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Corcho Alvarado JA, Röllin S, Sahli H, McGinnity P. Isotopic signatures of plutonium and uranium at Bikar atoll, northern Marshall Islands. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2022; 242:106795. [PMID: 34923320 DOI: 10.1016/j.jenvrad.2021.106795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
We present plutonium (Pu) and uranium (U) isotopic fingerprints (or signatures) in environmental samples collected at Bikar Atoll. Bikar is the second -most northern atoll of the Republic of the Marshall Islands, and therefore an important reference point to evaluate the extension of the regional fallout from the Pacific Proving Grounds (PPG) in Bikini and Enewetak Atolls. Previous studies have shown that regional fallout from atmospheric nuclear weapon testing (NWT) in Bikini and Enewetak has resulted in elevated levels of fallout radionuclides in this atoll. In order to optimally interpret the isotopic fingerprints, we compare our results with data obtained in eleven certified reference materials, representing different contamination sources. As well as 238Pu, 239Pu, 240Pu, 241Pu, 238U and 235U, this study also encompasses less commonly reported radionuclides such as 242Pu, 244Pu and 236U. We show the importance of combining numerous fingerprints for improved assessment of the source of a nuclear contamination. In samples from Bikar, Pu and U isotope ratios were found to vary within narrow ranges. Pu and U fingerprints suggest that regional fallout from the Castle Bravo test in March 1954 was the main source of the contamination. This was further confirmed by two different age dating approaches that estimated 1954 as the year of the contamination. We demonstrate that use of an exponential function to approximate the yield of heavy radionuclides in thermonuclear explosions with increasing mass is a valid approach for estimating the age of a contamination. We show that, if sufficient radionuclide activity concentration measurement results with low uncertainties are available, this method is robust.
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Affiliation(s)
- J A Corcho Alvarado
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland.
| | - S Röllin
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
| | - H Sahli
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
| | - P McGinnity
- International Atomic Energy Agency, Environment Laboratories, Monaco
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Corcho-Alvarado JA, Guavis C, McGinnity P, Röllin S, Ketedromo T, Sahli H, Levy IN, de Brum K, Stauffer M, Osvath I, Burger M. Assessment of residual radionuclide levels at the Bokak and Bikar Atolls in the northern Marshall Islands. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149541. [PMID: 34418620 DOI: 10.1016/j.scitotenv.2021.149541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
The Bikar and Bokak Atolls, located in the northern Marshall Islands, are extremely isolated and consist of pristine marine and terrestrial ecosystems. Both atolls may have experienced significant radioactive deposition following the nuclear weapon testing conducted at Bikini and Enewetak proving grounds. Here we report activity concentrations of artificial radionuclides (239Pu, 240Pu, 241Pu, 241Am, 137Cs and 90Sr) in marine and terrestrial samples collected from Bikar and Bokak Atolls. Artificial radionuclides in soil from the Majuro Atoll are also reported and form a radiological baseline against which the levels at the other atolls can be compared. We observed low levels of artificial radionuclides in soil from Majuro and Bokak, but significantly higher levels in soil from Bikar. The residual radioactivity in the Bikar environment is comparable to the levels previously reported for other nearby atolls, including Taka and Utrik, but lower than for Rongerik, Rongelap, Bikini and Enewetak. An analysis of 240Pu/239Pu isotope ratios and estimations of the dates of contamination from 241Am/241Pu activity ratios both indicated that the Bikar Atoll was contaminated mainly by radioactive fallout from the Castle Bravo test in 1954. We compare the results of our measurements at Bikar and Bokak to data from other atolls in the Marshall Islands and to regions of the world affected by both global and regional fallout from atmospheric nuclear weapons testing and nuclear accidents.
