Study of Response of Human Beings Accidentally Exposed to Significant Fallout Radiation
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.._... —____ ... _.. - ‘---- ( --- . c Jk!-t 1+. “’?mlts,w OPERAIION CASTLE - ~lNAL REPORT PRO Jt(’1 4 1“ ~ * Study of Response of Human Beings Accidentally Exposed to Significant Fallout Radiation ,. by !--- E. P. Cronkite, Commander, MC, USN .. V. P. Bond, M. D., Ph.D. L. F,. Browning, Lt. Col., MC, USA W. H. Chapman, Lt., MSC, USN .- . S. H. Cohn, Ph.D. ft. A. Conard, Commander, MC, USN .+$$$ ,#Je C. L. Dunham, M.D. 1?. S. Farr, Lt., MC, USN W. S. Hall, Conlm:mder, MC, USN ,,,:$gl~$ti it. Sharp, Lt. (jg), USN N. R. Shulman, L~., MC, USN <~“:’’~,~ \ ~.;L ,).’ , !,3$ ,@ ,\ +“’.:: ! ()t,ltb(, r 1954 ;. g . .. ‘. ,,<f\~ :W ,). +! NIIVUIMcdicwl 1{{.search III. IIUI(, ~.. Iltth(si;,,Marvl:n,lS3~;’~&$ “‘“ ““ }Ind ‘\ 11.S. Naval Rad]olo~mal Defense Lubo&‘ .V San i~’rant isco, California ,; ,. .- -.——.—— .. .. -4 ., L. ,. -k -w ABSTRACT . F(Jll(JwIIIg tli(, cf(, donation” of Shot 1 I)n Ilikini Atoll (m 1 Mar(mh 1!)54, 28 Ali)(,]-i(-;ttt*”i\l]ct 239 M~rsllill 1(,s(, W(Sr(J(,x]J(~s(,d to fill lout. One hull(irtd fifty -SCW(,II(I[ th(} Mitrsll:Ill(,s(~ wi~r{ 011 U(Irik /ltoli, M WI,I.(, III) 1{1111~{,l;Il) Aloll, ;Lll(i 18 w(.rt~ (III th(, 1]~.i~hl)orll]g :11011of .Alllll~litilt~. TII(J 2X An)(,rl(:ll]~ w(,I( I)n l{(,!l~!(,rlk Atoll. TII(s l)rI.s(*I\r(I of SIKIIIII(.;IIII fiillo~lt 011tli(~st, i~l(]ll~ was flrsi lll.l(r II IIIII.11 I)v :1 r{>(.{)1.{lltig(h)sil])(4(,r, 1()(’;l[td 011 lton~t, rik, Wh(~[l thls (t(Wl(. () W(.[lt (Iff ti(’alt> ;lt 10[) 1111.III. SIIIII.IIV ;Ift(, I. [II(, (I(,l(]natt(m. Kltl(’rg(mcy surv(>ys (1(.l(x’t(xi rtidlii(loll 011 th(s Inhabitt,d :II!)II,s, ;III(i ISV:I(. II:It 1(III of tl)ll,ii)ll; tnt.% 10 th(~ Nav:Il Stat lolk at KW>lJal(.111W;IS I)rollll)iiy (.;trriect out. ‘1’1)((J(I+(Lof r:l(il:it 1(111to wl)i(. h III() indiviciu; lls werl~ cxpotitxi was (;il(.ulittl,(i frolil the intensities III(II)(i(III t II!,’ IS l;III[is ;III(I It)(, d(,(.;Iy (,XpOIICIIiof the fall(tut nl;lt[. rual. The i]l(i]vlduals On Rongclap Ir(x.(IvtL(l ti~]i)t.(jxll]i;~t(,ly 175 r, thosc~ on Aillnginae received approxinlatcly 69 r, and the Amt, ri - Ians oI~ i{oll~{,rlk rl,(,t,iv(~d ;m average calculated dose of 78 r. The Marsh allese on Utirik re - (.(,]v(!d approxin,; itei y 14 r. The fallout on Rongelap, Ailinginae, and to a lesser extent on Ronge - rik was (distinctly visible, No fallout was observed on Utirik. A significant number of indi- viduals (m Rongeiap suffered from mild nausea and one or two individuals vomited on the day of the exposur(~. with the exception of nausea in one Ailinginae individual, there were no other definite gastrointestinal synlptonls in the other Marshallese or the Americans. The