Medical Survey of Rongelap People Five and Six Years After Exposure to Fallout (with an Addendum on Vegetation)

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MEDICAL SURVEY OF RONGELAP PEOPLE FIVE AND SIX YEARS AFTER EXPOSURE TO FALLOUT [With an Addendum on Vegetation) MAYNARD EICHER, DAVID POTTER, ISAAC LANWI, PRACTITIONER, EZRA RIKLON, PRACTITIONER, JOHN lAMAN, PRACTITIONER, AND JACK HELKENA, PRACTITIONER BROOK HAVEN NATIONAL LABORATORY ~ Associated Universities, Inc. under contract wtth the United States Atomic Energy Commission

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A NOTE ON THE VEGETATION OF THE NORTHERN ISLETS OF RONGELAP ATOLL, MARSHALL ISLANDS, MARCH 1959 Fosberg’2 reported changes in the vegetation of the northern islets of Rongelap Atoll (observed in 1956) which he inferred might have been associated with the radioactive fallout that occurred on this atoll in 1954. During the medical survey of the Rongelap people’ carried out in March 1959, an opportunity arose to visit some of these islets *National Institutes of Health, Bethesda, Maryland, and to re-examine the vegetation. A helicopter was available for transportation, which permitted general and detailed air examination as well as two short ground surveys. The northern islets were estimated to have received a radiation dose of x3000 r. The islets of Naen and Gegen were examined in greatest detail. The most striking feature observed from the air was the generally gray color of much of the vegetation, in contrast to its Figure A-1. Map of Rongelap Atoll showing position of major islets.

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FIVE AND SIX SURVEY OF RONGELAP PEOPLE YEARS AFTER EXPOSURE TO FALLOUT an Addendum on Vegetation) JOHN IAMAN, PRACTITIONER,2 AND JACK HELKENA, PRACTITIONER with the technical assistance of t Brookhaven National Laboratory, Upton, New York 2Department of Public Health, Trust Territory of the Pacific Islands 3Walter Reed Army Medical Center, Washington, D.C. ~South Nassau Communities Haspital, Rockville Centre, New York 5M. D. Anderson Hospital, University of Texas, Houston, Texas dNational Institutes of Health, Bethesda, Maryland 7Atomic Bomb Casualty Commission, Hiroshima, Japan ‘Naval Medical Research Institute, Bethesda, Maryland ‘Memorial Hospital for Cancer and Allied Diseases, New York, New York

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Figure A-2. AfFected Guettardasfieczosawith normal appearing Scaevob sencea. normal green color. Ground surveys revealed that Scaevola sertcea was common and normal in appearance. Many of the Guettarda speciosa appeared to be in poor condition (Figure A-2). In some, all or nearly all the leaves were gone from the terminal 1 to 12 in. of the branches, and other leaves were yellowed and shriveled. In other Gtsettarda, nearly all the leaves were gone, and the bushes appeared completely dead. More than fio~o of the Guettarda were affected in whole or part. In one area of Naen several hundred yards inland from the ocean beach, there was a field of ZZ30 Gwttarda, all of which were dead. Some young Pi.sonia grandis were seen which appeared to be in good condition. Mature Pisonia were seen which were partially defoliated, but these did not appear to be greatly different from those seen on Rongelap Islet on the southeast corner of Rongelap Atoll. None of the mistletoe-like clumps described by Fosberg were observed. Several Ochrosia oppositz~olia were seen with nearly complete defoliation, which appeared dead. A small grove of coconut trees near the center of Naen Islet contained 4 to 5 dead trees within a radius of z 300 yards, which were decapitated at heights 5 to 12 ft above the ground with no evidence of axe or machete marks. Two 2headed coconu~ trees were seen, one with fronds that were mostly brown and appeared dead growing from the trunk =2 ft below the true crown of the tree. Several trees had dry and shriveled’ tionds, and Z6 had deformed bulges 4 to 8 fi below the crown with apparently normal growth above the bulges. Photographs of the affected vegetation were examined by Dr. Fosberg, and he stated that the changes were similar to those he had previously It is not possible to evaluate the cause of the changes from the present observations. More extensive and detailed botanical and ecological surveys will be necessary, both on the islands that received radiation and on those that did not, to determine whether the changes seen bear any relation to fallout. In particular, it should be noted that these observations were made during the dry We are indebted to Professor Frank Richardson of the University of Washington for identifying the plants, and to Commander W. Lyons, USN, for his assistance in taking the photographs. March 1958, Four YearsAfter Exposureto Fallout, 13NL