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Affiliation(s)
- José A Corcho-Alvarado
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland.
| | - Candice Guavis
- Marshall Islands Marine Resources Authority (MIMRA), Majuro, Marshall Islands
| | - Paul McGinnity
- International Atomic Energy Agency (IAEA), Environment Laboratories, Monaco
| | - Stefan Röllin
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
| | - Tuvuki Ketedromo
- Environmental Protection Authority (RMI EPA), Majuro, Marshall Islands
| | - Hans Sahli
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
| | - Isabelle N Levy
- International Atomic Energy Agency (IAEA), Environment Laboratories, Monaco
| | - Kalena de Brum
- Marshall Islands Marine Resources Authority (MIMRA), Majuro, Marshall Islands
| | - Marc Stauffer
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
| | - Iolanda Osvath
- International Atomic Energy Agency (IAEA), Environment Laboratories, Monaco
| | - Mario Burger
- Nuclear Chemistry Division, Spiez Laboratory, Federal Office for Civil Protection, CH-3700 Spiez, Switzerland
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Towne SD, Kim Yeary KH, Narcisse MR, Long C, Bursac Z, Totaram R, Rodriguez EM, McElfish P. Inequities in Access to Medical Care Among Adults Diagnosed with Diabetes: Comparisons Between the US Population and a Sample of US-Residing Marshallese Islanders. J Racial Ethn Health Disparities 2021; 8:375-383. [PMID: 32529423 PMCID: PMC9972993 DOI: 10.1007/s40615-020-00791-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We examined barriers to accessing medical care for migrant US-residing Marshallese Islanders. METHODS Cross-sectional analyses were conducted to identify potential inequities. Surveys from largely migrant diabetic Marshallese Islanders (n = 255) were compared with nationally representative data. Two major outcomes were assessed including 1-whether or not one reported having forgone medical care in the past year because of cost-and 2-whether or not one reported not having a usual source of care. RESULTS Overall, 74% and 77% of Marshallese Islanders reported forgone care and no usual source of care, respectively, versus 15% and 7% of the US diabetic population. In multivariable analyses, being younger; uninsured; unemployed; male; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with forgone care nationwide, whereas only lacking insurance was associated with forgone care among Marshallese Islanders. Nationwide being younger; uninsured; unmarried; female; of lower education; Native American or Hispanic (versus White); and residing in the South were associated with not having a usual source of care, whereas only being younger and uninsured were associated with not having a usual source of care among Marshallese Islanders. CONCLUSION The largest group of diabetic Marshallese Islanders in the continental US faces severe healthcare access inequities necessitating policies that increase access to health insurance options and associated resources.
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Affiliation(s)
- Samuel D. Towne
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL 32816, USA,Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA,Southwest Rural Health Research Center, Texas A&M University, College Station, TX 77843, USA,Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA
| | - Karen H. Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR 72703, USA
| | - Chris Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR 72703, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th Street AHC5, Miami, FL, USA
| | - Rachel Totaram
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL 32816, USA
| | - Elisa M. Rodriguez
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Pearl McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR 72703, USA
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Nembhard WN, McElfish PA, Ayers B, Collins RT, Shan X, Rabie NZ, Zarate YA, Maity S, Cen R, Robbins JA. Nuclear radiation and prevalence of structural birth defects among infants born to women from the Marshall Islands. Birth Defects Res 2019; 111:1192-1204. [PMID: 31313527 DOI: 10.1002/bdr2.1551] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/13/2019] [Accepted: 07/01/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND With their unique history of exposure to extensive nuclear testing between 1946 and 1958, descendants of Marshall Island residents may have underappreciated genetic abnormalities, increasing their risk of birth defects. METHODS We conducted a retrospective cohort study of resident women with at least one singleton live birth between 1997 and 2013 in northwest Arkansas using state birth certificate data linked to data from the Arkansas Reproductive Health Monitoring System, a statewide birth defects registry. We calculated unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) from modified Poisson regression analyses for non-Hispanic (NH) whites, NH-blacks, Hispanics and Marshallese, using NH-whites as the reference group. RESULTS Of the 91,662 singleton births during the study period, 2,488 were to Marshallese women. Due to the relatively small number of Marshallese births, we could not calculate prevalence estimates for some defects. Marshallese infants had higher rates of congenital cataracts (PR = 9.3; 95% CI: 3.1, 27.9). Although the number of defects was low, Marshallese infants also had higher rates of truncus arteriosus (PR = 44.0; 95% CI: 2.2, 896.1). CONCLUSIONS Marshallese infants may have increased risk of specific birth defects, but estimates are unstable because of small sample size so results are inconclusive. Larger population-based studies would allow for further investigation of this potential risk among Marshallese infants.
