BNL46444 informal Report L-, / .— The Experiences of a Medical Team In the Care of a Marshallese Population Accidently Exposed to Fallout Radiation RobeflA. Conard . BNL 46444 Informal Report Fdloui_ The Experiences of a Medical Team In the Care of a Marshaliese Population Accidently Exposed to Fallout Radiation Robefl A. Conard h n I 1 September 1992 MEDICAL DEPARTMENT BROOK HAVEN NATIONAL LABORATORY ASSOCIATED UN IV ERSITIES, INC. UPTON, NEW YORK 11973 UNDERCONTRACTNO.DE-AC02-76Cl+0CO16WITH THE UNITED STATES DEPARTMENT OF ENERGY DISCIAIMER Thie report wu Prepared ae ●n ●ccount of work sponsored by an agency of the United Stetee Government Neither theUnitedSWteeGovernmentnorany ●gency thereof. nor any of their empioyeee. nor any of thmr cottuacIom. sub$ontmctors. or their ●mployees. mskee UIY wamentY. expr- or implied.or=--- ●nylegalliability or reeponeibility for the ●ccur8cY. completer-a. or useftdrte- of ●ny infonrmtton. ●pparatua, producL or [email protected] representsthat ita ruewould not infringe privately owned nghte.ibference herein to enY spectfic commemal product. proms. or eenme bytrade name. trademark. manufacturer. or othennce. doee not rtececsaniy conotmtte or Impiy NJwtdoreement.r-mmcndation. or favoring by theUnitedStatea Government or sny ●gency. contractor or subcont-fior thereof. The views and optniorm of ●uthore ●xpmeed herein do notneceuwtiyeta- orreflectthoseofthe United Stetu Government or ●ty ●gency. cortuector or ●hcontiaor thereof. Printedin the Unitd States ofAmerica Avaiiablefrom .NationaiTechnicaiInformationServrce U.S.DepartmentofCommem 52S5 Port RoyalRoad Springfield.VA22161 NTISprim codes: Printed Copy: A04: Microfiche Copy AOI Location of Marshall Islands. Iv Chapter VII. The lbdioio~cal Surveys for Dedication . v Res]dual Radiation . 29 Foreword . vi A. The Surveys . 29 B. Findings . 31 Acknowledgments. ~ii Chapter VIII. The DiapiacedBikinians . 33 Chapter L Background . 1 Chapter IX. Probiems in the M&math of Chapter H. The Brauo Accident . 4 the Accident, . 36 A. Eariy Events . ... , 4 A. Backgroun d . 36 B. The Lucky Dragon Episode . 5 B. probiema AfTectingthe Program . 3a C. Evacuationofthe Marahalleae . 5 Chapter X The Marehalleae Experience l. Rongeiap. 5 Related ta Other Radiation Accidents . 44 2. Utink . 6 Chaptur XI. Closing Remarks. , 46 D. AtomIcEnergy Commiaaion (AEC), References A Selected TechnicalReports, 46 Washington . 6 B. Other References . , 51 E. NavalStation, Kwajalein . 7 Appendix L Marahall Iaiand Survey F. Initmi MedicalExanxmatione. Partxipanta 1954-1990. 54 l. Facditiea. .,, : AppancUXKL ChmmoiogicaiListing of Petiinent Events in the Marshall Isianda 63 2..Medicai Findings . 7 G. DoseEstimatea. 9 Chapter III. Return to Rongeiap. 11 Chapter IV. Health Care in the Marshall Islands . 13 Chapter V. The Continuing Medical Sumeya 15 A. NeedforContinuing Medical Surveys - AEC$fandau for the Examinations . 15 B. Lim.kstionand Expansion of the Program . 15 Chapter VI. The Medical Examinations . la A. Orgszuzation . 18 1.Supporting Agencies . 18 2. Wdical Parncipazite in the Surveya 18 3. Supplies and Equipment , . 18 4. Examination Facilities . 18 5. Transportation . 19 B. ScopeofExaminationa. 20 C. ProblemsMeociated with the Exsmmationa . 21 D. BnefSurnma~ ofMedical Findings . 22 E. Human Interest Relations . 24 1. In The191anda . 24 F. The MarshalleaePatienta in the United states . 25 G. Fanuiies Most AiTectedby Fallout . 27 ... 111 . -.-.. —--- - .-- —- - . --uzp, ~ F. Village d Utirik AtQIL iv . Dedication This report is dedicated to John Anjain, who was the Marshallese .Mayor of Rongelap Village at the time of the fallout in 1954. John is a qui- et, unassuming man, well liked. and a respected leader of the Rongelap people. His family suf- fered extremely from the effects of the fallout. He and four members. of his family underwent surgery for removal of thyroid tumors. The tumor in his wife was malignant. His youngest son, who was one year of age at the time of the fallout, had a thyroid tumor removed at age 12 and later developed an acute fomn of leukemia when he was 19 years old. Although extensively treated in the United States, he died. His death was a cause of great grief to his family and to the Marshallese people. In spite of all these troubles, including evacu- ation from their home island and socioeconomic disruption, I have never heard John express bit- terness. However, he has continued to champion the cause of his people. I am grateful that he has always appreciated and supported the efforts of our medical team to heip his peopie. He has remained a true friend over the years John Aa,jain (Left), Mayor of Rongelap in 1964 and I treasure his friendship. studing beside the oldest wommn on the island (over lW yearn old?). v Foreword More than