Report to the Scientific Director 

OPERATION CASTLE - ADDENDUM REPORT PROJECT 4.1A 

MEDICAL EXAMINATION OF RONGELAP PEOPLE 

SIX’ MONTHS AFTER EXPOSURE TO FALLOUT 

V. P. Bond 

R. A. Conard 

J. S. Robertson 

E. A. Weden, Jr. 

April 1955 

Naval Medical Research Institute 

Bethesda, Maryland 

and 

U.S. Naval Radiological Defense Laboratory 

San Francisco. California 

l-2 

ABSTRACT 

Follow-up medical examinations were made of the Marshallese inhabitants of Rongelap 

Atoll 6 months after they had been exposed to atomic bomb fallout radiation during the Operation CASTLE test series in March, 1954. During the early acute period following exposure, 

these people had shown systemic effects and marked hematological changes resulting from 

penetrating gamma radiation; extensive superficial skin lesions and epilation associated principally with beta and soft gamma radiation from fallout material deposited on uncovered skin 

areas; and minimal internal contamination with fission products, resulting principally from 

ingestion of fallout material. At the time of the 6-month resurvey the individuals, in general, 

appeared healthy and normally active, and no deaths had occurred in the interim period. Three 

babies had been born since exposure, none of whom displayed detectable abnormalities. One 

miscarriage at 3 months occurred during the interim period. No specimen was available for 

study. The skin lesions previously prominent had healed completely, and only occasional hyperpigmentation of depigmented scars was seen in a few individuals who had severe early skin 

damage. Regrowth of hair had commenced during the third month following exposure and was 

essentially complete at the g-month examination. Residual of the fingernail discoloration previously noted was found in three individuals. No additional findings on physical examination 

could be ascribed to radiation exposure, and most had gained weight during the interim period. 

A measles epidemic was in progress during the examinations. The severity of the disease in 

the Rongelap people was no greater than in a control unexposed population, and the incidence 

was no higher. Chest X-rays of all individuals revealed no abnormalities ascribable to the 

fallout radiation. Analysis of hematological data obtained failed to demonstrate a significant 

effect of measles on the peripheral blood count. Neutrophile, lymphocyte, and platelet counts 

were not significantly different from counts taken on the 74th post-exposure day, and none of 

these values had returned to control levels. Studies of bone marrow specimens obtained on 20 

adult individuals revealed no significant abnormalities. Minimal amounts of residual radioactivity were detectable in the urine of approximately one-third of the exposed individuals. 

3-4 
. c 

, . 
ACKNOWLEDGMENTS 

The authors are indebted to a number of individuals at a number of administrative levels 

for their extensive aid and willing cooperation, so necessary for the success of a field mission 

of this type. Drs. John Bugher and Charles Dunham of the Division of Biology and Medicine, 

Atomic Energy Commission, coordinated and expedited all necessary arrangements among the 

State Department, the Department of the Interior, the Navy Department, and the Trust Territories. The Chief of Naval Operations arranged all necessary transportation. Commander 

Harry Etter of the Bureau of Medicine and Surgery was instrumental in completing arrangements so that the resurvey team could proceed on schedule. CAPT R. A. Hinners, Director, 

U.S. Naval Radiological Defense Laboratory (NRDL), and CAPT W. E. Kellum, Commanding 

Officer, Naval Medical Research Institute (NMRI), placed all necessary facilities of the two 

laboratories involved at the disposal of the medical team, as did CAPT A. R. Behnke, Radiological Medical Director, NRDL; CAPT T. L. Willmon, Executive Gfficer, NMRI; and Drs. P. C. 

Tompkins and E. P. Cooper, Scientific and Associate Scientific Director, respectively, of the 

NRDL. The authors are particularly indebted to CDR. E. P. Cronkite, NMRI, in charge of the 

original observations on the exposed people, for his extensive efforts in organizing the resurvey and for his support throughout all phases of the endeavor. 

Maynard Neas, District Administrator, and Dr. Dunham Kirkham, Medical Officer at the 

Trust Territory Headquarters, Majuro, Marshall Islands, furnished all necessary facilities at 

Majuro, and the entire resurvey team is grateful for the cooperation and hospitality extended 

by all Trust Territory representatives. The efforts of LCDR L. J. Smith, advance administrative representative for the resurvey team, materially expedited the accomplishment of the 

work. The authors are indebted to all members of the team for their cooperation and extensive 

efforts, particularly to Chief P. K. Schork, and to H. H. Hechter for performing the necessary 

analyses of data. 

The authors are indebted for histopathological consultation provided by Dr. David Wood of 

the University of California Medical School and by Dr. E. A. Alpen of the NRDL. Also, to Drs. 

E. P. Cronkite, N. L. Petrakis, and R. K. Reed for aiding in the interpretation of marrow findings and to Dr. N. L. Petrakis for performing the differential counts. 

5-6 

c 
. * . 
CONTENTS 

ABSTRACT 

Page . . . . . . . . . . 3 

ACKNOWLEDGMENTS . . . . . . . . . 5 

ILLUSTRATIONS . . . . . . . . . . 8 

TABLES . . . . . . . . . . . . 8 

CHAPTER 1 INTRODUCTION . . . . . . . . 9 

1.1 Objectives . . . . . . . . . . 9 

1.2 Background . . . . . . . . . . 9 

1.3 General Methods; Control Population . . . . 10 

CHAPTER 2 CLINICAL EXAMINATION , . . . . . 11 

2.1 Previous Findings . . . . . . . . 11 

2.2 Procedures . . . . . . . . 11 

2.3 Clinical Findings . . . . . . . . 11 

CHAPTER 3 SEIN LESIONS, EPILATION, AND NAIL PIGMENTATION 14 

3.1 Previous Findings ...... . . . . 14 

3.2 Procedures ........ . . . 15 

3.3 Present Findings ...... . . . 15 

CHAPTER4 HEMATOLOGY ...... . . . 25 

4.1 Previous Findings ...... . . . . 25 

4.2 Methods ........ . . . 25 

4.3 Present Findings ...... . . . . 25 

CHAPTER 5 INTERNAL RADIOACTIVE CONTAMINATION . . . . 35 

5.1 Previous Findings ...... . . . 35 

5.2 Methods ........ . . . . 35 

5.3 Results ........ . . . . 35 
CONTENTS (Continued) 

Page 

CHAPTER 6 DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS . . . 36 

6.1 Discussion . . . . . . . . . . . . . 36 

6.2 Conclusions . . . . . . . . . . . . 37 

6.3 Recommendations . . . . . . . . . . . 37 

APPENDIX A EXPOSED POPULATION: COMPARISON WITH INITIAL FINDINGS 

OF INDIVIDUAL WEIGHTS AND HEMATOLOGICAL VALUES . . 38 

APPENDIX B CONTROL POPULATION: INDIVIDUAL WEIGHTS AND HEMATOLOGICAL VALUES . . . . . . . . . . 40 

ILLUSTRATIONS 

CHAPTER 3 SKIN LESIONS, EPILATION, AND NAIL PIGMENTATION 

Color plates 1 to 12 . . . . . . . . . . . 17 

CHAPTER 4 HEMATOLOGY 

4.1 Serial Post-exposure Changes in the Mean Total Leukocyte, 

Neutrophile, and Lymphocyte Counts for the Rongelap Group . . 28 

4.2 Serial Post-exposure Changes in the Mean Platelet Counts 

for the Rongelap Group. . . . . . , . . . 29 

4.3 Cumulative Neutrophile Counts for the Rongelap Group at the 

Time of Maximum Depression and 6 Months After Exposure . . 30 

4.4 Cumulative Platelet Counts for the Rongelap Group at the 

Time of Maximum Depression and 6 Months After Exposure . . 31 

TABLES 

CHAPTER 2 CLINICAL EXAMINATION 

2.1 Positive Findings on Physical Examination of the Exposed and 

Control Populations . . . . . . . . . . 12 

CHAPTER 4 HEMATOLOGY 

4.1 Hematological Data for Control Populations by Age and by Sex . . 26 

4.2 Mean Values for Peripheral Blood Determinations on the Rongelap 

Group 185 Days Post-exposure . . . . . . . . 27 

4.3 Mean Values for Peripheral Blood Determinations on the Ailinginae 

Group 185 Days Post-exposure . . . . . . . . 27 

4.4 Mean Blood Counts for the Exposed and Control Populations, with and 

without Measles . . . . . . . . . . , 32 

4.5 Bone Marrow Differential Counts on Exposed and Control Marshallese 33 
CHAPTER 1 

INTRODUCTION 

1.1 OBJECTIVES 

The present medical resurvey was organized as the first of a contemplated series designed to provide long-term medical examinations of the Marshallese people exposed to radiation from fallout during Operation CASTLE. 

1.2 BACKGROUND 

Following the detonation of a thermonuclear device on Bikini Atoll on 1 March, 1954, 28 

Americans on Rongerik Atoll and 239 Marshallese (64 on Rongelap, 18 on Ailinginae, and 15’7 

on Utirik) were exposed to significant amounts of radiation from fallout. These individuals 

were evacuated to Kwajalein, where they were cared for during the acute period following exposure by a special medical team composed of individuals from the Naval Medical Research 

Institute (NMRI) in Bethesda and in the U.S. Naval Radiological Defense Laboratory (NRDL) in 

San Francisco. A report of medical findings has been issued as an Operation CASTLE report.’ 

