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The Department of Energy program in the Marshall Islands consists of medical, monitoring and assessment components, Past, current and estimated future operating costs (X 1000) FY 77 FY 78 FY 79 F Y 5 0 FY '81 F Y 82 FY 83 Estimated manpower requirments vary between 4 0 - 5 0 of effort depending upon number of trips, specific needs, unanticipated requests, etc, It must be emphasized that it is extremely difficult to anticipate all possible needs and contingencies in the activities in the Marshall Islands, that unexpected findings and unanticipated requests fram various sources (e,g., the Marshall Islands Government, legal representatives for various groups of people) may significantly affect, alter or add to the projected program. issues have been included herein to the best of our knowleeige, additional efforts and requests a r e not precluded, and other reasons, a standing capability of response must be maintained, The projected cost estimates, therefore, should only be considered as tentative, 'Past and present experience shows The two major components of the program are discussed in greater detail below: The medical program in the Marshall Islands in FY 79 p r o - vides medical surveillance of persons on Rongelap and Utirik who were radiologically exposed following testing in the
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Marshall Islands, plus a matched control population consisting primarily of unexposed Rongelap people, In addition, a limited surveillance has been provided to those persons I who were relocated from Bikini, The approximate numbers of Depending upon circumstances, usually three of four trips are made each year to these locations, Laboratory (BNL) Medical Department physicians coordinate and direct these programs. a large medical staff (usually 12}, the majority of whom tions are given, including hematological, urological, serological and other examinations as appropriate, One of these trips consists of At this time the annual physical examina During these visits, "sick call" is held for all residents wishing medical attention; this usually results in up to several hundred persons on each atoll seeing the physicians. Included in "sick calls" are physical examinations, blood tests, treatment if possible, and rcferral'to the Trust Territory Health Services, Other visits during the year are far more specialized examina- . tions (e,g,, pediatrics, thyroid, dental, intestinal parasites, etc.) and include BNL staff and appropriate specialists.
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A resident physican assists in these visits, -Because of the particular concern related to radiation effects on the thyroid, a separate baseline comparison group has been established, consisting of approximately 500 persons on Rongelap and Utirik and a limited number of other atolls. While this group does not receive complete annual physical examinations, they do provide a baseline for a number of thyroid function tests and thyroid disease incidence rates. The medical program may need to be expanded in FY 80: 1. Persons who resided on Bikini will be included in the Baseline medical information will be obtained on persons scheduled to return to Enewetak; this may include in excess of 450 people. It may be necessary to conduct a medical survey of approximately 600 persons who were present on Likiep It is anticipated tIiat based upon radiological surveillance results other population groups (unknown at present) may need to be included. $1 million which is above current budget availability. These activities could require Depending upon medical findings, the medical program in FY 81 is expected to include persons living on Rongelap, Utirik and Li ki ep, and Bikinians at their residence locations. The greater than three-fold increase anticipated in the population under medical surveillance during FY 80 and FY 51 results in a special problem. The ship which is presently
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under charter for these (and other) visits is only marginal adequate for the present program, and would be totally inadequate f o r any expansion in the program, If an adequate medical program is to be conducted, it is essential that funds be made available for purchase of a 175-foot ship, An estimated cost for the ship and appropriate outfitting is $1,500,000- $2,000,000but is not in the budget. The past, present and estimated projected operating funding Monitoring and Assessment Prog rz m The radiological monitoring and assessment program in the Marshall Islands consists of field operations, laboratory studies and analyses., exposure assessments, and advisory During F Y 79 three trips are being conducted to carry out whole-body counting activities among the Rongelap, Utirik and Bikini peoples, and to begin acquisition of baseline information from Enewetak people planning to return to their atoll. The approximate numbers of people included in this activity are: Rongelap -100 plus controls Utirik -100 plus controls Bikinians -200 plus controls
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It i s expected that two or three trips a year will be continued, with four or five professional staff participating on each trip, If circumstances require (e.g,, including all resettled Enewetak people, other atoll peoples), additional effort may be required, Environmental monitoring is conducted on the atolls of Enewetak, Bikini, Rongelap and Utirik. Included are studies of radionuclide transport mechanisms and exposure pathways to man ce.g., foods and food chains) from both the terrestrial and the marine environments, A l s o included are studies of the dietary components on the several atolls, At present, these efforts require four trips per year to the Enewetak and Bikini atolls, and two trips per year to the Rongelap and Utirik five to s.even professional staff persons participate. These trips result in 2000-3000 samples of various types being returned from analytical examination each year, Depending upon the specific purpose of each trip, It is expected that the current progran will be continued, and that some modest expansion may be projected due to b) additional studies at Enewetak after the people return, and Cb) possible increased effort at other atolls (unknown at present) as radiological findings and circumstances Individual and population dose assessments are based upon the actual measurements of radionuclides in residents and i n the .environment. These ,assessments provide the bases upon which decisions are made with respect to the acceptability o r unacceptability *of various living patterns, residence locations, food consumed, etc.
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The immediate past and current funding levels, togerher with estimates of projected operating funding requirements for FY 80-83 a r e as follow (X 1000): FY 77 FY 7 8 FY 7 9 FY_ L _ _ .9 0 FY 8 1 FY 82 FYcc_53 It i s anticipated that a whole-body counter will require replacement at a cost of about $100K. Also, replacement of and additions to other laboratory and field equipment will amount to roughly 5-10 percent of the operating