Operation Castle Final Report Project 4.1

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Study of Response of Human Beln~sAccidentallg Exposed Naval Medical Researoh Institute San Ranoisco, California

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Follmiag the detonation of a thennonuclear device on Bikini Atoll on Xmch 1, 1954, 28 Ameriaans and 239 Marsballeae were exposed to fd,I6.5 ‘681~on Rongelap A t o l l , end 18 were on the nelghborlng atoll of Mlbgnes. The 28 Bmericana wem on Rongerik A t o l l . The premnoe 02 sigallicant fallout on these atolls was first determinsd by are cor w dosimter located on Rongerik, when thls device went off scale at 100 NFi per hour shortly after the detonation. Emergoncy surveys of redietion were detected upon the lahabited atolls, and evacuation of inha51tants to the Naval Station at Kwa jal el n was promptly carried out. Thc dose of radiation to which the individuals were exposed am celoulated fro31 the inLensities founc! on the islands and the decay exponent of on Rorgerik receimd an average cs3culafed does of 78 r. n q rrnd to E lesser eatent on Rongerik was &tinct;ty vlslble. fallout was obsemd on U-ik. A slgnifietmt nmbe of indivfduaLs on Rougelap suffered from mild nauaea and one or tmo Mi vl du8lsd ted on the day of the 5xposurc. nae individuals hero were no other definite gestrointsstlnel symptom in the other mrshalleae or ths Americans. and Ailiagaes, and the Bmerlcans experienced to a varyhg degree burn-, ku; of the eyes and itchhg of the ski0 for I to 3 -6. The 5n~ividu~1I.6on Rongelap received approxbately Tbe fallout on Rongelap, w~ The Karshal.lese on Rongelap

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of rsafaticn LJury 5acluded definite epilation in the Rongelap and pigmented akin lesions that bequamatad f r o m the tantar of raw, weeping leeions. The dmericans developed only minor skia lesions without ulceration. There were no &in lesions in tbe utirik natims. dll lesions baled rapidly w i t h no lurthsr breakdom of the akin noted during the period of observation. Mioroecopic araminstion or bfopsiea o f the le6iom showed chsllgsa usuLUy aawciated with radiation injury. Fully clothed Individual8 and those remabhg inside of baildings or huts were protected to v m degrees fhm developient of lesiom. Aematalogla changes were dafinite I n the Rongelap, Wiagnas, and the Bmerican groups. Igmphopenla appeared promptly and was peroiatent for ap longed period minimrrm oaluea occurring around tbe llth day folloued by IUI Incream in tke counts and a secondary nlnlmrn around the 40th to 45th dny. The most consistent hfnnatologlc c h t u p (1s8 the dqtression in the platelet post expoem and progressiwly decreased attaining a minimrmn between minima, the platelet counts had not returned to normal by the campleaor. of the Initial study on the 76th poet sxposure day. The lncideece of vario-a respiratory and cuQneous Weations waa Identical I n all exposure groups and bore no relafionship t o the hemafologic chatpa. some caws fhs skin damage was sufficient to result I n There w a s no full fhlcknesa necrosis of the skin. Neutropenia occurred in a l l of the individuals with initial Platelets were below normal when first counted on the loth day Although recowry commenced f oll mw this

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T h i s report l a one of the mpurts pressntfng the resulta of the Castle, which included e k teat dsfo ~ tlona. For readers Interested in other pertinent b a t iaformstion, reference l e made to fiR-934. SRILVlRP OF WFMONS EFFECTS TESTS, MWtarJr Effects Progrm. aummacy report includee tb following infornStion of possible germel (a) A n ov8r-sll description of each detonation, including yield, height of burst, ground zero loaatloa, time of detonation, ambient atmospheric conditions at detonation time, etc., for the 3 shots. (b) Discuealon of all project resulfs. (e) A swmary of each project, Including objectioes and resulte. (d) A omplete listing of e l l &ports covering ths Military Effects Teat Program.