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Affiliation(s)
- Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Science, Fayetteville, Arkansas
| | - Britni Ayers
- College of Medicine, University of Arkansas for Medical Science, Fayetteville, Arkansas
| | - R Thomas Collins
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Xiaoyi Shan
- Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Nader Z Rabie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii
| | - Yuri A Zarate
- Section of Genetics and Metabolism, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Suman Maity
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - Ruiqi Cen
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | - James A Robbins
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas.,Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Background gamma radiation and soil activity measurements in the northern Marshall Islands. Proc Natl Acad Sci U S A 2019; 116:15425-15434. [PMID: 31308236 PMCID: PMC6681725 DOI: 10.1073/pnas.1903421116] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
From 1946 to 1958, the United States tested 67 nuclear weapons in the Marshall Islands, a remote constellation of atolls in the Pacific Ocean that was then a US trust territory. Two atolls, Bikini and Enewetak, were used as ground zero for the tests, which caused unprecedented environmental contamination and, for the indigenous peoples of the islands, long-term adverse health effects. In addition to the populations of Bikini and Enewetak, the people of Rongelap and Utirik were also affected by radioactive fallout from the largest nuclear test the United States has ever conducted, the Bravo test held March 1, 1954. This article presents a picture of current radiological conditions by examining external gamma radiation and soil radionuclide activity concentrations. We report on measurements of external gamma radiation on 9 islands in 4 atolls in the northern Marshall Islands, all of which were affected by the US nuclear testing program from 1946 to 1958 (Enjebi, Ikuren, and Japtan in Enewetak Atoll; Bikini and Enyu in Bikini Atoll; Naen in Rongelap Atoll; and Aon, Elluk, and Utirik in Utirik Atoll). We also report americium-241, cesium-137, plutonium-238, and plutonium-239,240 activity concentrations in the soil samples for 11 islands in 4 northern atolls (Enewetak, Japtan, Medren, and Runit in Enewetak Atoll; Bikini and Enyu in Bikini Atoll; Naen and Rongelap in Rongelap Atoll; and Aon, Elluk, and Utirik in Utirik Atoll) and from Majuro Island, Majuro Atoll in the southern Marshall Islands. Our results show low external gamma radiation levels on some islands in the Enewetak Atoll and Utirik Atoll, and elevated levels on Enjebi Island in the Enewetak Atoll, on Bikini Atoll, and on Naen Island in the Rongelap Atoll. We perform ordinary kriging on external gamma radiation measurements to provide interpolated maps. We find that radionuclides are absent from all Majuro soil samples, and that they are present at highest activity concentrations in samples from Runit and Enjebi islands (Enewetak Atoll), Bikini Island (Bikini Atoll), and Naen Island (Rongelap Atoll). We contextualize all results by making comparisons between islands and to various standards, as well as to regions of the world affected by nuclear accidents. We also discuss implications for informed decision-making by the Marshallese and local atoll governments and their people on issues pertaining to island resettlement.
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Felix H, Rowland B, Long CR, Narcisse MR, Piel M, Goulden PA, McElfish PA. Diabetes Self-Care Behaviors Among Marshallese Adults Living in the United States. J Immigr Minor Health 2018; 20:1500-1507. [PMID: 29243017 DOI: 10.1007/s10903-017-0683-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Marshallese experience high rates of type 2 diabetes. Proper management of diabetes requires multiple self-care behaviors, yet little is known about Marshallese's diabetes-related self-care behaviors. Survey data from 111 Marshallese adults with diabetes were used to examine relationships between self-care behaviors and socio-demographic characteristics. The most common self-care behavior was attending annual doctor visits, while the least common was maintaining a normal weight. Age group, education level, and having a regular doctor were significantly associated with engaging in self-care behaviors. Having a regular doctor had the most effect on performing self-care behaviors (p = 0.006); although, only 38.7% reported having a regular doctor. To minimize diabetes-related complications, efforts to improve self-care behaviors among the Marshallese should be developed. Alternatives to traditional healthcare providers, such as community health workers, may be a viable strategy with this population given only one-third reported having a regular doctor.
