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The presence of radioactive isotopes of iodine in fallout from atomic explosions is well know. In the accidental exposure of the inhabitants of one of the marshall islands after a fusion-type explosion in 1954, thyroid radiation from radioiodine, particularly in the children, was sizable. This resulted in the late development of thyroid insufficiency or thyroid nodules or both in 80% of those children exposed at less than 10 years of age. At the present time, the thyroid effects constitute the only important overt medical problem in the exposed population. Detection of thyroid damage was hindered by its insidious onset and by the unexpected occurrence of elevated blood levels of iodoprotein in the marshellese population. The greater prevalence of thyroid abnormality in the children is probably due to two factors: a larger radiation dose due to small thyroid size and a greater likelihood of the growing organ to manifest changes resulting form chromosomal alterations. The spectrum of radiation exposure of the thyroid glands in any population is very wide, ranging from stratospheric fallout from atomic explosions and clinical testing with radioiodine isotopes to high radiation rates intentionally produced in therapy of thyroid disease. The marshall island experience will help to define the range in which significant thyroid damage may occur.
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