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Operation Caetb did aot ineltda e blamedlcal pxqpsm. Tim patticlpanta in project 4.1 were drsnn from various laboratories and were totid& ~ p wp are dfor a field progrerm when the Com m der, Research Team be org ded. Speclel meapons Project, selected the Projeot officer end requssted that the selection of t6-a aad professional paomel be oommenced hmsdlately. Tbe cwperation of ths Surgeons General of haedfate and complete support of all n d medical research tletlvIt,i.es and assigned responsibility ta Capt. Van Tipton, E, En, and Commander Rarrg Etter, MC, El?,o f the Atomic Defense Divlslon, Burerru of Uedicfne end Sllrgary’, Navy Department, for the implementetion of the project, Since little detailed information %as wailable about dose and initial spptamatology, the research tea waa organized to Inc1ud.e the fol3arring talents for the constitution of the aaergencg medical pest ezperience in biomedical zwmarch in the fhld w i t h atonic infernal mdlcjne, hematology, radiation tschmhgy end radio- & ttse selecfion of prsonnel the emphasis WM placed on

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additional epsolalized par8onnel in cam they were needed. Ingly, a preventips medicine unit of the Camander-in-CNef, Peclfic Fht,wa8 alerted for possible Luxteriologla studies; blwd bank personnel, aud edditlonal ollnioiene and 11m-6 were notified in 0868 oonditiona just lf bd their semices in the Kaajjalsb needed medical feelllties of the Pr l fic Flset Personael were obtained within Continental Mta of the U. S. for the research tern as follonsr Napel Medlcal Ressarch Instftub 2 medical servioe coqm off%cere(W. B. Chaprum and Re Division of Biology E& Medicine, AEC A m d Forces Special. Weapons Project Preliminary studies had been made by Commander V. S. Hall, ICa IRR, Station mdedioal Mficer and his staff, and decontaminat%on of

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the. individuals was well rmderwey when Project 4.1 personnel arrived ia t h o field. Preliminary henatolcgic studies indicated that the ln dir i dual s probably had not received acutely fatal doses of radiation. The pr her y reaponsibiritlea wifhin the project group were delegated As *.e clinical picture developed, e further breakdown in responsibility for a alp m 3 of skin lesions, and Dr. S. H. Cobn om mado respozr slble for studying the problem concerned with the excretion of rediaisotopes and the estimates of body burdens in the Earposed individu&b The project officer conmcends all of the professional and technical members of the group for tbah well ent motivation, inltiatioe, and voluntary long hours of extra work that mere essential the r4;iid completion of the prelininary reprt in the field. amphasized that the work ~ ~ 1 1 8a cooperative endeavor in rhich all viere mutually dependent upon each o*r. cerned constituted a renarkable exemple of tefun-mork and sacrifice of the clinical and research o5joctiws, and for

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personal mbltlons and desires for tb good of the project at large. The authors nish t o expmss their gratitude and indebtedness C, Dr. John C. Bugher, Cspt. Pan Tipton, and Coamarrdsr Hamy E t t e r ; Capt. Exeoutlve Officere, respectiwly, tsaoal l7edioal Research Institute; Cqt.R. A. Hinaers, UNS, Directar, 0. S. Naval Radiological Defense USfiiMRDL; all o f whom gem udumited Bupport and reduced administratim p-ocedures to a bare mlnlmm, thus makiry It possible SOP the mzlt to be assembled and undernay in a matter of hma. opoa arrival et Kwajalein Rear Bdmiral R. S. Clarke, UIUS, Comaadall the feelllties at h i s dlsporral. As E result, a laboratorg and clinic mas established and operating within 24 hours after &vel of the project persannel. Project personnel a l s o wish to acknonledge the outstanding con8. A, H-ht, tlc, Eii, Division of IT lita ry Application, AEC; Col. iC, Houghton, LE, USAF, Special 17eapona Center; Copt. Donald Demnt, IC9 Dr. G o V, SmFby, University of Chiaago. During a l l phases of the much as thelr other primary duties would psnnit. In addition ve nisb

