Thyroid Disease Among the Rongelap and Utirik Population-An Update

Abstract

In 1954, 253 Marshallese were accidentally exposed to fallout radiation from the hydrogen bomb, BRAVO. The Marshall Islands Medical Program (MIMP) was established by the Department of Energy in 1955 to monitor and treat radiation-related disease pursuant to this accident. Medical teams from Brookhaven National Laboratory, a federal institution, regularly visit the Marshall Islands to give medical care to the exposed population. The most significant complication of the exposure has been found to be thyroid disease due to the ingestion of radioactive iodides from the fallout. In 1963 the first thyroid nodules were found in Rongelap subjects and in 1969 in Utirik. Non-neoplastic adenomatous nodules were associated with higher doses of radiation and neoplastic nodules developed in individuals receiving lower doses of radiation. Women were more susceptible to the development of palpable thyroid nodules than men. In 1994 the MIMP initiated examination of the thyroid by ultrasound to supplement the clinical examination. One hundred and sixty-four patients were evaluated. No significant differences were found in the incidence of thyroid nodules or the mean nodule count between the three groups of Rongelap and Utirik exposed and a comparison patient population. There was no significant difference in the incidence of thyroid nodules in males vs. females. Five exposed patients were referred for surgical excision of a nodule detected only by ultrasound. These ultrasound findings are unexpected in that females are known to have a higher incidence of thyroid disease than males and we expected that the incidence of ultrasound nodules would be higher in the exposed population.

Risk of Thyroid Cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station Accident

“…Beginning in 1992, articles began to appear reporting increased rates of thyroid cancer in children who were exposed to radiation from the Chernobyl accident in April of 1986 (64,65). Marked increases in childhood thyroid cancer have since been reported for areas surrounding the Chernobyl reactor especially in Belarus and Ukraine (66)(67)(68).…”

“…In addition, the combined effects of deviations in more than one of these assumptions were investigated. The detailed results of these sensitivity calculations were provided in the Pilot Study Final Report (pages [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74]. Based on the results, the following conclusions were reached:…”

The cancer epidemiology of radiation

“…The number of Marshall Islanders who were heavily exposed was limited at around 250, but nine thyroid cancers were observed in this group over the following 32 years, although interpretation is complicated by the high occurrence of surgery and hormonal therapy (UNSCEAR, 1994;Howard et al, 1997). Broader studies of thyroid cancer in the Marshall Islands have found evidence of a general excess risk among the Marshall Islanders potentially exposed after the BRAVO test (Hamilton et al, 1987;Takahashi et al, 2003).…”

Survivor Rongelap: Health issues and use of traditional medicine among the women of Rongelap Atoll

“…Healers may have taken a back seat in cases of radiation sickness based on their inexperience in treating the new symptoms and in deference to the U.S. personnel. Further, some of the effects of radiation exposure such as the growth of thyroid nodules (Howard et al 1997) and the appearance of cancers take years to appear in the population so would be recent medical maladies for which local remedies have not been developed and tested. Members of the Rongelap community continue to receive medical care and treatment for these diseases from the U.S. government and perhaps there is a feeling that the U.S. doctors have access to more effective treatments thus healers have left the treatment of these diseases to them.…”

“…The people of the northern atolls, including those of Rongelap and Ailinginae, are expected to experience 95% of all radiation related thyroid cancers in the Marshall Islands (National Cancer Institute 2004). The risk of thyroid disease was reported to be twice as high among exposed females than exposed males (Howard et al 1997, Takahashi et al 2003. Additionally, 84% of children who were ten years old or younger when they were exposed, have since developed thyroid nodules (Stanbury 1970), and at least five of the 19 children originally exposed to the BRAVO blast showed signs of growth retardation attributable to thyroid abnormalities (Conard 1976).…”