Mar- shallese cm Rongclap and Ailing inae, and the Americans experienced to a varying degree burn- ing of th(~ eyes and itrhing of the skin from 1 to 3 days. Later, signs of radiation injury included definite (,pilatioo 10 th(, Rongelap and Ailinginae groups, and the development of spotty, super- I_i,:ial, hyperl)ign)ented skin lesions that desquamated from the center of the Iesi(ms outwards. rl) SIJM(, (;as(~s lh(, sk}n damage was sufficient to result in raw, weeping lesions. There was no full tl)ick[i(,ss necrosis of the skin. Thr Americans developed only nlinor skin lesions without ~llc(,rntit,rl. TII(, I-1, w(,r(, II() skin 1(.sions in II)(I Utirik natives. All l(,s IOIIS h(~al(,d riq]idly with III}flirll~(~r l)r(,;lk(iown of III(, skin not(:d during (II(! perio(i of obs(, rvat ion. Ml(. rosco[)i(. (>xanlI- 11;111011(Ir 111(ll)sl[, s {)r III(, l(~+ions si)I)wI,ci (hang(w usu;Illy ;~ss(x. i;lt(xl wlt h rmii;li IIm IIljury. Fu]ly [.1(1111(.(1II I(t Iv I(tu; Ils ;iIIIt Il)(),s[, r(,!ll;lin~ng lll~l(t(. of ~ulldll]gs or ]Iilt.s wt, r(. prott,(.t(.(i to Vilrylllg (llgr(,(Ls fr’11111(IOV(>lol)lll(,llt”or I(>HIOIIS. }l(~nlal(~l[~gic rh;uig(>s w(,r(~ d{,fll~ltt~ III tll(, ltoIlgelitp, AIi InKIIIat., mId III(LAnl(,ri(.ull gr(IL.lIs. LylI~pho})(vlia appear(xi prun~~d iy ;ui(i W;IS persistent for ;I IJr(Iio ItgLvi l)(,rlod of tin]c, . Neulropenia occurred in all of th~, Illdivi(iuais with ]Jlitial minimum V:IIU(SS(J(.(.urring tiroun[t th(, 1lth day followe(i by an increast, in the (.ounts ;Inct a secondary !nlnimun] arouuci th~~ 40th tu 45th day. The most consistent henmtologic cha]~(, was the de- I)ression in ~he plateiet (.ounts. Platelets were below normal when first counted on the 10th day of post-exposure and progressively decreased attaining a minimum between the 25th and 30th day. Although recovery commenced following this minimuru, the platelet counts had not returned to normal by the completion of the initial study on the 76th post-exposure day. The incidence of various respiratory and cutaneous infections was identical in all exposure groups and bore no relationship to the hematologic changes. Urinary excretion of radioisotopes was studied. Small amounts of radioactive material were found. Estimates of total body burden indicate that there is no long term hazard and that ingestion and inhalation of isotopes did not contribute significantly to the initial radiation exposure. ‘“+=?L@@~~~~.......U-.+-”.. -. ‘-ti . ,..’ . ... *~. :.. - :-,.:: -*$’: . : : : . .—— —— —___ . _ . ,- —.. .—.— — ...-.— -. Iwi.ALJ - ~~.