The present report is concerned with the medical status 6 months later of the Marshallese 

people who received the highest estimated dose of gamma radiation, the Rongelap and Ailinginae 

groups. * 

The Rongelap group was exposed to an estimated 175 r of gamma radiation, calculated 

from dose rates measured free in air, over a period of approximately 46 hr. The Ailinginae 

group received an estimated 69 r of gamma radiation over approximately 54 hr. Both groups 

received additional beta radiation to exposed skin areas. All findings were more severe in the 

Rongelap than in the Ailinginae group. These findings are reviewed later in the report. 

Because of the continuing hazard from radiation on their home atolls, the Rongelap and 

Ailinginae people were not returned to their homes after observation at Kwajalein. Instead, 

they were moved to Majuro Atoll, the Trust Territory Headquarters for the Marshall Islands. 

Housing was furnished them on Ijij Island (pronounced “edgit”), 10 minutes by boat from the 

Trust Territory Headquarters, where they were residing at the time of the present examinations. 

*The Utirik people, who received comparatively slight exposure, were returned to their 

home atoll following observation at Kwajalein and were not examined during the present resurvey. The exposed Americans had been returned to their duty stations in the United States. 
1.3 GENERAL METHODS; CONTROL POPULATION 

The facilities of the Marshall Island Memorial Hospital in the Trust Territory Headquarters were made available for the clinical and laboratory examinations. The resurvey included the establishment of a control group of unexposed Marshallese, in addition to obtaining 

interval histories, complete physical examinations, hematological studies, and radioactivity 

excretion studies on all the exposed individuals. Similar examinations were conducted on this 

control group for immediate comparison of findings and to serve as a base line for comparing 

growth and other future changes in the two groups. 

The control patients were obtained principally from among the residents of the village of 

Rita, located about 2 miles from the hospital. This population was chosen on the basis of its 

similarity with respect to the living conditions of the exposed people, its relative permanence, 

and its accessibility to the Memorial Hospital. The individuals were selected on the basis of 

age and sex to be paired with the members of the exposed group. Thus, each individual of the 

exposed group was assigned a control individual of the same sex and approximately the same 

age. The age distribution of the exposed and control populations is given with the hematological 

results in Chap. 4. The age distribution of the exposed and control groups was the same, except that suitable controls were not found for two women of reported ages 60 and 100, nor were 

controls established for the three babies born to members of the exposed group since March, 

1954. Numbers were assigned to the controls by adding 1000 to the number of the corresponding member of the exposed group. For example, Labnir, number 1011, was the control for 

Antak, number 11. 

REFERENCE 

1. E. P. Cronkite et al., Study of Response of Human Beings Accidentally Exposed to Significant 

Fallout Radiation, Operation Castle final report of Project 4.1. 

10 
CHAPTER 2 

CLINICAL EXAMINATION 

2.1 PREVIOUS FINDINGS 

Within hours of exposure to radiation, approximately two-thirds of the Rongelap people 

felt nauseated and one-tenth of the group had vomiting and diarrhea. One Ailinginae individual 

reported nausea. Itching and burning of the skin and eyes during this period occurred in over 

one-quarter of the Rongelap residents and in a smaller number of the Ailinginae population. 

With the exception of skin lesions and epilation reported in Chap. 3, there were no further 

*symptoms nor findings on physical examination that could be attributed with certainty to radiation exposure. All individuals were normally active throughout the period of observation. The 

various clinical conditions encountered in the highest exposed Rongelap and Ailinginae groups 

were not remarkably different in type or extent from those seen in the least exposed Utirik 

group. Although a number of individuals were markedly neutropenic, no infections attributable 

to neutropenia@r se were observed. No external evidence of hemorrhage was observed, although platelet counts in 20 per cent of the Rongelap group fell to 90,000/mma or lower at the 

time of maximum depression. Antibiotics were used in a few individuals where indicated for 

incidental infections. However, no prophylactic or therapeutic drugs were necessary or given 

because of whole-body radiation exposure alone. 

2.2 PROCEDURES 

The following procedures were carried out routinely on both exposed and control groups: 

(1) brief past history,* (2) complete interval history, (3) skin examination (including biopsies 

and photographs in selected cases), (4) complete physical examination (including ophthalmoscopic, rectal, and pelvic examinations), (5) chest X-ray, and (6) hematological studies (including bone marrow aspirations in selected cases). Serology was done on some of the exposed 

individuals. Special measurements were taken on children to provide a base line for future 

growth and development studies. 

2.3 CLINICAL FINDINGS 

Past histories revealed little of note, with the exception of a high incidence of yaws (exposed group, 23; control group, 17) and gonorrhea (exposed group, 21; control group, 19). One 

* Interval and past histories were taken by Dr. John Iaman, a Gilbertese physician who 

spoke excellent English as well as Marshallese. English-speaking Marshallese nurses aided 

in the physical examinations. 

11 
control patient gave a history of syphilis for which she had been treated twice. Interval histories were essentially negative. No deaths had occurred in the exposed population, and three 

apparently healthy infants had been born in the interim period. Their in utero ages at the time 

of exposure were approximately 3, 6, and 7 months. Three other pregnancies were noted during 

the present examinations, in one of which conception had occurred at about the time of exposure and in the remaining two, 2 to 4 months after exposure. 

TABLE 2.1-Positive Findings on Physical Examination 

of Exposed and Control Populations 

No. of No. of Btta 

exposed cant rol 

Diagnosis group group 

Cardiovascular system: 

Generalized arteriosclerosis 

with heart disease 

Hypertension 

with heart disease 

Luetic heart disease (7) 

Heart disease, etiology unknown 

Arthritis: 

Hypertrophic 

Rheumatic 

Parkinsonism 

Diabetes mellitus 

Gynecological system: , Pregnancy 3 1 

Ftbromyoma of uterus (?) 0 1 

Cervical erosion 1 7 

Cervical cyst 0 2 . Cervical polyp 0 1 

Urethral curuncle 2 0 

Furuncle of labium 1 0 

Syphilis (cltnical diagnosis), activity (7) 0 1 

Tuberculosis, pulmonary, arrested 0 1 

Leprosy, arrested (7) 1 0 

bm=tigo 6 1 

Bronchitis 0 1 

Gtitis externa 1 0 

Gtitis media 0 1 

Pyorrhea 7 2 

Blindness, traumatic 0 1 

Hernia, ingufnal, direct 0 1 

Table 2.1 summarizes the principal findings from history and physical examinations, and 

additional data on individuals are given in Appendices A and B. Dermatological findings are 

reported in detail in Chap. 3. There appeared to be no significant difference in disease incidence between exposed and control populations, and no findings, with the exception of those reported in Chap. 3, could be ascribed to radiation effects. A measles epidemic, in progress in 

both populations during the examinations, had begun to decline in the control group but was ‘;_ 

still at its peak in the exposed group at the completion of this study. The time interval between 

the peak incidence of measles in the two populations was probably due to the relative isolation 

of the exposed group. 

Body weights of the exposed patients were compared with their weights in March, 1954. 

Although there were a few instances of significant weight loss in individuals, the over-all popu12 
lation showed an increase. This was probably because of relative inactivity in addition to having 

ample supplies of food. Weight changes are shown in Appendices A and B. The special measurements taken on children age 19 or less showed no significant abnormalities. 

Chest X-ray examinations revealed only long-standing changes ascribable to previous 

disease.* Estimates of bone age from wrist X-rays’ were in keeping with the stated age. Xrays of long bones showed no abnormalities ascribable to radiation effects. Of 40 Kahn tests 

given to exposed individuals, three were 3+. Two of these gave a history of, or had physical 

findings consistent with, late syphilis. Previous yaws per se did not result in a positive Kahn 

test. 

REFERENCE 

1. John Caffey, Pediatric X-ray Diagnosis, Year Book Publishers, 1950. 

*The authors are indebted to CDR C. D. Burroughs for interpreting the X-ray films. 

13 
CHAPTER 3 

SKIN LESIONS, EPILATION, AND NAIL PIGMENTATION 

3.1 PREVIOUS FINDINGS 

The Rongelap and Ailinginae groups observed the fallout as a powdery material that fell 

for several hours and clung to their skin and hair. 

Thorough decontamination was not accomplished until evacuation occurred one to two days 

later. The dosage to the skin, resulting from soft beta and soft gamma radiation, could not be 

calculated due to the complex make-up of the fallout material. Initial symptomatology related 

to the skin consisted of burning and itching in a large number of people, and irritation of the 

eyes with lacrimation in a small number, the first two days after exposure. The early symptoms were followed by pronounced lesions of the skin and epilation of the head, which first 

appeared about the 12th to the 14th day post-exposure in the Rongelap group and after the 20th 

day in the less-exposed Ailinginae group; the lesions occurred primarily on the exposed parts 

of the body which were not protected by clothing. Those persons who remained under shelter 

in their homes developed less severe lesions or no lesions. Also, there was some protection 

to those who bathed or remained in their homes during the fallout. 

