Chromosome studies on Marshall Islanders exposed to fallout radiation.

Cytogenetic studies of blood lymphocytes of Marshall Islanders, 10 years after their exposure to radiation from fallout in 1954, show chromosome-type aberrations in 23 of 43 exposed persons. Half the aberrations are of the exchange type. An unexpectedly large number of acentric fragments, but no exchange-type aberrations, appear in a few unexposed people on the same island.

Historical events associated with fallout from Bravo Shot--Operation Castle and 25 Y of medical findings.

The events prior to Bravo Shot-Operation Castle that led to a decision not to evacuate the Marshallese prior to testing the thermonuclear bombs are presented as are the actions taken after the fallout incident in evacuating the exposed Marshallese and the military personnel. The initial medical effects (findings during first 6 wk after exposure) are briefly described and are followed by description of long term effects, namely, induction of one case of fatal acute myeloid leukemia and a large number of thyroid tumors (benign and malignant) in addition to hypothyroidism in adults and children and two cases of cretinism. The hypothyroidism and cretinism responded well to administration of oral thyroxine. During the first 25 y, there was also much unrest and political agitation initiated by exposed and unexposed Marshallese who were very unhappy as a result of relocation and inability to return to their homelands and feeling that all illness and deaths were due to the mysterious radiation, which they understandably did not understand. The difficulties in part were ameliorated by financial aid from the U.S. Congress. In view of one of us (EPC), no one agency or person in the U.S. Government was willing to take the responsibility for care of the Marshallese and its financing. The exposed and nonexposed Marshallese had their lifestyle changed, some of their homelands made uninhabitable for several years and could aptly be called "nuclear nomads," an expression coined by others.

Protracted exposure to fallout: the Rongelap and Utirik experience.

From June 1946 to August 1958, the U.S. Department of Defense and the U.S. Atomic Energy Commission (AEC) conducted nuclear weapons tests in the Northern Marshall Islands. On 1 March 1954, BRAVO, an above-ground test in the Castle series, produced high levels of radioactive material, some of which subsequently fell on Rongelap and Utirik Atolls due to an unexpected wind shift. On 3 March 1954, the inhabitants of these atolls were moved out of the affected area. They later returned to Utirik in June 1954 and to Rongelap in June 1957. Comprehensive environmental and personnel radiological monitoring programs were initiated in the mid 1950s by Brookhaven National Laboratory to ensure that body burdens of the exposed Marshallese subjects remained within AEC guidelines. Their body-burden histories and calculated activity ingestion rate patterns post-return are presented along with estimates of internal committed effective dose equivalents. External exposure data are also included. In addition, relationships between body burden or urine-activity concentration and declining continuous intake were developed. The implications of these studies are: (1) the dietary intake of 137Cs was a major component contributing to the committed effective dose equivalent for the years after the initial contamination of the atolls; (2) for persons whose diet included fish, 65Zn was a major component of committed effective dose equivalent during the first years post-return; (3) a decline in the daily activity ingestion rate greater than that resulting from radioactive decay of the source was estimated for 137Cs, 65Zn, 90Sr and 60Co; (4) the relative impact of each nuclide on the estimate of committed effective dose equivalent was dependent upon the time interval between initial contamination and rehabilitation; and (5) the internal committed effective dose equivalent exceeded the external dose equivalent by a factor of 1.1 at Utirik and 1.5 at Rongelap during the rehabitation period. Few reliable 239Pu measurements on human excreta were made. An analysis of the tentative data leads to the conclusion that a reliable estimate of committed effective dose equivalent requires further research.

Medical effects of exposure of human beings to fallout radiation from a thermonuclear explosion.

On March 1, 1954, after detonation of a thermonuclear device on Bikini atoll, an unexpected wind shift resulted in the deposition of radioactive fallout on inhabited atolls. The fallout radiation caused fleeting systemic effects, dose-dependent depression of hematopoiesis and skin burns primarily due to the beta ray component of the fission radionuclides. Within a few weeks, hematopoietic recovery was substantial but slight depression of blood counts was maintained for several years. One case of fatal acute myeloblastic leukemia developed in a boy receiving 1.9 Gy as an infant. Cretinism developed in two boys exposed as infants with estimated thyroidal dose in excess of 50 Gy. Chemical hypothyroidism was detected in several persons. Thyroid adenomas and cancer commenced appearance ten years after exposure and became a major long-term medical problem. There have been no late effects attributable to the beta burns 40 years after exposure. Internal contamination from ingestion and inhalation of radionuclides is detectable. The doses are comparable to background levels in the U.S. There is no detectible decrease in longevity of the exposed Marshallese compared to an unexposed Marshallese population.

The frequency of "rare" protein variants in Marshall islanders and other Micronesians.

Blood specimens from a sample of 373 Marshall Islanders were studied with reference to variants of 23 serum proteins and erythrocyte enzymes. Six of the traits studied exhibited genetic polymorphisms (adenosine deaminase, phosphoglucomutase1, acid phosphatase, 6-phosphogluconate dehydrogenase, haptoglobin, and group specific component). There were in addition four "rare" variants (albumin, transferrin, lactate dehydrogenase, and galactose-1-phosphate uridylyltransferase) involving nine persons, among 8,503 determinations. The frequency of rare variants in Micronesians was compared with the frequencies in West European Caucasians and Amerindians. There are many difficulties in such comparisons, and although the observed values for the three ethnic groups differ by a factor of three (the Micronesians exhibiting the lowest frequency), it is felt that no firm conclusions concerning differences between ethnic groups can be drawn at this time.

Thyroid hypofunction after exposure to fallout from a hydrogen bomb explosion.

Thyroid function was evaluated in the Marshallese who were accidentally exposed to fallout-containing radioiodine isotopes in 1954. Measurements of thyrotrophin (TSH, thyroid-stimulating hormone) levels and free thyroxine (T4) index (FT4I) have revealed that, among 86 persons exposed on Rongelap and Ailingnae atolls, 14 have shown evidence of thyroid hypofunction. This was first noted in some individuals about ten years after exposure. Only two of these showed clinical evidence of hypothyroidism. The most marked TSH elevations were noted in nine persons exposed when younger than 6 years, with estimated doses to the thyroid from 390 to 2,100 rad. Most of this group subsequently had surgery for removal of thyroid nodules. The remaining five cases have been noted more recently among 36 surviving adults exposed at an older age who showed no other detectable thyroid abnormalities. This group had received estimated thyroid doses ranging from 135 to 335 rad and showed modest elevation of serum TSH levels (6 to 9 microU/mL) and a slightly subnormal FT4I. No abnormalities were found in persons on Utirik who received substantially less radiation, and hypothyroidism was present in less than 1% of the control, unexposed Marshallese. The high prevalence of a thyroid hypofunction in these persons indicates that this condition, as well as thyroid nodularity, can be a delayed complication of exposure to early fallout from a nuclear explosion. The fact that a significant fraction of the radiation to the thyroid was from short-lived radioiodine isotopes (132I, 133I, 135I), as opposed to 131I, may account for the severity of the thyroid damage.