thirty-six years have passed since our attempts to cope with some of the problems the Marshallese people of Rongelap and Utirik that developed. The medical findings will be were accidentally exposed to radioactive fallout referred to only briefly because they have been following the detonation by the United States of published elsewhere in great detail. (Section A, a powerful thermonuclear device called “Bravo” References. ) at Bikini, .March 1, 1954. The repercussions of I first went to the Marshall Islands during this accident have been widespread. This was World War H as a naval medical officer. The the first time that a human population had been Solomon Islands campaign had just been com- seriously exposed to radioactive fallout and the pleted and we were on our way to the Marianas carefully documented findings have formed an Islands for landings at Saipan, Guam, and important basis for action in other types of acci- Tinian. My first sight of Kwajalein and dents involving radioactive fallout, the most Enewetak revealed the smoldering ruins from notable being the recent reactor accident at the invasion. Little did I realize that I would Chernobyl in Russia. return to these islands for many years. As a Medical teams from Brookhaven National navai radiological safety officer, I returned to Laboratory, sponsored by the Department of participate in Operation Crossroads at Bikini, Energy LDOE), formerly the Atomic Energy and later, in Operation Greenhouse at Commission (AEC), have visited the Marshall Einewetok. However, my real interest was in Isiands regularly since 1954 to examine and the biomedical effects of radiation. I took a contribute to the medical care of the course in radiation physics at the University of Marshallese. The medicai findings have been California, followed by a year’s training in published in numerous Brookhaven National radiobioiogical research at Argonne National Laboratory reports and in medical journals (see Laboratory. Later, I continued this research at References, Section A).* I headed the medical the Naval Medical Research Institute and, still teams from 1956-1979. In carrying out these later, at Brookhaven.National Laboratory when examinations, the medical teams were faced my tour of duty with the Navy ended in 1955. I with many problems and dilemmas, some of participated in the initial examinations of the which were unforeseen and unique to a medical .Marshallese in 1954, and from 1956 until my group. Some of the problems were related to cui- retirement in 1979, I was responsible for orga- tural differences, and to the lack of understand- nizing the continuing medical surveys. For a ing by the Marshallese of radiation and its short period after my retirement, Hugh S. Pratt effects, resulting in unfounded fears and psy - and Eugene P. Cron”kite headed the program. choio~cal effects. Other problems were related Since that time, the program has been ably han- to displacement of the people, socioeconomic dled by William H. Adams and I have drawn on disruption, and increasing resentment against his reports for findings since my retirement. the United States with poiiticai involvement and demands for compensation. Nevertheless, the medical teams and the Marshallese people developed a strong feeling of mutual respect and friendship in spite of these problems, and the people have expressed their gratitude for the benefits rendered them. In this report an attempt is made to review, in an informal, nar- rative style, some of the highlights of events that occurred, the human interest aspects, and me reference are dividedintotwoeectiom:A Sekcted Technxal&xxu andB.OtherReferences,includingcomeof thenumerousmesemedia eItldIP9. Acknowledgments I In wrlt~ng this report I am grateful for the Edward Lessard, Peter Rathvon, Charles help of several people at Brookhaven Nationai Meinhold. and David Potter. From other insti- Laboratory. Eugene P. Cronkite and Victor P. tutions: J. Edward Rail, Jacob Robbins, Jan Bond, who have been closely invoived with the Wolff, Baruch Blumberg, and Roger Rittmaster project since its inception, have encouraged me at the National. Institutes of Health; Brown in writing the report and given helpful advice. Dobyris and David Reid at Cleveland William A. Scott and Peter M. Heotis, who have .Metropolitan General Hospital; Wataru Sutow worked with me in organizing and carrying out and Ernest Libby at M.D. Anderson Hospital; the examinations, have been of great assis- Edward Held of the University of Washington; tance. I am grateful to Avril Woodhead and Shields Warren, Bentley Colcock, William Katherine Vivirito for editorial assistance, Meissner, and Marion Legg at New Engiand Robert Crease, BNL Historian, for his heip, and Deaconess Hospital; Leo Meyer, Veterans Bernice