The development of the skin lesions did not conform in all respects to beta skin lesions 

described in the literature. No primary or secondary erythema was observed; however, the 

dark skins of these people may have obscured this phenomenon. The lesions showed differences 

in the latent period and appeared on different parts of the body in roughly the following sequential order: scalp, neck, axillary region, antecubital fossae, feet, arms, legs, and trunk. Epilation and scalp and neck lesions were observed in 60 to 70 per cent of the Rongelap group, and 

foot lesions were also common. 

The first indication of a developing skin lesion was the appearance of pigmented macules, 

papules, and raised plaques. Usually, these dark pigmented lesions had a dry, thickened, leathery feel. However, some areas developed only simple hyperpigmentation of the skin over extended areas. The majority of lesions were superficial without vesicle formation, which, after 

several days, showed dry, scaly desquamation of the pigmented skin from the center of the 

lesion outward. Desquamation left depigmented pink-to-white epithelium not remarkedly different in texture from the surrounding skin. During the next few weeks the lesions gradually 

became repigmented, resulting in a relatively normal appearance. 

Approximately 20 per cent of the Rongelap people developed lesions of a deeper nature, 

which occurred primarily on the feet, to some extent on the neck and scalp, and, in one case, 

on the ear. These lesions also began with hyperpigmentation, followed in a few days by wet 

desquamation with weeping and crusting ulcer formation. In some of the foot lesions bullae 

formation occurred, followed by a breaking of the bullae with ulceration. Many of the lesions 

were accompanied by symptoms of pruritus and a burning sensation, and some of the deeper 

lesions were painful during the acute stage. The application of bland antipruritic lotions and 

14 
ointments was the only treatment necessary, except in a few lesions which became secondarily 

infected and which were treated with antibiotic ointments. 

Essentially, all lesions healed rapidly and re-epithelialized in a week or 10 days. Repigmentation gradually took place in most of the lesions, and in some, notably on the neck, hyper- , 

pigmentation of a grayish, dusky color developed with thickening, resulting in an “orangepeel” appearance. The deeper foot lesions, however, did not show repigmentation. 

An unexpected finding in nearly all the Rongelap and Ailinginae people was the development 

of a bluish-brown semicircular band of pigmentation of the fingernails and toenails which was 

first noted about the 23rd day. The pigmentation band started in the semilunar area and progressed distally with growth of the nail. Since all the American Negroes but none of the white 

Americans exposed developed this pigmentation, it appeared that this phenomenon was characteristic of dark skinned races. It also was probably due to whole-body irradiation and not local 

skin irradiation, since some individuals without skin lesions developed the pigmentation and 

vice versa. 

Biopsies taken from active lesions showed spotty transepidermal damage with atrophy and 

flattening of the retepegs. Areas of relatively normal skin intervened, emphasizing the particulate nature of the radioactive material. Cells of the malpighian layer showed pleomorphic nuclei, pyknosis, and cytoplasmic halos. Focal disorganization of the malpighian and basal layers 

was present in extensively damaged areas. In the dermis, telangiectatic vessels were noted in 

areas where the overlying epidermis showed greatest damage, and there was considerable 

lymphocytic infiltration surrounding these telangiectatic spaces. An outstanding feature of the 

early histological changes was the pronounced damage to the epithelium, with relatively minimal damage in the dermis. 

Biopsies taken at six weeks post-exposure showed, in general, that the epidermis had made 

a definite recovery, except for a few persistent areas of atrophy and finger-like downgrowths 

of stratum malpighii, with cells showing rather prominent pigment content. There were many 

outward epidermal excrescences covered by thickened stratum corneum. The dermis showed 

less cellular infiltration of the papillary layer but still some slight degree of telangiectasis of 

the capillaries. 

3.2 PROCEDURES 

In addition to an examination of the skin and its appendages of the exposed people, 80 control Marshallese living on Majuro Atoll were also examined. Color pictures were taken of the 

skin where indicated, and attempts were made to take pictures of lesions magnified 20 times. 

Biopsies were taken at the site of former lesions in 12 exposed individuals. Most were repeat 

biopsies from individuals who had been studied in this manner during the initial examinations. 

Several skin biopsies from control individuals were also taken. 

3.3 PRESENT FINDINGS 

Healing of all the early superficial lesions was essentially complete. The skin had repigmented to normal color, appeared to be of normal texture, and gave no remaining gross evidence of previous injury. Plates 1, 2, 8, and 9 show the early lesions as compared with their 

appearance at 6 months. Those lesions which had been deeper, and particularly those which 

showed evidence of transepidermal injury, continued to show slight evidence of previous damage, largely in the form of pigment alterations. Most of the neck lesions, which at 10 to 11 

weeks after exposure had shown the thickened skin with grayish, dusky pigmentation, showed 

much less thickening and less marked pigmentation at 6 months. It was observed that the skin 

of the necks of many of the control population, particularly of the women, showed slightly increased pigmentation. Hence it was frequently difficult to determine whether there was remaining hyperpigmentation in this area or whether the degree of pigmentation was in the normal 

range. There were, however, 10 cases out of an original 16 in which the amount of pigmenta15 
i 

tion of the neck appeared to be definitely increased at the site of previous lesions. However, 

little thickening, if any, was apparent and the skin appeared otherwise normal. It is noteworthy 

that none of the neck lesions showed depigmentation. Small areas of hyperpigmentation 

persisted also at the site of two axillary, four antecubital fossae, one arm, and one back lesion. 

In contrast to the neck and other lesions mentioned, the deepest foot lesions showed no 

hyperpigmentation but, on the contrary, persisting depigmentation. Plates 3 and 4 show deeper 

foot lesions early and at 6 months post-exposure. The skin texture in these depigmented lesions appeared essentially normal on a gross scale. However, pictures magnified 20 times 

showed that there was scattered, blotchy, faded pigmentation with some slight atrophy (flattening of skin ridges). Depigmented foot lesions were observed in six cases. One antecubital 

fossae lesion also showed a small area of depigmentation. 

The persistent lesion of the ear, noted in the initial examination, had gradually healed with 

considerable scarring and atrophy and some scaling of the epidermis. Plates 5, 6, and 7 show 

this lesion early and at 6 months post-exposure. Telangiectatic vessels can also be seen in 

Plate 7 (magnified 20 times). 

In every case, there appeared to be a complete regrowth of hair, with normal color, texture, and distribution. Plates 5, 6, 8, and 9 show epilation and regrowth of hair. 

The bluish-brown pigmentation of the nails, noted in most of the Marshallese in the initial 

examinations, had disappeared, apparently with growth of the nails, in all but three cases. The 

pigment in these individuals remained at the distal end of the nail (Plate 10). It was evident in 

these cases that the pigment was not in the nail plate but between it and the nail bed, closely 

adherent to the underside of the nail. 

Biopsies showed some residual damage to the epidermis, as well as to the dermis. In the 

epidermis the following changes were present: (1) focal atrophy of the stratum granulosum; 

(2) slight focal pigmentary disturbances in cells of the basal layers; (3) slight-to-moderate 

hyperheratinization; and (4) in some cases persistent, but minimum cellular, changes as manifested by the presence of paranuclear cytoplasmic halos and slight disturbances in polarity of 

epithelial cells in the basal capillary projections. In the dermis a slight-to-moderate degree 

of telangiectasis was evident. Some of these changes are shown in Plates 11 and 12. 

NOTE 

Color plates (Plates 1 through 12) numbered with 

letters a, b, c, and d are considered to be pages 

17 through 24. 

16 




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. ‘ 

. . 

CHAPTER 4 

HEMATOLOGY 

4.1 PREVIOUS FINDINGS 

Hematological determinations employed in the initial post-exposure period included total 

leukocyte, neutrophile, lymphocyte, and platelet counts and hematocrit determinations. Whenever possible, an entire exposure group was studied in a single day. In order to estimate the 

severity of the hematological response, findings were comparable to a phase of a control group 

similar, where possible, with respect to race, age, sex, background, and habits. 

Depression of the total white, neutrophile, lymphocyte, and platelet counts was marked in 

the Rongelap group and less severe in the Ailinginae group. The total white count was consistently lowest during the sixth and seventh post-exposure weeks, followed by an upward trend 

with levels remaining below that of the control population at the end of the observation period. 

The drop in lymphocytes was early and profound, with little or no evidence of recovery during 

the period of observation. Fluctuations in the total white count were due to changes in the neutrophile-count. Neutrophile counts in 10 per cent of the Rongelap group fell to below 1000 

cells/mm” at the time of maximum depression. Platelet counts showed less fluctuation than 

did the total white and neutrophile counts and reached lowest values on the 30th post-irradiation 

day. At this time, counts in 20 per cent of the Rongelap group were below 90,000/mms. A 

secondary fall in platelets, with greatest depression on the 55th day, was observed, and recovery to control levels was not complete at 6 months. 

