45 mother was diagnosed as having congenital heart disease and died several monthsafter birth. The suggestive evidence of increased miscarriages and stillbirths in the exposed women duringthefirst few years after exposure mightbe related toirradiation of the germ plasm. Thefinding that male children of exposed parents were shorter in stature than children of the same age of unexposed par- Thelevels of internal contamination per unit weight appearedto be aboutthe samefor juveniles such a conclusion. Hematological studies showed that certain time for comparison. The Zn®level in adult males (1.51 muC/kg) dropped to 17% of the mean value measured 2 years ago. With a larger detector and a longer counting time than previously employed, it was possible to identify and quantify Co” for the first time in these people; the meanlevel of Co" was about 11% of the Zn" level. A smal! amount ents may have some genetic significance, but further studies would be necessaryto substantiate peripheral blood elements in the more heavily ex- posed Rongelap group continued to showslightly lower levels than in the unexposed comparison population, suggesting a persistent irradiationeffect on hemopoietic function. Examination of the data by age and sex groups showedthat neutrophil and platelet levels among the exposed were consistently below the unexposed levels, and that exposed males aged 7 to 15 vears and exposed persons, both males and females, aged >40 showed the most difference from their controls. The ex- posed males and females of ages 15 to 40 showed less difference. with even higherlevels of someele- ments than the unexposed groups of the same ages. The plateiet levels. however. were consistently lower in all age groups in both sexes. It was noted also that male children of exposed parents had somewhat lower levels of neutrophils, |lympho- cytes. and platelets than children of unexposed parents. The Rongelap population as a whole continued to showslightly lower erythropoietic function than found generally in Americans, the explanation for which is not clear. Thoughiron deficiency does not appearto be a problem in view of generally normal serum iron levels, some other type of nutritional deficiency may be responsible. The high incidence of eosinophilia may be partly related to chronic fungus infection of the skin and intestinal parasitism, but other causes, not immediately obvious, may be involved. The “portable” whole-body counter was used to obtain the gammaspectra of 110 Marshallese, half of whom hadbeen exposedto thefallout in 1954. No significant difference in body burdensof the gamma-emitting radioisotopes was observed between the Marshallese exposed to fallout in 1954 and those of the comparison populationliving in the same environmentfor the past 4 years. as for adults, male and female. Wide variations in levels of contamination in any group were found, apparently dueto differences in diet and metabolism. The mean Cs'** body burden in adult males was 14.7 muC/kg, which is not significantly different from the mean value of a similar group obtained 2 years ago; it was 300 times that of the medical team, who were measured at the same of residual activity was still present after the subtraction of K*° and the above radionuclides from the total spectrum. The mean level of urinary excretion of Sr’? was 7.2 wuC/l or 14% higher than measured in the 1959 medical survey. Thoughthe acute effects of radiation exposure in the Marshallese have largely subsided, it is possible that certain late or delayed effects mayoccur. Some late effects have already been observed in the Japanese, such as an increased incidence of leukemia and possibly other malignancies and also development ofcataracts. Still other late effects have been observed in irradiated animals. It is unhkely that such abnormalities will develop in the relatively small Rongelap population and, should they develop, the incidence should be quite low. Nevertheless, it is extremely important that further surveys be conducted to detect subtle changes associated with the development of such abnormalities so that they can be documented and therapeutic proceduresinstituted whenever possible. The examinations show somefindings which persist in the exposed people, and these need to be carefully followed. These include incomplete recovery of certain blood elements to levels found in the unexposed people, retardation of growth and developmentin someofthe irradiated children, and pigmented changesatthe sites of radiation burnsof the skin. Recognizing the importanceofthese surveys, the Trust Territory of the Pacific Islands and the USS. Atomic Energy Commission have agreed that annual medical surveys of the Marshallese people exposed to fallout in 1954 should continueindefinitely.

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