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Affiliation(s)
- Holly Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Marie-Rachelle Narcisse
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Michelle Piel
- College of Pharmacy, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Peter A Goulden
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
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McElfish PA, Narcisse MR, Long CR, Ayers BL, Hawley NL, Aitaoto N, Riklon S, Su LJ, Ima SZ, Wilmoth RO, Schulz TK, Kadlubar S. Leveraging community-based participatory research capacity to recruit Pacific Islanders into a genetics study. J Community Genet 2017; 8:283-291. [PMID: 28689351 DOI: 10.1007/s12687-017-0313-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 06/08/2017] [Indexed: 12/14/2022] Open
Abstract
Pacific Islanders face many health disparities, including higher rates of cardiovascular disease, cancer, obesity, and diabetes compared to other racial and ethnic groups. Specifically, the Marshallese population suffers disproportionately from type 2 diabetes, with rates 400% higher than the general US population. As part of an ongoing community-based participatory research (CBPR) partnership, 148 participants were recruited for a study examining genetic variants to better understand diabetes. Participants provided a saliva specimen in an Oragene® DNA self-collection kit. Each participant provided approximately 2 mL volume of saliva and was asked qualitative questions about their experience. The study yielded a recruitment rate of 95.5%. Among the 148 persons who participated, 143 (96.6%) agreed to be contacted for future studies; 142 (95.9%) agreed to have their samples used for future IRB-approved studies; and 144 (97.3%) gave permission for the researchers to link information from this study to other studies in which they had participated. Qualitative responses showed that the majority of participants were willing to participate because of their desire to contribute to the health of their community and to understand the genetic influence related to diabetes. This study demonstrates willingness to participate in genetic research among Marshallese living in Arkansas. Willingness was likely enhanced because the feasibility study was part of a larger CBPR effort. This study is important to community stakeholders who have voiced a desire to collaboratively conduct genetic research related to diabetes, perinatal outcomes, and cancer.
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Affiliation(s)
- Pearl A McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA.
| | - Marie-Rachelle Narcisse
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Christopher R Long
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Britni L Ayers
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Nia Aitaoto
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Sheldon Riklon
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - L Joseph Su
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Shumona Z Ima
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Ralph O Wilmoth
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Northwest Campus, 1125 N. College Ave, Fayetteville, AR, 72701, USA
| | - Thomas K Schulz
- Department of Internal Medicine Division of Hematology/Oncology, UAMS College of Medicine, Northwest, 1125 N. College Avenue, Fayetteville, AR, USA
| | - Susan Kadlubar
- Division of Medical Genetics, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
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Kim Yeary KHC, Long CR, Bursac Z, McElfish PA. Design of a randomized, controlled, comparative-effectiveness trial testing a Family Model of Diabetes Self-Management Education (DSME) vs. Standard DSME for Marshallese in the United States. Contemp Clin Trials Commun 2017; 6:97-104. [PMID: 29740640 PMCID: PMC5936863 DOI: 10.1016/j.conctc.2017.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a significant public health problem, with U.S. Pacific Islander communities-such as the Marshallese-bearing a disproportionate burden. Using a community-based participatory approach (CBPR) that engages the strong family-based social infrastructure characteristic of Marshallese communities is a promising way to manage T2D. OBJECTIVES Led by a collaborative community-academic partnership, the Family Model of Diabetes Self-Management Education (DSME) aimed to change diabetes management behaviors to improve glycemic control in Marshallese adults with T2D by engaging the entire family. DESIGN To test the Family Model of DSME, a randomized, controlled, comparative effectiveness trial with 240 primary participants was implemented. Half of the primary participants were randomly assigned to the Standard DSME and half were randomly assigned to the Family Model DSME. Both arms received ten hours of content comprised of 6-8 sessions delivered over a 6-8 week period. METHODS The Family Model DSME was a cultural adaptation of DSME, whereby the intervention focused on engaging family support for the primary participant with T2D. The Standard DSME was delivered to the primary participant in a community-based group format. Primary participants and participating family members were assessed at baseline and immediate post-intervention, and will also be assessed at 6 and 12 months. SUMMARY The Family Model of DSME aimed to improve glycemic control in Marshallese with T2D. The utilization of a CBPR approach that involves the local stakeholders and the engagement of the family-based social infrastructure of Marshallese communities increase potential for the intervention's success and sustainability.