4.2 METHODS 

Determinations made on peripheral blood included total white, neutrophile, lymphocyte, 

and platelet counts, as well as hematocrit determinations. Techniques employed were identical 

with those used during the initial observation period.’ Two determinations were made on each 

individual approximately one week apart (date of all counts taken as the 185th post-irradiation 

day). In addition to peripheral blood, bone marrow from the anterior or posterior iliac crest 

was obtained on 21 exposed and 20 control individuals. Approximately 1 ml was aspirated, and 

cover slip preparations were made from the small particles of marrow thus obtained. Differential counts were taken on these preparations. Part of the marrow was allowed to clot on a 

glass slide and was then fixed in formalin-sublimate solution for later examination of histological structure and degree of cellularity. 

4.3 PRESENT FINDINGS 

Peripheral blood count data for the exposed and control populations are given in Tables 

4.1 to 4.3, Figs. 4.1 to 4.4, and in Appendices A and B. To obtain valid comparisons within 

25 
TABLE 4.1-Hematological Datafor Cantrol Populationsby Age andby Sex 

No. of 

individuals WBC XlOS 

Neutropblle 

x10' 

~phocyte 

x 10' 

Platelet 

x 10' Bematocrit.% 

Age 

Majuro 

M F 

Rlta 

M F 

wuro 

M F 

Rtta 

M F 

MajlUO 

M F 

Rita 

Lb F 

Ma)ur\, 

Y F 

Rtta 

M F 

hfajm 

M F M 

Rita 

F 

Majum 

M F 

luta 

M F 

z 

5 

6-10 

11-15 

ll-l20 

16-20 

21-30 

31-40 

41-50 

50 

10 

6 

1 

5 

17 

4 

3 

10 

14 9 

446 

3 2 

335 

10 5 

9 2 

12 8 

4 7 

7 

4 

7 

4 

2 

8 

13.9 

11.8 

10.8 

8.9 

7.9 

7.5 

9.1 

12.6 

9.6 

8.9 

10.6 

9.3 

9.4 

10.2 

12.2 8.8 

12.8 9.3 

9.6 9.3 

7.5 9.8 

14.4 12.9 

8.9 7.3 

8.1 9.3 

4.3 

5.5 

5.1 

4.3 

3.8 

4.5 

4.9 

4.8 

3.9 

4.6 

5.8 

4.7 

4.7 

5.1 

6.4 

6.6 

5.6 

4.3 

7.6 

4.6 

4.9 

4.0 

5.2 

5.2 

5.6 

7.9 

3.0 

4.6 

8.4 

5.1 

4.7 

3.8 

3.3 

3.6 

3.5 

6.6 

5.1 

3.8 

4.2 

4.1 

4.0 

4.2 

5.0 

4.3 

3.4 

3.3 

6.2 

3.7 

2.6 

4.3 

3.9 

3.4 

3.7 

4.4 

3.6 

3.9 

42.2 

39.7 

28.0 

27.6 

23.6 

25.0 

21.3 

30.2 

35.9 

38.7 

38.3 

43.3 

34.2 

39.2 

35.4 

32.2 

35.0 

35.0 

24.5 

37.0 

25.4 

26.5 

27.4 

25.3 

31.7 

36.2 

33.7 

32.6 

29.3 

30.0 

23.5 

27.6 

38.5 

41.2 

42.0 

48.4 

46.9 

47.2 

42.3 

43.7 

37.4 

39.2 

42.3 

38.7 

38.9 

41.2 

41.8 

41.7 

35.9 37.8 

38.5 37.7 

38.0 39.2 

42.3 38.2 

46.2 40.1 

466.0 42.5 

44.1 42.0 

40.6 41.0 

• • c . ••
TABLE 4.2-Mean Values for Peripheral Blood Determinations on 

the Rongelap Group 185 Days Post-exposure 

Determination 8ex Age, Lowest 185th Majuro 

years COUIh* daY control 

WBC <5 5.6 8.5 13.2 Combined (in thousands) >5 5.5 6.6 9.7 

Neutrophiles <5 2.3 4.6 4.8 Combined (in thousands) >5 2.4 4.2 4.8 

Lymphocytes <5 2.5 3.6 7.4 

(in thousands) >5 2.2 2.2 4.1 

<lo 136 244 412 Platelets Male 1>lO 126 203 258 (in thousands) Female All ages 114 232 365 

Monocytes <5 1.2 1.4 2.6 Combined (in thousands) >5 1.2 1.1 2.0 

Eosinophiles <5 0.9 2.5 9.5 Combined (in thousands) >5 0.7 1.6 4.7 

<15 36.3 38.0 39.6 Hematocrit , % Male 

1 >15 41.6 41.7 46.0 

Female All ages 36.8 38.2 39.9 

*Approximately post-exposure days 39 to 51 for WBC, neutrophiles, lymphocytes, monocytes, and 

eosinophiles; days 26 to 30 for platelets; and days 26 to 33 for hematocrit. 

TABLE 4.3-Mean Values for Peripheral Blood Determinations on 

the Ailinginae Group 185 Days Post-exposure 

Approx. 

Determination SSX Age, lowest 185th Majuro 

years counts* day control 

WBC <5 7.5 7.7 13.2 Combined (in thousands) >5 6.4 6.5 9.7 

Neutrophiles X5 3.2 4.8 4.8 

(in thousands) >5 3.8 3.9 4.8 

Lymphocytes <5 4.0 2.7 7.4 

(in thousands) >5 2.4 2.2 4.1 

<lO 198 252 412 

Platelets Male { >lO 133 142 258 

(in thousands) Female All ages 178 239 365 

Monocytes X5 2.2 1.1 2.0 Combined (in thousands) >5 1.9 1.4 2.0 

Eosinophlles <5 2.3 1.5 9.5 Combined (in thousands) >5 1.0 2.2 4.7 

Cl5 35.5 37.5 39.6 Hematocrit. % Male { >15 43.8 40.1 46.0 

Female All ages 36.8 37.3 39.9 

*Approximately post-exposure days 39 to 51 for WBC, neutrophtles, lymphocytes, monocytes. and 

eosinophfles; days 26 to 30 for platelets; and days 33 to 39 for hematocrit. 

27 
C I I 

HAJURO CONTROLS LEUKOCYTESj 

a-

?-

bS- I , UAJURO CONTROLS-NEUTROPHILES -

’ \ 

\ 

I’ \ I 1 I / YAJURO CONT*OLs- LtWrOCYlES - 4-

I z I 3- : 

: 

2-

DISPENSARY 

COUNTS 

; 

: 

PROJECT 

COUNTS 

4 I 

I, 

0 

! : 

69 IS 

1 

24 

I 

32 

I 

40 

1 

40 

I 

S6 

I 

I_ 

POST EXPOSURE DAY 

Fig. 4.1- Serial Post-exposure Changes in the Mean Total Leukocyte, Neutrophile, and Lymphocyte 

Counts for the Rongelap Group. 
3 

MAJURO CONTROLS. MALE <IO (16) 

MAJURO CONTROLS, FEMALE, ALL AGES 159) 

RONGELAP I I 

I 

I I Platelets 1 

&1,JUR0 ,,?TROLS, 

0 MALES,<10 III)’ 

A MALES.>10 (40) 

0 FEMALES, ALL AGES (33) 

POST EXPOSURE DAY 

Fig. 4.2- Serial Post-exposure Changes in the Mean Platelet Counts for the Rongelap Group. 

29 
••

I 

‘... 

b.)., ” 

% N

+

-J--Jo

I0 0 

IN33 L13d 3hllVlflWll3 

30 
. / b 

TIYE W PEAK DEPRESSION 

100 I90-

POST EXPOSURE DAY 185 MAJURO CONTROLS 

70 -

60. 

SO40 _ 

50 -

PLATELETS 

Cumulative -All ages 

20 

Fig. 4.4-Cumulative 

and 6 Months After 

Platelet 

Exposure. 

PLATELETS x 10~ 

Counts for the Rongelap Group 

45 49 

at the Time 

53 57 

of Maximum 

61 65 

Depression 

69 
and among the exposure groups, the groups were subdivided as to age and sex as was done in 

the initial report.’ Control data for both the Rita group and for the Majuro control group obtained during the initial period of observation are shown in Table 4.1. The Rita control values 

did not differ appreciably from the Majuro levels and were used for some comparisons with 

the exposed population. However, because of the possible effect of the measles epidemic, the 

values for the two control groups were not combined. Instead, the Majuro control values alone 

were taken as the “normal” for the population in most considerations throughout the report. 

From the control data given in Table 4.1, it is seen that the total white and neutrophile 

counts were independent of age and sex, that the lymphocyte count was dependent on age but not . on sex, and that the platelet count and hematocrit were dependent on both age and sex. The 

values given in Tables 4.2 and 4.3 are presented ln accordance with this dependency to allow 

valid comparisons. In addition, the total white, neutrophile, monocyte, and eoslnophile counts 

are presented for ages less than, and greater than, five to allow a comparison of response in 

children and adults. 

