1196
J.A.M.A., July 13, 1957
FALL-OUT RADIATION—CONARD ET AL.
Special examination of blood smears from both ex-
posed and contro] groups. stained for alkaline phosphatase, have been carried out. Nosignificant findings
in regard to a leukemic process were found, but this
examination vields good base-line data on these populations for future examinations, Differential counts on
4,000 white blood cells showed no cases in which the
proportion of basophils was increased.
Ophthalmic Examinations.-Ocular disorders were
about as common in the exposed as in the control
population, All lens opacities and cataracts could be
classified as congenital. presenile, or senile. There were
no opacities that resembled those due to effects of
radiation. It is not known whether or not the wholebody dose of 175 r of gammaradiation received by
the Rongelap people may result in opacities of the
lens at a later date. The incidence of cataracts and
other ocular disorders observed in the Rongelap and
control people is consistent with that which might
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be expected when their racial background and the
climatic conditions under which they live are taken
into consideration.
Analysis for Internal Radioisotopes
Radiochemical analysis of 57 liters of chemically
treated pcoled urine from Roneglap people showed
that the precipitate contained radioactive strontium
(Sr°°) in the amount of 64 +4 disintegrations per
minute, with a like amount of ‘radioactive yttrium
(Y°"). The greatest activity, present in the amount of
700 =10 disintegrations per minute, was identified as
due to radioactive cerium (Ce') and radioactive
praseodymium (Pr'**). Earlier studies had shown that
the average 24-hour urine output of the Marshallese
was 580 ml. Thus the 57 liters represented about 100
24-hour samples, which gave the following values in
disintegrations per minute per 24-hour sample: Sr*’,
0.6 and Ce’™ and Pr'*"*, 7.0. These values are estimated
to be well below the maximum permissible body burdens of these isotopes and when biological and physical half lives are taken into consideration agree fairly
well with the original estimates of body burden two
vears ago.
Radiochemical analysis of bone samples taken from
the Marshallese man who died revealed Sr°® in the
amount of 1.6 +0.06 disintegrations per minute per
gram of ash, which is well below the accepted toler-
ance limit and is in the range of activity for this isotope found in the bones of Americans. Examination
of roentgenograms of femurs of exposed children revealed no bone defects from possible deposits of
radionuclides.
Summary
The medical survey of the Rongelap people two
years after exposure to fall-out radiation shows that
the people appear to have been generally in a good
state of health and nutrition and are making satisfactory recovery from their radiation exposure. Serious
illness had occurred in two individuals, but neither
of these illnesses nor clinical findings in other individuals can be attributed to radiation effects. One
death, which was due to hypertensive heart disease,
occurred in May, 1956, in a 46-year-old Rongelap
man, The cause of death could not be correlated with
radiation effects. Previous examinations show that the
disease was undoubtedly present at the time of exposure to fall-out radiation.
There is evidence of continued improvement of
hemopoiesis. The mean lymphocyte count, which was
slightly increased over the one-year levels, was still
found to beslightly below the mean control count.
The mean platelet level is about the same as that
found at one year after exposure andis still slightly
below the control level. The mean neutrophil count,
as at one year after exposure, was up to the control
level. Evidence from the Marshallese experience indicates that the lowered levels of these blood elements
have not lowered the resistance of the people to disease, and the present levels are not considered to
represent a serious condition.
Residual changes in the skin from the beta irradiation continue to show improvement. Pigment abberations are still evident in 15 cases, and, in 4 of these,
there is also scarring with some adherence of the skin
to the subcutaneoustissue. There is, however, no gross
evidence of tissue breakdown or malignant change
in any of these lesions, and surgical repair is not considered necessary at the time of this study. Histological examination of skin biopsy specimens from sites
of radiation lesions show residual effects of radiation
damagebutno evidence of premalignant or malignant
changes. Ophthalmological survey reveals that there
are no radiation-induced lens opacities and that the
incidence of ocular lesions is similar in exposed and
control populations.
The radiochemical analysis of the urine of the Rongelap people shows measurable activity which is
largely due to radioactive cerium (Ce '**) and praseodymium (Pr '**), with only slight activity due to radioactive strontium (Sr°°). The body burden of these
isotopes is estimated to be well below the permissible
levels. Examination of bone specimens taken from the
patient who died shows noradiation that can definitely be associated with fall-out deposition in the bones.
Studies of roentgenograms of the femurs of the exposed children show no evidence of any bone defects
from possible deposits of radionuclides.