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Affiliation(s)
- Karen Hye-cheon Kim Yeary
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, USA
| | - Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Zoran Bursac
- College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
| | - Pearl Anna McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
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Tanaka K, Ohtaki M, Hoshi M. Chromosome aberrations in Japanese fishermen exposed to fallout radiation 420-1200 km distant from the nuclear explosion test site at Bikini Atoll: report 60 years after the incident. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2016; 55:329-337. [PMID: 27017218 DOI: 10.1007/s00411-016-0648-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
During the period from March to May, 1954, the USA conducted six nuclear weapon tests at the "Bravo" detonation sites at the Bikini and Enewetak Atolls, Marshall Islands. At that time, the crew of tuna fishing boats and cargo ships that were operating approximately 150-1200 km away from the test sites were exposed to radioactive fallout. The crew of the fishing boats and those on cargo ships except the "5th Fukuryu-maru" did not undergo any health examinations at the time of the incident. In the present study, chromosome aberrations in peripheral blood lymphocytes were examined in detail by the G-banding method in 17 crew members from 8 fishing boats and 2 from one cargo ship, 60 years after the tests. None of the subjects examined had suffered from cancer. The percentages of both stable-type aberrations such as translocation, inversion and deletion, and unstable-type aberrations such as dicentric and centric ring in the study group were significantly higher (1.4- and 2.3-fold, respectively) than those in nine age-matched controls. In the exposed and control groups, the percentages of stable-type aberrations were 3.35 % and 2.45 %, respectively, and the numbers of dicentric and centric ring chromosomes per 100 cells were 0.35 and 0.15, respectively. Small clones were observed in three members of the exposed group. These results suggest that the crews were exposed to slightly higher levels of fallout than had hitherto been assumed.
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Affiliation(s)
- Kimio Tanaka
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan.
- Institute for Environmental Sciences, Takahoko, Rokkasho, Kakimita, Aomori, 039-3213, Japan.
| | - Megu Ohtaki
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Masaharu Hoshi
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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Measurement of background gamma radiation in the northern Marshall Islands. Proc Natl Acad Sci U S A 2016; 113:6833-8. [PMID: 27274073 DOI: 10.1073/pnas.1605535113] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We report measurements of background gamma radiation levels on six islands in the northern Marshall Islands (Enewetak, Medren, and Runit onEnewetak Atoll; Bikini and Nam on Bikini Atoll; and Rongelap on Rongelap Atoll). Measurable excess radiation could be expected from the decay of (137)Cs produced by the US nuclear testing program there from 1946 to 1958. These recordings are of relevance to safety of human habitation and resettlement. We find low levels of gamma radiation for the settled island of Enewetak [mean = 7.6 millirem/year (mrem/y) = 0.076 millisievert/year (mSv/y)], larger levels of gamma radiation for the island of Rongelap (mean = 19.8 mrem/y = 0.198 mSv/y), and relatively high gamma radiation on the island of Bikini (mean = 184 mrem/y = 1.84 mSv/y). Distributions of gamma radiation levels are provided, and hot spots are discussed. We provide interpolated maps for four islands (Enewetak, Medren, Bikini, and Rongelap), and make comparisons to control measurements performed on the island of Majuro in the southern Marshall Islands, measurements made in Central Park in New York City, and the standard agreed upon by the United States and the Republic of the Marshall Islands (RMI) governments (100 mrem/y = 1 mSv/y). External gamma radiation levels on Bikini Island significantly exceed this standard (P = <<0.01), and external gamma radiation levels on the other islands are below the standard. To determine conclusively whether these islands are safe for habitation, radiation exposure through additional pathways such as food ingestion must be considered.
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McElfish PA, Hallgren E, Yamada S. Effect of US health policies on health care access for Marshallese migrants. Am J Public Health 2015; 105:637-43. [PMID: 25713965 DOI: 10.2105/ajph.2014.302452] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Republic of the Marshall Islands is a sovereign nation previously under the administrative control of the United States. Since 1986, the Compacts of Free Association (COFA) between the Republic of the Marshall Islands and the United States allows Marshall Islands citizens to freely enter, lawfully reside, and work in the United States, and provides the United States exclusive military control of the region. When the COFA was signed, COFA migrants were eligible for Medicaid and other safety net programs. However, these migrants were excluded from benefits as a consequence of the Personal Responsibility and Work Opportunity Reconciliation Act. Currently, COFA migrants have limited access to health care benefits in the United States, which perpetuates health inequalities.