TABLE 4.4-Mean Blood Counts for the Exposed and Control Populations, with and without Measles 

Rongelap Control 

Determination With Without With Without 

measles measles measles measles 

WBC (in thousands) 6.7 7.3 10.7 9.1 

Neutrophiles (in thousands) 4.1 4.5 5.6 5.0 

Lymphocytes (in thousands) 2.2 2.5 4.3 3.5 

Monocytes (in thousands) 0.2 0.1 0.2 0.2 

Eosinophiles (in thousands) 0.2 0.2 0.6 0.4 

Platelets (in thousands) 246 206 332 274 

Hematocrit, % 30.3 38.9 39.2 41.5 

It is apparent from the tables and figures that, while all peripheral blood elements had 

shown definite recovery from the peak depression observed earlier, none of the values had returned to control levels at 6 months. 

In order to investigate the possible effects of the measles epidemic on the peripheral blood 

count, values for those individuals with and without measles were averaged separately (Table 

4.4). No significant effect of measles on any of the determinations could be demonstrated in 

this manner. Since these averages were taken without regard to the time relation between onset 

of symptoms and the date of the determination, counts were tabulated with relation to onset of 

symptoms and averaged. It was not possible, however, to demonstrate changes in any of the 

peripheral elements at the time of onset of the disease by this approach. 

The results of bone marrow differential counts on exposed and control individuals are 

given in Table 4.5. No consistent significant abnormalities were found in the control and exposed groups in the character of the differential count nor in the degree of cellularity or histological structure. In a few instances in both groups of patients, variations in cellular distribution were found which were consistent with systemic infections, such as rubella. These marrows are indicated in the table. Considerable variability in the degree of cellularity was observed, attributable in a large measure to inherent variability in the amount of peripheral blood 

in the aspirated marrow specimen. 

REFERENCE 

1. E. P. Cronkite et al., Study of Response of Human Beings Accidentally Exposed to Significant 

Fallout Radiation, Operation Castle final report of Project 4.1. 

32 


CHAPTER 5 

INTERNAL RADIOACTIVE CONTAMINATION 

5.1 PREVIOUS FINDINGS 

Following the contaminating event, high levels of activity were found in drinking water and 

on the external surface of plants on the contaminated atolls. Gross beta activity was found in 

the urine of the majority of Rongelap and Ailinginae inhabitants, with an average of 1208 

dis/min/24 hr for the Rongelap and 553 dis/min/24 hr for the Ailinginae groups 6 weeks after 

exposure. The excretion rate of radmactivity was found to be three times as great in adults as 

was found in the 0 to 5 year old age group. Strontium, barium, and the rare earth group together contributed 75 per cent of the total beta activity of the urine at this time. The degree of 

internal radiation hazard was considered too low to have contributed significantly to the acute 

effects observed following exposure. 

5.2 METHODS 

Twenty-four hour urine specimens were obtained for analysis by the U.S. Naval Radiological Defense Laboratory (NRDL), Chemical Technology Division, and by the New York 

Operations Office of the Atomic Energy Commissiop Methods of analysis have been described 

previously.’ 

5.3 RESULTS 

Of 53 urine specimens obtained from the Rongelap and Ailinginae groups and analyzed by 

the NRDL Chemical Technology Division, detectable gross beta activity was found only in six 

patients, all of whom were in the Rongelap group, and only one of whom was over 12 years of 

age. Counts ranged from 6 to 90 dis/min/24 hr. Barely detectable radioactivity was found in 

23 urine specimens analyzed by the New York Operations Office. 

REFERENCE 

1. E. P. Cronkite et al., Study of Response of Human Beings Accidentally Exposed to Significant 

Fallout Radiation, Operation Castle final report of Project 4.1. 

35 
CHAPTER 6 

DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS 

6.1 DISCUSSION 

It would not have been possible, from physical examination alone at the time of the resurvey, to conclude that the Rongelap and Ailinginae groups had been exposed to penetrating gamma 

and external beta radiation. The people were in average good health on physical examination. 

The residual pigment changes from previous skin lesions were not prominent. The mean peripheral blood counts were within the range of normal for individual counts, although definitely 

below the mean values for the control groups. The bone marrow findings were in no way diagnostic, and thus a diagnosis of previous exposure would be difficult, if not impossible, without 

a medical history. 

The marked improvement in the appearance of the skin of most of the exposed individuals 

is in conformity with the superficial nature of the earlier lesions that resulted principally from 

exposure to soft radiation. Even the deeper skin lesions showed healing in all cases, with only 

minimal remaining evidence of damage in the form of scarring and pigment aberrations. 

The contrasting residual change of hyperpigmentation in the neck lesions and depigmentation in the foot lesions is worthy of comment. In general, the foot lesions were more severe 

than the neck lesions. It might be assumed that the chromatophores were destroyed; consequently, repigmentation was impossible. On the other hand, the chromatophores of the neck 

apparently were not completely destroyed, and thus repigmentation resulted. 

It is significant that no secondary breakdown of tissue had occurred in either the superficial or deep lesions, although there was suggestive evidence of atrophy in the deep foot lesions 

and of atrophy and telangiectasis in the persistent ear lesion. It is possible that the deep lesions, particularly that on the ear of one individual, may still break down, requiring consideration of excision and repair. With regard to prognosis over the next several years, there are 

factors for and against the future development of further lesions, or cancer of the skin in these 

people. A favorable prognosis is suggested by (1) the superficial nature of most of the lesions 

with rapid healing and little scarring, (2) lack of gross telangiectasis or extensive vascular 

changes that would portend chronic radiodermatitis, (3) the lack of marked histologic changes 

after 6 months, and (4) the fact that the Negroid skin is reported to be less prone to develop 

malignancy. The prognosis still must be guarded, however, when one considers that (1) the 

large number of young people exposed with long life expectancy probably exceed the induction 

period of cancer development, (2) the continuous exposure to tropical sunlight, (3) the possible 

influence of the sublethal whole-body exposure, and (4) the persistent aberrations in pigmentation. 

The apparent delay in recovery of mean peripheral blood counts to normal values has been 

discussed’ in Chap. 4 and, apparently, is in keeping with previous experience on human exposures. Depression appears more protracted in human beings than in large animals. 

36 
The radioactivity in the urine of the exposed individuals had decreased rapidly with time 

and was barely detectable at 6 months. This rate of elimination, coupled with the initial estimates of a low degree of internal contamination,’ minimizes the possibility that chronic irradiation effects from this source will occur. 

6.2 CONCLUSIONS 

Re-examination of the Rongelap and Ailinginae people 6 months after exposure to fallout 

radiation revealed the following: 

1. Skin lesions were completely healed, and only a few hyperpigmented or depigmented 

scarred areas remained at the sites of the most severe early lesions. There was no evidence 

of secondary breakdown of any lesions. 

2. Regrowth of hair was essentially complete. No changes in hair color or texture were 

noted. 

3. Residual bluish-brown discoloration of the fingernails was observed in three individuals. 

4. No other findings on physical examination or X-ray examination of the chest were ascribable to radiation exposure. 

5. The total white, neutrophile, lymphocyte, and platelet counts remained depressed below 

control levels. 

6. No significant abnormalities were detected in bone marrow samples aspirated from 22 

exposed and 20 control individuals. 

7. Minimal amounts of residual gross beta activity were detectable in the urine of approximately one-third of the exposed individuals. 

6.3 RECOMMENDATIONS 

It is recommended that the following procedures be considered for future medical resurveys: (1) complete serological studies on all exposed and control individuals, (2) stool examinations for parasites, and (3) complete ophthalmological examinations with photographs of lenses. 

Also, when additional X-ray pictures are contemplated, consideration should be given to 

including a portable X-ray machine in the equipment. The machine at the Majuro hospital at 

present is old and badly in need of repairs. 

In summary, information of considerable importance can be obtained by continued observation of the exposed Marshallese people; however, possible late effects cannot be properly 

evaluated in the absence of an adequate control population. The lack of suitable controls in the 

Nagasaki-Hiroshima data has been a most serious difficulty in evaluating changes that have 

appeared. During the present resurvey a control population thought to be adequate was established and examined. It is strongly recommended that consideration be given to the adequacy 

of this population and, if it is felt to be adequate, that measures be taken to ensure continued 

observation of the control individuals. Consultation with Dr. Hardin Jones in relation to radiation and longevity is recommended. 

REFERENCE 

1. E. P. Cronkite et al., Study of Response of Human Beings Accidentally Exposed to Significant Fallout Radiation, Operation Castle final report of Project 4.1. 

37 
APPENDIX A 

TABLE A.1 -Exposed Population: Comparison with Initial FindIngs of individual Weights and Hematolcgical Values 

Peripheral blood counta, in thousands 

Case 

No. 

