Late Effects of Radioactive Iodine in Fallout

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Abstract
In the accidental exposure of the inhabitants of one of the Marshall Islands following a fusion type explosion in 1954, thyroid radiation from radioiodine, particularly in the children, was sizable. This resulted in the late development of thyroid insufficiency and/or thyroid nodules in 80% of these children. At the present time, the thyroid effects constitute the only important overt medical problem in the exposed population. Detection of thyroid damage was hindered by its insidious onset and by the unexpected occurrence of elevated blood levels of iodoprotein in the Marshallese population. The greater incidence of thyroid abnormality in the children is probably due to 2 factors: a larger radiation dose due to small thyroid size, and a greater likelihood of the growing organ to manifest changes resulting from chromosomal alterations. The spectrum of radiation exposure of the thyroid glands in any population is wide, ranging from stratospheric fallout from atomic explosions and clinical testing with radioiodine isotopes to high radiation rates intentionally produced in therapy of thyroid diseases. The Marshall Island experience will help to define the range in which significant thyroid damage may occur.