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Affiliation(s)
- Pearl Anna McElfish
- Pearl Anna McElfish is a PhD candidate with the University of Arkansas for Medical Sciences Northwest, Fayetteville. Emily Hallgren is a sociology PhD student at University of Illinois at Chicago. Seiji Yamada is with the Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu
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Website application for calculating cesium-137 ingestion doses from consumption of locally grown foods in the Marshall Islands. J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-2153-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Distribution of cesium-137 in tree crop products collected from residence islands impacted by the U.S. nuclear test program in the northern Marshall Islands. J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-2139-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wang J, Caccamise SAL, Wu L, Woodward LA, Li QX. Spatial distribution of organochlorine contaminants in soil, sediment, and fish in Bikini and Enewetak Atolls of the Marshall Islands, Pacific Ocean. CHEMOSPHERE 2011; 84:1002-1008. [PMID: 21616519 DOI: 10.1016/j.chemosphere.2011.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 03/14/2011] [Accepted: 04/01/2011] [Indexed: 05/30/2023]
Abstract
Several nuclear tests were performed at Enewetak and Bikini Atolls in the Marshall Islands between 1946 and 1958. The events at Bikini Atoll involved several ships that were tested for durability during nuclear explosions, and 24 vessels now rest on the bottom of the Bikini lagoon. Nine soil samples were collected from different areas on the two islands of the atoll, and eighteen sediment, nine fish, and one lobster were collected in the vicinity of the sunken ships. Organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polychlorinated terphenyls (PCTs) in these samples were analyzed using gas chromatography/ion trap mass spectrometry (GC/ITMS). The average recoveries ranged from 78% to 104% for the different PCB congeners. The limits of detection (LOD) for PCBs, PCTs, DDE, DDT, and dieldrin ranged 10-50 pg g(-1). Some fish from Enewetak contained PCBs at a concentration range of 37-137 ng g(-1), dry weight (dw), and most of the soils from Enewetak showed evidence of PCBs (22-392 ng g(-1)dw). Most of the Bikini lagoon sediment samples contained PCBs, and the highest was the one collected from around the Saratoga, an aircraft carrier (1555 ng g(-1)dw). Some of the fish samples, most of the soil samples, and only one of the sediment samples contained 2,2-bis(4-chlorophenyl)-1,1-dichloroethylene (DDE) and PCBs. In addition to PCBs, the soils from Enewetak Atoll contained PCTs. PCTs were not detected in the sediment samples from Bikini Atoll. The results suggest local pollution sources of PCBs, PCTs, and OCPs.
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Affiliation(s)
- Jun Wang
- Department of Molecular Biosciences and Bioengineering, University of Hawaii, Honolulu, HI 96822, USA
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Bouville A, Beck HL, Simon SL. Doses from external irradiation to Marshall Islanders from Bikini and Enewetak nuclear weapons tests. HEALTH PHYSICS 2010; 99:143-156. [PMID: 20622549 DOI: 10.1097/hp.0b013e3181dc521d] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Annual doses from external irradiation resulting from exposure to fallout from the 65 atmospheric nuclear weapons tests conducted in the Marshall Islands at Bikini and Enewetak between 1946 and 1958 have been estimated for the first time for Marshallese living on all inhabited atolls. All tests that deposited fallout on any of the 23 inhabited atolls or separate reef islands have been considered. The methodology used to estimate the radiation doses at the inhabited atolls is based on test- and location-specific radiation survey data, deposition density estimates of 137Cs, and fallout times-of-arrival provided in a companion paper (Beck et al.), combined with information on the radionuclide composition of the fallout at various times after each test. These estimates of doses from external irradiation have been combined with corresponding estimates of doses from internal irradiation, given in a companion paper (Simon et al.), to assess the cancer risks among the Marshallese population (Land et al.) resulting from exposure to radiation from the nuclear weapons tests.