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Thk report was prepared as an account of Government sponsored work. Neither the United States, nor the Commission, nor any person acting on behalf of the Commission: A, Makes any warranty or representation, expressed or implied, with respect to the accuracy, completeriess, or usefulness of the information contained in this report, or that the use of any information, apparatus, method, or process disclosed in this report may not in~lnge privately owned rights; or B, Assumes any liabilities with respect to the use of, or for damages resulting from the use of any information, apparatus, method, or process disclosed in this report. As used in the above, “person acting on behalf of the Commission” includes any employee or contractor of the Commission, or employee of such contractor, to the extent that such employee or contractor of the Commission, or employee of such contractor prepares, dissemmates, or provides acceas to, any information pursuant to his employment or contract with the Commission, or his employment with such contractor, PRINTED IN USA Available from the Office of Technical Services, Department of Commerce

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Beta Irradiation of the Stin ........................................ ........................................ Location of Examinations ................................................................................ Studies of Genetically Inherited Characteristics.. . .............................

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Interval Medical Histoq ...................................................................................... 15 Review of Data on Mortality and Pregnancy Terminations Over the Past Six Year n.... ...................................... 17 Growth and Development Studies .................................................................. 20 Studies of Aging Criteria ...................................................................................... 28 Rmidual Beta Burns ............................................................................................ 33 Sodium and Potassium Levels, 1959 ................................................................ 38 Studies of Genetically Inherited Traits ............................................................ 41

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APPENDIX 1. Rongelap Blood Counts .............................................................. ...... APPENDIX 2. Ailingnae Bloti Counfi ...................................................................... APPENDIX 5. Individual WBC, Basophil, and Alkaline Phosphatase, 1959- 1960., APPENDIX 6. Blood Groupings and Haptoglobins, 1958-1959, and ADDENDUM. A Note on the Vegetation of the Northern Islets of Rongelap Atoll, Marshall Islands, March 1959 ...........................

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MEDICAL SURVEY OF RONGELAP FIVE AND SIX YEARS AFTER EXPOSURE The results of medical surveys of the people of Rongelap in the Marshall Islands, carried out in March 1959 and in March 1960 at 5 and 6 years after the accident, are presented in this report. These people had been accidentally exposed to fallout radiation following a detonation of a high yield thermonuclear device during experiments at Bikini in the Pacific Proving Grounds in March 1954. An unpredicted shift in winds caused a deposition of significant amounts of fallout on four inhabited Marshall Islands to the east of Bikini (see Figure 1) and also on 23 Japanese fishermen aboard their fishing vessel, the Lucky Dragon. Of the inhabitants of the island of Rongelap, 105 nautical miles away from the detonation, 64 received the largest fallout exposure: an estimated dose of 175 r of whole-body gamma radiation, contamination of the skin sufficient to result in beta burns, and slight internal absorption of radioactive materials through inhalation and ingestion. Another 18 Rongelap people away on a nearby island (Ailingnae), where less fallout occurred, received only an external gamma dose of about 69 r. There were 28 American servicemen on the island of Rongerik further to the east who received about the same amount of radiation as did the Rongelap people on Ailingnae. Lasd y, 157 Marshallese on Utirik Island, about 200 miles further east, received about an estimated 14 r of whole-body radiation. The fallout was not visible on this island and no skin effects developed. The exposed people were evacuated from these islands by plane and ship about two days after the accident and taken to Kwajalein Naval Base about 150 miles to the south, where they received extensive examinations for the following three months. In view of the generally negative findings on the American servicemen, they were later returned to their duty stations. The Utirik people were also allowed to return to their home island, where radioactive contamination was considered to be of a slight enough extent to allow safe habitation. Because Rongelap Atoll was considered to be too highly contaminated, a temporary village was constructed for the Rongelap people on Majuro Atoll several hundred miles to the south, where they lived for the following 3% years and were examined at yearly intervals by a special medical team. In July 1957, after careful evaluation of the radioactive contamination situation, Rongelap Island was considered safe for habitation. A new village was constructed, and the Rongelap people were moved there by Navy ship. The annual medical surveys have since been carried out on RongeA group of more than 100 Rongelap people, who were relatives of the exposed people but had been away from the island at the time of the accident, moved back with the Rongelap people to their home island and have served as an ideal comparison population for the studies. Following the initial survey of the Utirik people on Kwajalein in 1954, a repeat survey was carried out in March 1957. In addition, during the past survey, as in the previous surveys, a visit was made to Majuro Atoll to examine a group of children who represent part of the control group used for the growth and development studies of the exposed Figure 1, Map of fallout area