Age, 

years Sex 

Weight, lb 

March SPt 

‘Neutrophiles 

Aprll 6ePt 

Lymphocytes 

April Sept 

Platelets 

March 6ept 

Hematocrlt , % 

March Sept 

Date of 

Measles 

1.6 

1 

38 

1.8 

31 

M 

M 

M 

hi 

M 

22 

22 

148 

20 

120 

26 

26 

152 

25 

128 

2.9 

2.8 

2.7 

2.6 

2.6 

3.4 

5.7 

3.1 

6.6 

3.5 

4.1 

4.2 

3.6 

2.7 

2.6 

3.7 

6.6 

4.6 

3.8 

1.6 

110 

166 

130 

116 

196 

240 

380 

286 

247 

280 

37 

38 

46 

35 

41 

37 

38 

42 

37 

40 

s/4 

9 

10 

11 

12 

13 

23 

30 

50 

19 

62 

M 

M 

M 

F 

F 

134 

124 

123 

96 

91 

137 

131 

114 

112 

91 

2.7 

2.8 

1.6 

3.3 

2.4 

6.6 

4.2 

6.6 

5.0 

5.1 

2.4 

1.6 

1.4 

1.3 

1.5 

2.3 

1.6 

1.6 

1.8 

2.3 

126 

106 

65 

150 

106 

190 

202 

215 

286 

275 

43 

46 

41 

32 

38 

43 

46 

37 

38 

37 

5/54’ 

s/w 

* 

14 

15 

17 

18 

19 

26 

7 

4 

24 

5 

F 

F 

F 

F 

M 

118 

37 

30 

101 

32 

122 

37 

32 

106 

32 

2.8 

1.6 

3.4 

4.3 

3.1 

5.8 

4.7 

4.0 

6.0 

6.0 

1.7 

2.3 

2.7 

1.7 

2.4 

1.1 

2.1 

3.0 

1.2 

2.3 

65 

200 

105 

45 

116 

160 

270 

170 

165 

262 

36 

36 

39 

34 

34 

36 

37 

36 

30 

40 

t 

S/l 

t 

20 

21 

22 

23 

24 

7 

3.5 

11 

4 

15 

M 

F 

F 

M 

F 

43 

29 

120 

37 

96 

43 

30 

116 

37 

100 

3.2 

2.7 

2.5 

4.1 

3.5 

2.9 

6.5 

4.8 

4.6 

3.8 

2.0 

2.0 

1.9 

2.8 

2.0 

1.6 

2.2 

1.7 

2.9 

1.6 

120 

86 

130 

196 

196 

230 

365 

235 

250 

166 

39 

35 

41 

37 

38 

39 

41 

4a 

38 

41 

9/l 

9/2 

s/2 

25 

26 

21 

30 

32 

43 

12 

28 

59 

4.5 

M 

M 

M 

F 

M 

162 

86 

145 

115 

29 

161 

104 

132 

29 

4.1 

3.5 

3.6 

3.9 

2.6 

4.2 

3.9 

5.1 

4.1 

4.5 

2.1 

2.3 

1.9 

1.6 

2.7 

1.4 

1.8 

3.8 

1.7 

3.0 

110 

145 

110 

85 

96 

276 

228 

182 

142 

260 

39 

39 

44 

42 

36 

36 

37 

43 

41 

39 

s/3 

33 

34 

35 

36 

37 

1 

16 

14 

6 

19 

F 

F 

M 

M 

M 

22 

113 

98 

50 

128 

26 

120 

94 

51 

132 

1.7 

3.7 

2.7 

2.5 

3.1 

4.2 

3.7 

5.4 

4.3 

3.7 

3.6 

2.4 

2.2 

2.6 

2.6 

6.6 

2.8 

2.1 

3.3 

1.2 

65 

126 

140 

130 

130 

260 

210 

187 

206 

167 

33 

38 

39 

36 

34 

35 

38 

40 

38 

40 

S/l 

38 

39 

40 

42 

46 

70 

15 

30 

3 

76 

M 

F 

M 

F 

M 

132 

104 

25 

132 

136 

102 

122 

27 

132 

2.9 

2.5 

2.5 

2.4 

3.0 

3.6 

5.2 

6.0 

2.1 

1.6 

2.9 

2.9 

2.1 

1.5 

1.4 

2.1 

3.7 

1.6 

166 

140 

80 

135 

162 

237 

270 

196 

146 

38 

33 

42 

33 

33 

42 

38 

37 

38 

36 

9/3 

8/16 

47 

49 

62 

64 

66 

8 

16 

56 

1.6 

76 

M 

F 

F 

M 

M 

66 

120 

114 

22 

149 

54 

123 

116 

22 

146 

4.7 

4.1 

3.0 

2.6 

1.5 

6.1 

3.6 

3.6 

2.6 

1.9 

2.3 

2.2 

2.6 

2.0 

2.7 

2.6 

2.0 

2.1 

4.2 

3.2 

120 

180 

160 

145 

136 

206 

267 

220 

160 

152 

32 

39 

38 

36 

37 

35 

39 

39 

34 

34 

S/2 

38 
TABLE A.l-(Continued) 

Peripheral blood counts. In thousands . 

Case 

No. 

Age, 

years 38x 

Weight, lb 

March 9ePt 

, 

Neutrophiles 

April SePt 

Lymphocytes 

Aprll 9ePt 

Platelets 

March SePt 

Hematocrit , % 

March *Pt 

Date of 

measles 

56 

57 

58 

60 

61 

78 

100 

so 

63 

6 

F 

F 

F 

F 

F 

108 

104 

100 

160 

66 

102 

107 

170 

70 

3.5 

2.0 

2.6 

4.1 

2.5 

5.4 

3.2 

3.3 

5.2 

7.9 

2.6 

2.7 

1.9 

2.5 

3.0 

1.2 

3.8 

2.2 

3.0 

3.2 

125 

55 

80 

160 

105 

295 

202 

160 

225 

235 

38 

34 

38 

38 

39 

37 

32 

37 

38 

40 

9/5 

9/3 

62 

63 

64 

66 

66 

30 

38 

28 

1 

30 

F 

F 

F 

F 

F 

113 

122 

21 

116 

118 

123 

23 

116 

5.2 

2.6 

3.2 

2.5 

2.8 

3.8 

3.7 

2.8 

4.0 

3.7 

2.8 

1.6 

2.1 

2.4 

3.1 

2.8 

1.9 

2.6 

3.3 

3.1 

110 

65 

70 

105 

146 

467 

262 

190 

200 

175 

41 

41 

37 

38 

38 

39 

41 

39 

34 

40 

67 

68 

69 

71 

72 

14 

49 

3 

2s 

7 

F 

M 

F 

F 

F 

115 

146 

33 

100 

44 

117 

150 

35 

109 

40 

3.0 

2.4 

1.4 

5.0 

1.8 

4.3 

2.7 

3.0 

7.5 

4.2 

1.9 

2.0 ( 

3.2 

2.7 

2.0 

2.2 

1.8 

2.2 

2.0 

2.2 

115 

120 

115 

105 

165 

250 

127 

130 

200 

430 

41 

43 

36 

41 

33 

41 

41 

36 

38 

41 

9/l 

9/l 

73 

74 

75 

76 

77 

18 

18 

12 

9 

22 

M 

F 

F 

M 

M 

160 

128 

79 

63 

117 

158 

134 

82 

64 

2.6 

7.3 

i 2.3 

2.8 

2.7 

3.5 

4.4 

4.2 

4.2 

1.3 

2.6 

1.7 

2.9 

1.4 

2.0 

1.2 

2.5 

1.5 

60 

155 

110 

150 

127 

262 

337 

235 

180 

49 

35 

38 

38 

51 

46 

38 

40 

38 

47 

t3/31 

8/31 

78 

79 

80 

82 

83 

84 

65 

37 

45 

46 

60 

0.25 

0.33 

F 

M 

M 

H 

M 

M 

125 

138 

132 

135 

133 

132 

15 

14 

3.4 

5.1 

2.9 

2.6 

3.5 

5.4 

4.0 

3.2 

2.5 

2.6 

2.0 

2.5 

2.5 

2.5 

1.3 

3.1 

2.7 

2.1 

3.0 

6.5 

95 

70 

100 

130 

250 

140 

250 

235 

a7 

440 

39 

47 

44 

40 

38 

40 

43 

40 

Aillnginae 

1 

6 

8 

16 

28 

54 

1 

2 

38 

69 

F 

M 

F 

M 

F 

144 

24 

22 

124 

99 

166 

35 

125 

107 

3.6 

3.5 

3.5 

2.2 

3.7 

6.7 

3.5 

7.1 

1.8 

3.2 

2.4 

5.6 

4.1 

2.3 

2.3 

2.2 

3.5 

3.0 

1.5 

3.8 

175 

215 

185 

195 

115 

185 

235 

250 

212 

187 

41 

37 

35 

47 

39 

38 

37 

37 

43 

39 

9/2 

9/2 

29 

31 

41 

43 

44 

65 

32 

44 

66 

4 

M 

M 

M 

F 

M 

124 

126 

99 

32 

124 

125 

32 

4.1 

3.0 

3.1 

3.7 

2.4 

3.9 

3.7 

3.8 

4.1 

3.5 

2.2 

2.5 

2.3 

2.0 

2.1 

2.4 

2.4 

2.6 

2.0 

1.6 

115 

145 

110 

215 

180 

177 

245 

175 

180 

270 

42 

45 

44 

41 

35 

39 

42 

40 

38 

38 

9/4 

9/5 

45 

48 

50 

51 

53 

33 

6 

39 

23 

8 

F 

F 

M 

F 

F 

116 

41 

164 

101 

48 

107 

43 

166 

98 

46 

4.2 

3.0 

4.0 

4.6 

3.7 

3.1 

1.2 

4.5 

5.2 

4.5 

1.5 

3.2 

2.9 

3.0 

2.5 

1.6 

2.0 

1.5 

2.0 

3.4 

180 

210 

95 

170 

240 

217 

205 

152 

230 

502 

32 

36 

41 

40 

36 

35 

38 

43 

38 

37 

.9/30 

8/25 

59 

70 

81 

34 

17 

8 * 

F 

F 

F 

92 

96 

43 

92 

104 

48 

8.1 

3.0 

2.3 

5.6 

3.3 

3.7 

3.7 

1.8 

2.2 

2.1 

1.6 

1.6 

105 

187 

240 

197 

207 

265 

37 

28 

36 

33 

32 

37 

*Delivered. 

t Pregnant. 