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Affiliation(s)
- André Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Simon SL, Bouville A, Land CE, Beck HL. Radiation doses and cancer risks in the Marshall Islands associated with exposure to radioactive fallout from Bikini and Enewetak nuclear weapons tests: summary. HEALTH PHYSICS 2010; 99:105-23. [PMID: 20622547 PMCID: PMC4042840 DOI: 10.1097/hp.0b013e3181dc523c] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Nuclear weapons testing conducted at Bikini and Enewetak Atolls during 1946-1958 resulted in exposures of the resident population of the present-day Republic of the Marshall Islands to radioactive fallout. This paper summarizes the results of a thorough and systematic reconstruction of radiation doses to that population, by year, age at exposure, and atoll of residence, and the related cancer risks. Detailed methods and results are presented in a series of companion papers in this volume. From our analysis, we concluded that 20 of the 66 nuclear tests conducted in or near the Marshall Islands resulted in measurable fallout deposition on one or more of the inhabited atolls of the Marshall Islands. In this work, we estimated deposition densities (kBq m(-2)) of all important dose-contributing radionuclides at each of the 32 atolls and separate reef islands of the Marshall Islands. Quantitative deposition estimates were made for 63 radionuclides from each test at each atoll. Those estimates along with reported measurements of exposure rates at various times after fallout were used to estimate radiation absorbed doses to the red bone marrow, thyroid gland, stomach wall, and colon wall of atoll residents from both external and internal exposure. Annual doses were estimated for six age groups ranging from newborns to adults. We found that the total deposition of 137Cs, external dose, internal organ doses, and cancer risks followed the same geographic pattern with the large population of the southern atolls receiving the lowest doses. Permanent residents of the southern atolls who were of adult age at the beginning of the testing period received external doses ranging from 5 to 12 mGy on average; the external doses to adults at the mid-latitude atolls ranged from 22 to 59 mGy on average, while the residents of the northern atolls received external doses in the hundreds to over 1,000 mGy. Internal doses varied significantly by age at exposure, location, and organ. Except for internal doses to the thyroid gland, external exposure was generally the major contributor to organ doses, particularly for red bone marrow and stomach wall. Internal doses to the stomach wall and red bone marrow were similar in magnitude, about 1 mGy to 7 mGy for permanent residents of the southern and mid-latitude atolls. However, adult residents of Utrik and Rongelap Island, which are part of the northern atolls, received much higher internal doses because of intakes of short-lived radionuclides leading to doses from 20 mGy to more than 500 mGy to red bone marrow and stomach wall. In general, internal doses to the colon wall were four to ten times greater than those to the red bone marrow and internal doses to the thyroid gland were 20 to 30 times greater than to the red bone marrow. Adult internal thyroid doses for the Utrik community and for the Rongelap Island community were about 760 mGy and 7,600 mGy, respectively. The highest doses were to the thyroid glands of young children exposed on Rongelap at the time of the Castle Bravo test of 1 March 1954 and were about three times higher than for adults. Internal doses from chronic intakes, related to residual activities of long-lived radionuclides in the environment, were, in general, low in comparison with acute exposure resulting from the intakes of radionuclides immediately or soon after the deposition of fallout. The annual doses and the population sizes at each atoll in each year were used to develop estimates of cancer risks for the permanent residents of all atolls that were inhabited during the testing period as well as for the Marshallese population groups that were relocated prior to the testing or after it had begun. About 170 excess cancers (radiation-related cases) are projected to occur among more than 25,000 Marshallese, half of whom were born before 1948. All but about 65 of those cancers are estimated to have already been expressed. The 170 excess cancers are in comparison to about 10,600 cancers that would spontaneously arise, unrelated to radioactive fallout, among the same cohort of Marshallese people.
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Affiliation(s)
- Steven L Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Bethesda, MD 20892, USA.