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The accumulation of data from these surveys is becoming increasingly voluminous. Since conditions have not been favorable for performance of extensive statistical analyses or use of electronic computing procedures to store and manipulate the data, the annual survey reports published by this Laboratory are made as complete as possible. This report, therefore, includes a considerable amount of raw data, much of it in appendices, so that others may have an opportunity to make further calculations if desired. This report also contains a brief addendum on the vegetation of Rongelap Island. Summary of Past Findings Reports have been published on the findings of surveys made at the following times after expoyears,’ 3 years,5 and 4 years.’ The following is a brief summary of the findings previously reported. During the first 24 to 48 hr after exposure, about 2A of the Rongelap people experienced anorexia and nausea. A few vomited and had diarrhea. Many also experienced itching and burning of the skht, and a few complained of lachrymation and burning of the eyes. Following this, the people remained asymptomatic until about 2 weeks after the accident, when cutaneous lesions and loss of hair developed, due largely to beta irradiation of the skin. It was apparent when the people were first examined, a few days after exposure, that the lymphocytes were considerably depressed and that significant doses of radiation had probably been received. In addition to the wholebody dose of radiation and the beta irradiation of the skin, radiochemical analyses of the urine showed that measurable amounts of radioactive material had also been absorbed internally. The effects of the radiation can best be summarized under three headings according to the mode of exposure: penetrating irradiation, skin irradiation, and internal irradiation. The changes in the peripheral blood of the more heavily exposed Rongelap people who received 175 r will be reviewed in the section on hematological examinations (see Figures 33, 35, and 38, and Appendices 1 and 2). The changes in the Ailingnae and Utirik groups were similar but less . marked. Certain unexplained fluctuations have occurred from year to year in the peripheral blood levels of the comparison populations as well as of the exposed groups. Depression of the peripheral blood elements as represented by mean population levels occurred as follows. Lymphocytes fell promptly and by the third day were about 55y0 of the control values in adults, and slightly lower in children. There was only slight recovery after six months. At 2 years, although further recovery was evident, the mean values of these cells were still found to be below the comparison population levels (75 to 80’ZO). At 3 years the mean lymphocyte counts were slightly below those of the comparison population. At 4 years the mean level appeared to be about the, same as that of the comparison population, but many counts remained lower. Neutrophil levels fluctuated considerably during the first few weeks but fell gradually to a low of about 509i0 of comparison population levels by the 6th week after exposure. Slow recovery ensued, but at 6 months they were still slightly below the unexposed levels. However, by 1 year post exposure they had returned to the level of the comparison population and have remained so, with the possible exception of those of children <12 years old, which generally have been lower than those of the unexposed children of comparable Platelets fell to about 30% of the unexposed values by the 4th week. By 6 months they had reached 70~0 of the controls; at 1 year the mean platelet count was still below that of the control population but higher than at the 6-month survey. Although further increases were apparent at the 2-, 3-, and 4-year examinations, the levels were still below those of the comparison population. Changes in hematocrit were not remarkable in any of the groups. Clinical examinations revealed no disease processes or symptoms which could be attributed to radiation effects, aside from skin lesions, loss of hair, and early symptoms. Epidemics of chicken pox and measles occurred. The diseases encountered were no more severe or frequent in the irradiated group than in the unexposed group, even during the period of greatest depression of peripheral blood elements. Three persons in the exposed population died of disease: (1) a 46-year-old man with a hypertensive heart disease which had been

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present at the time of exposure, who died 2 years after the accident; (2) a 78-year-old man who died, 3 years after exposure, of coronary heart disease complicating diabetes; and (3) a 36-year-old man who died of acute varicella, 4 years after exposure, who had received only 69 r, having been on Ailingnae at the time of the fallout. There was no apparent relationship between any of these deaths and radiation exposure, and mortality in the exposed group did not appear to be greater than in the unexposed population. It was difficult to evaluate the effects on fertility. However, a number of apparently normal babies were born during the 4-year period, and there has been no discernible fall in birth rate. A slightly higher number of miscarriages occurred in the exposed women than in the unexposed group; this will be further evaluated in the present report. No opacities of the lens or other eye changes have been found that could be related to radiation. Studies on height, weight, and bone age seemed to show a slight degree of retardation in growth and development in the exposed children. However, the small number of children involved, and a later finding that exact ages of some of the children were in doubt, has resulted in a re-evaluation of these data based on more reliable …