39 
APPENDIX B 

TABLE B.l-Control Population: Individual Weights and Hematological Values 

Case 

No. 

Age, years 

&2X 

Weight, 

lb 

Peripheral blood counts, in thousands 

A . 

Neutrophtles Lymphocytes Platelets Hematocrit, 

% 

Date of 

measles 

1001 

1002 

1003 

1004 

1005 

54 

1 

2.6 

52 

1 

F 

hi 

M 

M 

M 

113 

16 

26 

19 

2.8 

9.2 

6.0 

4.2 

6.4 

3.8 

9.5 

7.5 

4.3 

5.4 

170 

362 

377 

250 

372 

32 

35 

40 

31 

8/23 

8/17 

8/27 

1006 

1007 

1008 

1009 

1010 

1 

36 

2.9 

26 

30 

M 

hi 

F 

M 

M 

22 

148 

27 

160 

130 

9.6 

7.2 

2.9 

3.8 

4.5 

3.1 

6.2 

3.1 

3.2 

4.0 

310 

307 

445 

320 

235 

38 

46 

41 

46 

49 

8/17 

1011 

1012 

1013 

1014 

1015 

50 

19 

62 

25 

7 

M 

F 

F 

F 

F 

143 

114 

133 

116 

44 

5.6 

4.9 

4.7 

4.0 

4.9 

3.5 

2.4 

2.7 

3.3 

3.4 

200 

377 

265 

310 

275 

46 

42 

39 

35 

36 

8/23 

8/24 

1016 

1017 

1018 

1019 

1020 

42 

4 

24 

5 

7 

M 

F 

F 

M 

M 

140 

31 

146 

42 

52 

4.2 

7.3 

3.7 

8.2 

3.6 

1.7 

3.5 

3.9 

3.1 

3.5 

240 

360 

385 

397 

350 

47 

36 

38 

39 

40 

8/19 

8/25 

8117 

1021 

1022 

1023 

1024 

1025 

3 

18 

4 

15 

43 

F 

F 

M 

F 

M 

32 

112 

37 

107 

143 

3.6 

5.6 

5.1 

5.3 

4.6 

4.4 

4.5 

6.1 

4.3 

4.9 

262 

240 

410 

375 

205 

34 

40 

38 

39 

47 

8/30 

8/30 

8/26 

1026 

1027 

1028 

1029 

1030 

12 

28 

70 

65 

59 

M 

M 

F 

M 

F 

51 

130 

86 

135 

131 

4.8 

3.3 

8.0 

3.6 

2.1 

3.4 

2.4 

4.5 

3.8 

2.8 

247 

265 

265 

302 

220 

40 

42, 

38 

42 

42 

8/24 

1031 

1032 

1033 

1034 

1035 

35 

4 

1.8 

50 

14 

M 

M 

F 

F 

M 

155 

32 

20 

139 

113 

5.1 

2.1 

2.0 

3.8 

3.2 

4.4 

3.5 

3.8 

215 

300 

265 

287 

240 

47 

38 

40 

42 

36 8/15 

40 
1040 

1050 

1060 

1070 

1080 

TABLE B.l-(Continued) 

Peripheralblood counta, inthousande 

Case 

No. 

Age, years 

Sex 

Weight, .Neutrophiles Lymphovtes 

lb 

Platelets'Hematocrlt, 

% 

Date of 

meaelee 

1036 

1037 

1038 

1039 

7 

19 

60 

15 

19 

M 

M 

M 

F 

M 

58 

96 

134 

95 

5.7 

10.6 

3.1 

4.6 

4.3 

4.3 

3.1 

1.9 

3.8 

3.8 

440 

600 

242 

367 

227 

35 

40 

40 

38 

44 

8/17 

8/23 

a/15 

1041 

1042 

1043 

1044 

1045 

44 

4 

4 

30 

M 

F 

M 

F 

159 

33 

31 

130 

4.0 

3.4 

5.3 

4.4 

6.3 

3.9 

3.8 

5.4 

3.1 

4.7 

292 

252 

305 

285 

207 

45 

35 

45 

34 

41 

8/24 

9/2 

1046 

1047 

1048 

1049 

60 

8 

6 

16 

M 

M 

F 

F 

172 

67 

41 

91 

6.3 

8.5 

6.1 

4.0 

2.7 

7.6 

5.0 

3.8 

195 

300 

370 

260 

36 

37 

39 

38 

8/17 

8/17 

8/30 

1051 

1052 

35 

2s 

60 

M 

F 

F 

162 9.2 

8.5 

4.9 

5.9 

4.5 

6.6 

340 

295 

320 

48 

37 

45 

8/27 

8 

1 

75 

F 

M 

M 

71 

19 

110 

5.3 

4.1 

6.4 

3.5 

4.1 

3.1 

505 

340 

272 

37 

36 

36 

8/21 

9/5 

1056 

1057 

1058 

75 

60 

34 

60 

F 

F 

F 

F 

113 

126 

6.4 

5.2 

2.4 

12.8 

5.7 

5.2 

1.6 

3.1 

4.9 

4.2 

190 

260 

350 

275 

242 

44 

50 

42 

39 

38 

1061 

1062 

7 

47 

F 

F 

56 

179 

3.8 

4.2 

3.6 

3.7 

297 

195 

36 

42 

8/25 

1063 

1064 

38 

28 

1.3 

F 

F 

F 

100 

161 

17 

5.3 

9.4 

5.6 

3.5 

3.8 

7.4 

305 

312 

390 

40 

44 

37 

1068 

1069 

30 

14 

49 

2.5 

16 

F 

F 

M 

F 

F 

136 

81 

130 

28 

133 

3.3 

6.2 

4.1 

3.3 

4.6 

2.8 

3.8 

2.7 

3.2 

4.7 

232 

315 

252 

315 

445 

43 

39 

41 

42 

38 

8/15 

8/18 

1071 

1072 

1073 

1074 

1075 

29 

7 

17 

15 

13 

F 

F 

M 

F 

F 

98 

40 

118 

86 

4.1 

5.5 

4.5 

8.6 

3.5 

3.2 

3.6 

3.0 

1.7 

2.1 

425 

425 

280 

350 

305 

43 

36 

42 

33 

41 

8/27 

8/17 

8/19* 

1076 

1077 

1078 

1079 

9 

22 

37 

45 

M 

M 

F 

M 

72 

128 

234 

108 

8.6 

3.4 

4.4 

5.3 

3.7 

3.3 

3.5 

4.1 

310 

350 

275 

275 

42 

47 

43 

41 

8/25 

8/18 

46 ' M 125 3.6 3.7 245 41 

1081 

1082 

9 

60 

F 

M 

58 

156 

5.8 

5.5 

4.9 

2.1 

310 

272 

41 

40 

8/24 

*Pregnant. 

41-42 
. 

. 
DISTRIBUTION 

Military Distribution Category 5-50 

ARMY ACTIVITIES 

Asst. Dep. Chief of Staff for Military Operations, D/A, Washington 25, D. C. ATTN: Asst. 

Executive (R&SW) 

Chief of Research and Development, D/A, Washington 25, D. C. ATTN: Special Weapons 

and Air Defense Division 1 

Chief of Ordnance, D/A, Washington 25, D. C. ATTN: ORDTX-AR 1 

Chief Signal Officer, D/A, P&O Division, Washington 25, D. C. ATTN: SIGOP 3 

The Surgeon General, D/A, Washington 25, D. C. ATTN: Chief, R&D Division 2 

Chief Chemical Officer, D/A, Washington 25, D. C. 2 

The Quartermaster General, D/A, Washington 25, D. C. ATTN: Research and Development Div. 1 

Chief of Engineers, D/A, Washington 25, D. C. ATTN: ENGNB 4 

Chief of Transportation, Military Planning and Intelligence Div., Washington 25, D. C. 1 

Commanding General, Continental Army Command, Ft. Monroe, Va. 3 

President, Board 91, Headquarters, Continental Army Command, Ft. Sill, Okla. 1 

President, Board 62, Headquarters, Continental Army Command, Ft. Knox, Ky. 1 

President, Board #3, Headquarters, Continental Army Command, Ft. Benning, Ga. 1 

Commanding General, First Army, Governor’s Island, New York 4, N. Y. 1 

Commanding General, Second Army, Ft. George G. Meade, Md. 1 

Commanding General, Third Army, Ft. McPherson, Ga. ATTN: ACofS, G-3 1 

Commanding General, Fourth Army, Ft. Sam Houston, Tex. ATTN: G-3 Section 1 

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Commanding General, Sixth Army, Presidio of San Francisco, Calif. ATTN: AMGCT-4 1 

Commanding General, U. S. Army Caribbean, Ft. Amador, C.Z. ATTN: Cml. Off. 1 

Commanding General, USARFANT & MDPR, Ft. Brooke, Puerto Rico 1 

Commanding General, Southern European Task Force, APO 168, New York, N. Y. 