*--J”’ FOREWORD This r(,l)ort IS on{> of th(’ r(q)orls pr(,s(~nt ln~ th(, rtv+ults of tl)t) 34 ~)roj(v.ts part 1(.Ipul InK In 1111,Mlllt:irv f?ff(x}ts l~ro~ran) of Operatl(]li (’ASTI, k’. For rtlad(>rs (nt(’r(’sti’(1 III 0111(>1” pt>r- ! IIIrIII II,,SI i]]forn)atio t),” r(,f(,r(vl(,(~ IS n)adt} to W’f’-934, l{c I)ort of th(’ f’(Iu IIII:In(i(Lr, Tusk Llnit 13, Milil:lry Klf I,(’ts l)ri)~ran). TI)Is sun]n]:lry r(, ~)ort In(’lud(s 1111,foll(lwlng lnforl)l~tii)n of l)IIss Ihl(, ~em,rtii tn[rr(,sf. (a) An ov(!r-:ill cf(’srrll)tion of each dctonat]on, including yield, height of burst, ground zero lorat ion, lin)(, of (ic, tonat ion, ambient atmosl)her]c conditions at detonation t In)t’, \}tc., for the ol)crltion. (]J) f)l S($UhSloll of all I)r(l](i[!t reSUlts. (c) A suninlary of (~a(’h I)roj{,(l, Including objectives and rt~sults. fd) A (’(JIIII)I(sI(’Ilsling of all r(!ports cov(>rlng the Military Kffe(”ts T(%t I)rogram. I)(,tiill(,(l r(,l)oris 1)11(Ioslnt(,try and intrrnal radioa(:tlv(, (.olltiil~)il]~ltlol]” will bt, l)LIi)lIslled as sul)plt, mt,n(s 10 lltis r(,port. Illodiral t(>rrl)lnology in this r(, ~)ort is t~xpla]n(,d in ~)art>nth(’s(’s for the benefit ,.+, 5–6 .d.j/’ .;/’ I / \ .“”. “’”,;*-’:;# ‘;. ‘ ‘. “ “ . ..”.; :., ..,. .—— ..-— ——_ _._.. _ . ————..–— . _ . PREFACE olN>r;tl )OT1(. A,S’I’I,1,:(Ii({ II(JI !lwIII(I(, a l)I(lIIiI,{iIrLtl ~)rogra!!]. ‘1”1)(’)Iarl 1(.l})illlts 111 I’rojtwt 4. I WI,].{.(ir; lwll (1.0111 varlolls l;ll)O1.;ll {)1, 11,s ;11)(1 Wt.].1, totally Illl})rt$l)artd (or ;1 fl(~l(i })r(lgl-,11]1 Whl,ll . I III, jIj IIIl Ix)l) Al,:( ‘ MIv II(.:11 1{(, sI, JI. (.11 T(,iIIII WI:IS (jrg:llli~,t~(l ;Ill(>r 111(~ olI($ral 1011 11.111 kIt$gu Ii. 1)1”. .] Idl II~’. Ilugh(’r, l)ir{>(.l(]r, l) Iv IsI(m IJ[ Iliol(]gy aIKI M(.({I(IIIIL, ,AKC, ;ILI(i Lt Col 1,. E. llrownIIIg, M(; . USA, Surg(i(m of the Armtxt For(.t,s Slwclal Wt,;\puns l>r(~j(w.t, st,l(, cttxf the proj - ()(.( (lffl(,(~r and rc,quc.st(ld that the select ion of t(!chn ical and professional pc,rs(]nnel b<’ con)- nlt>n(.(,d lmm(xiiat(!ly. Rear Admiral Clarence Brown. Deputy Surgeon General, Medical De- IJar[nwnt, USN, g;ive immediate and complete support of all naval medical research activities and assigned responsibility to CAPT van Tipton, MC, USN, and CDR Harry Etter, MC, USN, of the Atomic Defense Division, Bureau of Medicine and Surgery, USN, for the implementation of the project. Since little detailed information was available about dose and initial symptomatology, the rese;~rch team was organized to include the following talents for the constitution of the emer- gency n)(,dical t(?am: internal medicine, hematology, radiation technology and radiobiology. In 111(1s(,ltx.li[)n of 1)(,rsoun(>l th(, cn;phasis was pl;iced on past (?xpericn(,e In biomedical research l!] III(s fi{.ld with aI(jIIII(< WCIa~NJIIS. In addition, provisions were nlad~~ for a s(,rond echelon of sl)(,(,i:ill~,(,(l lwr~(mn(~l in (.as(, they wert! nc!eded. Accordingly, a prev(mtivt, m(,di(ln(, unit of ltl{, (T{)r])llltirlll(,r 111-clljt.1, l~a(,lfi(.