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to tha& tbem for the extensive and complete data whlch they collected in the a t o l b or their hame laboratories and kindly fipmished to the The continuow help and aoopration of hvst Terrifary w p r c eentatives, and their aid in obtaMng neaessary contra1 data on native Marshallese at U 4 m 0 , is hereby seknonledged. Fle wish in parflcular to aaknmledge our krdebta8ness to blr. John Tobin. Hls help as an interpreter, and ME extensive knowledge of the Marshalleee furnished his records on the exposed individuals WonfaPinatsd by the radiation group of the VP-29 squadron stationed at Kwahalaino The authors wish especially fo express their addratdon ?or the aary, Knajaleln, in completing the axtenslm laboratory exmiinations fhEt mere required t o obtsin a prompt initial evaluation of the severity of t h e radiation injury. The authors are h e p l y grateful to Dr. David A. Wood of the Uniwrslty of California Hoqitel, Sea Francisco and Dr- Edward 1, dlpen and Ellss Pat Roau of the Naval Rediological Defense LaboratcnY, Sari Francisco for pvizluable aid in carrging out the histapafholc@mLl evehation of skin lesions. The extensive contributions of r&* C. A. Sondhsus of the USW.DL in dosage caloulatlons we grate- e&ntn?=

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1.2 General Deaarlption of t h e Erpoed Croup 17 I.& Estimation of Maole Body Erternal Does 18 Epaolation ard Early hof the Exposed Oroaps . . CBapTw 2 CLINICAL OBSERVATIONS AND TKERAPX . . e 39 Cynical Observation a d lbelapy a8 Related b 41 B e Effect of an Epidemic of Upper Respiratory Infeation Cm@son d t h the Utirik Omup of Diseases Seen in on an Irradiated Population ............ 45 the R@ngehpand Ailingnae Groups M n g the Period of Observation ................ 47 in Radiation Injuqv. .................49 Discussion on the Use of Bntibioucs In this Gmup and

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Fig. 1.1 I h e Uyhg Area on Rangelap Islaad,Mioattqg the Fig, 1.2 Ustagrsm of Pmportion of Total Dose Contributed by Various Enera Regions fTom the Fallout Radiation . z'F lg. 1.3 ,Clmmilative Dose mak tion of Tipro diter the Fig, 1-4 Comperauve Dapth Dosea for Bilateral Expoaura Fige 1.5 Comparative Depth Do sea in a Phantom lEan of Initidl Atomio Bomb RBdiation sad Radiation Rpm a Field of Fission Products.. Fig, 2.1 'Lhe Blood Count Chengeg in a h.0 Year Old Child dth Mg, 2.2 '&e Blood Count Chaagwr in a Wty Pear Old pbpa dth Fig. 3.1 Coqnrieon of the Incl&mae aad of AppeaTame Fig. 4.1 Seri sl Changes in Neutro@~ile Counts of Roslgap 0For nose Loss 5 Ieara anl Greater than 5 For lhose Imsa than 5 l[earo ana Graafar than 5 Fig. 4.3 C c u 5 ~ t l v eserial changer3 in the motell Lsukoogfs, Neufrophile, srd Q@mcyte Counts in fhoee Gwatar rigc.4-4 serial Platelet Cbenges in !hose Less than 15 Teers and Greater than 15 Yesrs of age of fbe Rongelap Gro ~ pe e oae oe o0toe115 Fig. 4.5 Serial Totel Leukocyte, Neutrophile, arr3