ATTN: ACofS, G-3 1 

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ATTN: ACofS, G-3 1 

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Commanding General, U. 5. Army Europe, APO 403, New York, N. Y. ATTN: OPOT 

Div., Combat Dev. Br. 2 

Commanding General. U. S. Army Pacific, APO 958, San Francisco, Calif. ATTN: Cml. Off. 2 

Commandant, Command and General Staff College, Ft. Leavenworth, Kan. ATTN: ALLLS(AS) 1 

Commandant, The Army Aviation School, Ft. Rucker, Ala. 

President, Board No. 66, CONARC, Ft. Rucker, Ala. 1 

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Secretary, The Sptjdkcraft Artillery and Guided Missile School, Ft. Bliss, Texas. ATTN: Maj. 

George L. Ale&and&; Dept. of Tactics and Combined Arms 1 

Commanding General, Army Medical Service School, Brooke Army Medical Center, Ft. Sam 

Houston, Tex. 1 

Director, Special Weapons Development Office, Headquarters, CONARC, Ft. Bliss, Tex. 

ATTN: Lt. Arthur Jaskierny 1 

43 
Commandant, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, 

Washington 25, D. C. 1 

Superintendent, U. S. Military Academy, West Point, N. Y. ATTN: Prof. of Ordnance 1 

Commandant, Chemical Corps School, Chemical Corps Training Command, Ft. McClellan, Ala. 1 

Commanding General, Research and Engineering Command, Army Chemical Center, Md. 

ATTN: Deputy for RW and Non-Toxic Material 2 

Commanding General, Aberdeen Proving Grounds, hid. (inner envelope). ATTN: RD Control 

Officer (for Director, Ballistics Research Laboratory) 2 

Commanding General, The Engineer Center, Ft. Belvoir, Va. ATTN: Asst. Commandant, 

Engineer School 3 

Commanding Officer, Engineer Research and Development Laboratory, Ft. Belvoir, Va. 

ATTN: Chief, Technical Intelligence Branch 1 

Commanding Officer, Picatinny Arsenal, Dover, N. J. ATTN: ORDBB-TK 1 

Commanding Officer, Army Medical Research Laboratory, Ft. Knox, Ky. 1 

Commanding Officer, Chemical Corps Chemical and Radiological Laboratory, Army Chemical 

Center, Md. ATTN: Tech. Library 2 

Commanding Officer, Transportation R&D Station, Ft. Eustis, Va. 1 

Director, Technical Documents Center, Evans Signal Laboratory, Belmar, N. J. 1 

Director, Armed Forces Institute of Pathology, Walter Reed Army Medical Center, 6825 16th 

Street, N. W. Washington 25, D. C. 1 

Director, Operations Research Office, Johns Hopkins University, 7100 Connecticut Ave., Chevy 

Chase, Md., Washington 15, D. C. 1 

Commanding General, Quartermaster Research and Development Command, Quartermaster 

Research and Development Center, Natick, Mass. ATTN: CBR Liaison Officer 2 

NAVY ACTIVITIES 

Chief of Naval Operations, D/N, Washington 25, D. C. ATTN: OP-36 2 

Chief, Bureau of Medicine and Surgery, D/N, Washington 25, D. C. ATTN: Special Weapons 

Defense Div. 

Chief of Naval Personnel, D/N, Washington 25, D. C. 

Chief, Bureau of Ships, D/N, Washington 25, D. C. ATTN: Code 348 

Chief, Bureau of Supplies and Accounts, D/N, Washington 25, D. C. 

Chief, Bureau of Aeronautics, D/N, Washington 25, D. C. 

Commander-in-Chief, U. S. Pacific Fleet, Fleet Post Office, San Francisco, Callf. 

Commander-In-Chief. U. S. Atlantic Fleet, U. S. Naval Base, Norfolk 11, Va. 

Commandant, U. S. Marine Corps, Washington 25, D. C. ATTN: Code A03H 1 

Superintendent, U. S. Naval Postgraduate School, Monterey, CaIif. 1 

Commanding Officer, U. S. Naval Schools Command, U. S. Naval Station, Treasure Island, San 

Francisco, Calif. 1 

Commanding Officer, U. S. Fleet Training Center, Naval Base, Norfolk 11, Va. ATTN: Special 

Weapons School 1 

Commanding Officer, U. S. Fleet Training Center, Naval Station, San Diego 36, Calif. 

ATTN: (SPWP School) 1 

Commanding Officer, U. S. Naval Damage Control Training Center, Naval Base, Philadelphia 12, 

Pa. ATTN: ABC Defense Course 

Commanding Officer, U. S. Naval Unit, Chemical Corps School, Army Chemical Training Center, 

Ft. McClellan, Ala. 1 

Commander, U. S. Naval Ordnance Laboratory, Silver Spring 19, Md. ATTN: R 1 

Commander, U. S. Naval Ordnance Test Station, Inyokern, China Lake, Calif. 1 

Commanding Officer, U. S. Naval Medical Research Inst., National Naval Medical Center, 

Bethesda 14, Md. 1 

Director, U. S. Naval Research Laboratory, Washington 25, D. C. ATTN: Code 2029 1 

Director, The Material Laboratory, New York Naval Shipyard, Brooklyn, N. Y. 1 

Commanding Officer and Director, U. S. Navy Electronics Laboratory, San Diego 52, Calif. 

ATTN: Code 4223 

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ATTN: Technical Information Division 4 

Commander, U. S. Naval Air Development Center, Johnsville, Pa. 1 

Director, Office of Naval Research Branch Office, 1000 Geary St., San Francisco, Calif. 1 

44 
Commanding Officer, Clothing Supply Office, Code lD-0, 3rd Avenue and 29th St., Brooklyn, N. Y. 1 

Commandant, U. S. Coast Guard, 1300 E. St. N. W., Washington 25, D. C. ATTN: Capt. J. R. 

Stewart 1 

AIR FORCE ACTIVITIES 

Asst. for Atomic Energy, Headquarters, USAF, Washington 25, D. C. ATTN: DCS/O 1 

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ATTN: Combat Components Div. 1 

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Med. Div. 1 

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New York, N. Y. ATTN: Directorate of Air Targets 1 

Commander, 497th Reconnaissance Technical Squadron (Augmented), APO 633, New 

York, N. Y. 1 

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Blast Effects Research 2 

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ATTN: CRQST-2 2 

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College 

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The RAND Corporation, 1700 Main Street, Santa Monica, Calif. ATTN: Nuclear Energy Division 

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Commander, Fifteenth Air Force, March AFB, Callf. ATTN: Operations Analysis Office 

OTHER DEPARTMENT OF DEFENSE ACTIVITIES 

Asst. Secretary of Defense, Research and Development, D/D, Washington 25, D. C. 

ATTN: Tech. Library 1 

U. S. Documents Officer, Office of the U. S. National Military Representative, SHAPE, APO 55, 

New York, N. Y. 1 

Director, Weapons Systems Evaluation Group, OSD, Rm 2E1006, Pentagon, Washington 25, D. C. 1 

Commandant, Armed Forces Staff College, Norfolk 11, Va. ATTN: Secretary 1 

Commanding General, Field Command, Armed Forces Special Weapons Project, PO Box 5100, 

Albuquerque, N. Mex. 6 

Commanding General, Field Command, Armed Forces, Special Weapons Project, PO Box 

5100, Albuquerque, N. Mex. ATTN: Technical Training Group 2 

Chief, Armed Forces Special Weapons Project, Washington 25, D. C. ATTN: Documents 

Library Branch 9 

Commanding General, Military District of Washington, Room 1543, Building T-7, Gravelly 

Point, Va. 1 

45 
ATOMIC ENERGY COMMISSION ACTIVITIES 

U. S. Atomic Energy Commission, Classified Technical Library, 1901 Constitution Ave. 

Washington 25, D. C. ATTN: Mrs. J. M. O’Leary (For DMA) 3 

Los Alamos Scientific Laboratory, Report Library, PO Box 1663, Los Alamos, N. Mex. 

ATTN: Helen Redman 2 

Saodia Corporation, Classified Document Division, Sandia Base, Albuquerque, N. Mex. 

ATTN: Martin Lucero 5 

University of California Radiation Laboratory, PO Box 808, Livermore, Calif. ATTN: Margaret 

Edlund 3 

Weapon Data Section, Technical Information Service Extension, Oak Ridge, Tenn. 1 

Technical Information Service Extension, Oak Ridge, Tenn. (Surplus) 220 

Y 

46 

AEC. Oak Ilidgc.TeM. 

_ •• • • • • .I 

.