Medical status of Marshallese accidentally exposed to 1954 Bravo fallout radiation: January 1988 through December 1991

Abstract

DISCLAIMER 99-239 (1986). The distribution of the initially exposed group was as follows: 64 persons on Rongelap, plus 3 fetuses; 18 persons on Ailingnae, plus 1 fetus; and 159 persons on U t a , plus 8 fetuses. In later years, the Ailingnae have been combined into the Rongelap population. The Department of Energy's (DOE) Office of Environment, Safety and Health is responsible for ensuring that the Marshallese who were exposed to radiation during Castle Bravo in 1954 receive medical care and treatment for any injury, illness, or condition that may be the result, directly or indirectly, from their exposure to the fallout from Castle Bravo. For the last 37 years, the Brookhaven National Laboratory (BNL), under contract to DOE, has provided the required health care and surveillance for this program. In addition to conducting surveillance of the exposed Marshallese group, BNL has been monitoring a cohort of unexposed Marshallese. The individuals in this cohort were selected to mirror the age, sex, etc., distribution of the exposed group. Currently, there are approximately 154 of the exposed population and 115 of the unexposed population being monitored. This report discusses the medical care provided and the medical findmgs for the years 1988-1991. ProcedureIn the spring and fall of each year, the BNL medical team visits the islands of Mejatto, Utrik, Ebeye, and Majuro to provide medical surveillance to the exposed and unexposed cohorts. Medical FindingsDuring the last 4 years, 95 percent of the exposed population from Rongelap, 98 percent of the exposed population from Utrik, and 90 percent of the comparison population have been examined at least once. Those persons not residing in the Marshall Islands are seen by a physician in their locality.After 37 years, there is little difference between the longevity curves of the Rongelap group, the Utirik group, and the unexposed cohort population.' Each of the deaths (4 exposed and 10 nonexposed) that have occurred during the report period is discussed later in the report. The Marshallese population has a high incidence of diabetes, and it appears that one of the deaths of the exposed population and five of the deaths of the unexposed population were diabetes related.There is a mild, but relatively consistent depression of neutrophil, lymphocyte, and platelet concentrations in the blood of the exposed population.