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Figa..4.7 Serial Esoinophile Counts on Those Less than end Greeter than 5 Years of Age of the Rongehp Fige &? Cumulative Neutrophile Counts for the Rongelap, AiUngnae and tTlajum Groups at the Tine of Wllngnae and ?iajrw Groups at the Time of re& Cmdative Platelet Counts for the Rongalap, Ailfagnes, Uti rik and Mej ll ro Groups 8%tke ?!.go 4JO Cmulatiw Lymphocyte Counts for the Rowelap, F:.ga 5-5 Autornciiograph of Rosgalap chtclen tlksa, 1%;X, Bahd secrfliced 45 dsy8 post . 0 1% exposure, Aninal saerlficed 58 dsya pcst eq.mm%

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deposits of fallout mate rid on the boas dace itself. Ths latter i a 5qmesible to estimate, but tbe fona nqy ba rolrghly ettmptdd The beta dose rate in air at a b - of three feet abow ths sm face of an infinite plane cantsminated with mixed 24 horn old fission pl’bducts 58 estimated fo be abouf three tM8 ths gamma dose. The n i d l h e gamm dose is 8ppodmaW.y 60 per mn-2 of tbs portion of the air gemns dose due to 80 KV radiation ar a b m . Tkie portion in turn is estimated to be 90 p ~ zaent of the gamna dom measured in air by tbs lmtrment. a phantom -sed to mlxed fisslon pr-t radiation from an e@. lane ~curcewht be q t e d to be 3/(0.6)(0.9) or about 6 tines the rnldllne dose, if both occur at three feet off the p2pund Such a depth dose measurement ha6 in fact bean made experimentally at a preoioucr field test,* using aphtm man tapoeed to bath the 3dtiG. end residual r&tfon. The depth doses for each situation are ahin Ffg 1.5, with a l l data 8s per cent of the 3 centineter dose. W i t h the &verging initial rdation tkm tbe point of explosion, the exit dose was seen to be 63 per cent of the 3 cm dose, but w i t h ths dlffnm rssitfual field of fission produat radiation, a &ace dose 8om ~8 tirms greater thm the 3 cm and deeper dose from the harder gmnm components w a a obsarvmd, This is seen to be o r the 8- order of magnitude as that estinafed above, 3 foot l ml this surface dose would becone 1Opm and higher respec+ Thus the dose nt the nurStlFe of A t heights abm and hlm the

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ively, but probably would not exoeed 50 t h e e tho 3 foot a i r gamma dose or 80 times the midlins dose, wen in contect with the ground. An eetimete of skin dose due to gropad eontmnhtion for tho Rongelap case would result, for example, In a dorsum of the foot, 600 rep at the hfp law1, and 300 rep at fb head if continuow exposum with IY, ohieldlng ocaurred. Some ment, and it seems probable that the external bta dose hrn local akin eontnmlnation fer outwigbd thet from t b gmuad in reduced the beta dose from the grow by 10 to 20 per cent, while it teaded to collect d loCaliso tla direct skis oonhnlmtlono of abut 2OOO rep to the This l e emphesieed by ths fact that alothine probably

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Fig. 1.1 The lie area on Roqelap Bland, indicating the Ught, opr~lptspeof conatruetion

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F i g . 1.2 Nstagram nf proportion of total dose oonMbutea by various energy mglona from the fallout radi a a

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It -88 kmnn w h b u that the exposed p - 8 had lWCdVOd a aignificaut muut of pemtrating radiation t o the e ntl re body, extensive contamination of the skin and possible Internal deposition of radioactive materhls. It w s therefore decided that cllnlcal obsematione would be as extensive and fTeqwnt as facilities arrt pereonnel pemltted in ordex t o rwognim and care for radiation effects as e a r 4 possible. rO~orclInglpcomplete initial hl8torf.e~ ternale a d the detailed skin fkdings rn raported in Chapter III. Sumeye of the skln were codlucted a t freqmnt hExtenltive bematelQgh18tfudleswere oondueted, the detailed realata of which are presented in Chapter IV. Results of examhatione for mlmry exoretion of radioisotopes am reported in Chapter V. In addltlon to perm exxminntions, routine sick ad1me held tnlce dally. bspital fao ill ties …