks
after the exposure. Residual skin lesions were found
in 15 subjects two years after the exposure. Hematological data show a progressive recovery from the
initial damage. The general health of the exposed
people was good, but the irradiated male children
showed a mean deficiency of 5.33 cm. in height
and 3.4 kg. in weight two years after the exposure.
No comparable effect was seen in the girls. The
‘quantitative data obtained from radiochemical analysis of the urine showed that these people arestill
excreting cerium-144, praseodymium-144, and
strontium-90, but in amounts estimated fo be well
below permissible levels.
Beta Irradiation of the Skin—No accurate estimate
of the radiation dose to the skin could be made. Spotty
lesions of the skin and epilation began to develop
about two weeks after the exposure. The lesions occurred Jargely on exposed parts of the body that were
not covered by clothing. Most of the lesions were
superficial and exhibited pigmentation and dry, scaly
desquamation and were associated with little pain.
Rapid healing and repigmentation followed. Some
lesions were deeper, exhibiting wet desquamation, and
were more painful, and a few became secondarilyinfected. Repigmentation gradually took place in most
lesions, and some of the healing lesions. particularly
on the back of the neck, developed pigmentation of a
grayish, dusky color and a thickening of the skin with
“orange-peel” appearance. By one year, however, this
type of pigmentation had greatly lessened. Deeper
lesions on the dorsum of the feet continued to show
lack of repigmentation, with scarring in some cases at
one year, Histopathological studies of the skin showed
changes consistent with radiation damage. Spotty
transepidermal damage with atrophy and flattening of
the rete pegs was a common finding, with areas of
relatively normal skin between. The dermis was much
less affected than the epidermis. Biopsies taken at six
months showed considerable improvement, but with
some persisting histopathological changes.