Letter to R Stone, Subject: Costs of Continuing and Anticipated DOE Programs in Marshall Islands (Attachment)

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Deputy Assistant Cei .xal Counsel Department of Decenst 1979, to members o; ny staff for ---- the prosran, it should be clearly ‘.:~.derstccdthat the enmight altp< the cost estimates. Furthermore, :$:should be noted ~.hatwe have not included are consi.ler’;dto terminate within the next fiscil year

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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) Estimated manpower requirements vary between 40-50 man-years , 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. Past and present experience shows that unexpected findings and unanticipated requests from 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, While these issues have been included herein to the best of our knowledge, additional efforts and requests are not precluded, For these a?d other reasons, a standing capability of response must be maintained, The projected cost estimates, therefore, should considered as tentative, major components of the program are discussed in The medical program in the Marshall Islands in FY 79 provides 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 who were relocated from Bikini. The approximate numbers of Depending upon circumstances, usually three of four trips are made each year to these locations, Brookhaven National Laboratory (BNL) Medical Department physicians coordinate and direct these programs. One of these trips consists of a large medics-lstaff (usually 12), the majority of whom are specialists from various leading U.S, medical centers and institutions, At this time the annual physical examinations are given, including hematological, urological, serological and other examinations as appropriate, During these visits, “sick wishing medical attention; several hundred persons on call” is held for all residents this usually results in up to each atoll seeing the physicians. Included in “sick calls” are physical examinations, blood tests, treatment if possible, and referral to the Trust Territory Health Services, Other visits during the year are far more specialized examinations (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 expandedin FY 80: 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 that based upon radiological surveillance results other population groups (unknown at present) may need to be included. These activities could require $1 million which is above current budget availability. Depending upon medical findings, the medical program in FY 81 is expected to include persons living on Rongelap, Utirik and Likiep, and Bikinians at their residence locations. The greater than three-fold increase anticipated in the population under medical surveillance during FY 80 and FY S1 results in a special problem, The ship which is presently

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under charter for these (and other) visits is only marginally adequate for the present program, and would be totally inadequate for 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 - $2,000,000 but is not in the budget, The past, present and estimated projected operating funding Monitoring and Assessment Program The radiological monitoring and assessment program in the Marshall Islands consists of field operations, laboratory studies and analyses-,exposure assessments, and advisory During FY 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 Ou100 plus controls t Utirik e100 plus controls Bikinians z200 plus controls

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It is 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, Also 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 atolls, Depending upon the specific purpose of each trip, five to seven professional staff persons participate. These trips result in 2000-3000 samples of various types being . returned from analytical examination each year, It is expected that the current prograu will be continued, and that some modest expansion may be projected due to (a) additional studies at Enewetak after the people return, and (b) 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 $n the environment, These assessments provide the bases upon whid”hdecisions are made with respect to the acceptability or unacceptability of various living patterns, residence locations, food consumed, etc.

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The immediate past and current funding levels, together with estimates of projected operating funding requirements for FY 80-83 are as follow (X 1000): It is anticipated that a whole-body counter will require replacement at a cost of about $1OOK. Also, replacement of and additions to other laboratory and field equipment will amount to roughly 5-10 percent of the operating