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Beck HL, Bouville A, Moroz BE, Simon SL. Fallout deposition in the Marshall Islands from Bikini and Enewetak nuclear weapons tests. HEALTH PHYSICS 2010; 99:124-42. [PMID: 20622548 PMCID: PMC2904645 DOI: 10.1097/hp.0b013e3181bbbfbd] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Deposition densities (Bq m(-2)) of all important dose-contributing radionuclides occurring in nuclear weapons testing fallout from tests conducted at Bikini and Enewetak Atolls (1946-1958) have been estimated on a test-specific basis for 32 atolls and separate reef islands of the Marshall Islands. A complete review of various historical and contemporary data, as well as meteorological analysis, was used to make judgments regarding which tests deposited fallout in the Marshall Islands and to estimate fallout deposition density. Our analysis suggested that only 20 of the 66 nuclear tests conducted in or near the Marshall Islands resulted in substantial fallout deposition on any of the 23 inhabited atolls. This analysis was confirmed by the fact that the sum of our estimates of 137Cs deposition from these 20 tests at each atoll is in good agreement with the total 137Cs deposited as estimated from contemporary soil sample analyses. The monitoring data and meteorological analyses were used to quantitatively estimate the deposition density of 63 activation and fission products for each nuclear test, plus the cumulative deposition of 239+240Pu at each atoll. Estimates of the degree of fractionation of fallout from each test at each atoll, as well as of the fallout transit times from the test sites to the atolls were used in this analysis. The estimates of radionuclide deposition density, fractionation, and transit times reported here are the most complete available anywhere and are suitable for estimations of both external and internal dose to representative persons as described in companion papers.
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Affiliation(s)
| | - André Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Brian E. Moroz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Steven L. Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Richards ZT, Beger M, Pinca S, Wallace CC. Bikini Atoll coral biodiversity resilience five decades after nuclear testing. MARINE POLLUTION BULLETIN 2008; 56:503-515. [PMID: 18187160 DOI: 10.1016/j.marpolbul.2007.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 11/20/2007] [Accepted: 11/21/2007] [Indexed: 05/25/2023]
Abstract
Five decades after a series of nuclear tests began, we provide evidence that 70% of the Bikini Atoll zooxanthellate coral assemblage is resilient to large-scale anthropogenic disturbance. Species composition in 2002 was assessed and compared to that seen prior to nuclear testing. A total of 183 scleractinian coral species was recorded, compared to 126 species recorded in the previous study (excluding synonomies, 148 including synonomies). We found that 42 coral species may be locally extinct at Bikini. Fourteen of these losses may be pseudo-losses due to inconsistent taxonomy between the two studies or insufficient sampling in the second study, however 28 species appear to represent genuine losses. Of these losses, 16 species are obligate lagoonal specialists and 12 have wider habitat compatibility. Twelve species are recorded from Bikini for the first time. We suggest the highly diverse Rongelap Atoll to the east of Bikini may have contributed larval propagules to facilitate the partial resilience of coral biodiversity in the absence of additional anthropogenic threats.
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Affiliation(s)
- Zoe T Richards
- Museum of Tropical Queensland, Flinders St, Townsville, QLD 4810, Australia.
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Distribution of 137Cs activities in clams, Tivela mactroidea collected along the northern coast of Venezuela and the island of Margarita. J Radioanal Nucl Chem 2007. [DOI: 10.1007/s10967-007-6844-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Robison WL, Conrado CL, Bogen KT, Stoker AC. The effective and environmental half-life of 137Cs at Coral Islands at the former US nuclear test site. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2003; 69:207-223. [PMID: 12832159 DOI: 10.1016/s0265-931x(03)00080-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The United States (US) conducted nuclear weapons testing from 1946 to 1958 at Bikini and Enewetak Atolls in the northern Marshall Islands. Based on previous detailed dose assessments for Bikini, Enewetak, Rongelap, and Utirik Atolls over a period of 28 years, cesium-137 (137Cs) at Bikini Atoll contributes about 85-89% of the total estimated dose through the terrestrial food chain as a result of uptake of 137Cs by food crops. The estimated integral 30, 50, and 70-year doses were based on the radiological decay of 137Cs (30-year half-life) and other radionuclides. However, there is a continuing inventory of 137Cs and 90Sr in the fresh water portion of the groundwater at all contaminated atolls even though the turnover rate of the fresh groundwater is about 5 years. This is evidence that a portion of the soluble fraction of 137Cs and 90Sr inventory in the soil is lost by transport to groundwater when rainfall is heavy enough to cause recharge of the lens, resulting in loss of 137Cs from the soil column and root zone of the plants. This loss is in addition to that caused by radioactive decay. The effective rate of loss was determined by two methods: (1) indirectly, from time-dependent studies of the 137Cs concentration in leaves of Pisonia grandis, Guettarda specosia, Tournefortia argentea (also called Messerschmidia), Scaevola taccada, and fruit from Pandanus and coconut trees (Cocos nucifera L.), and (2) more directly, by evaluating the 137Cs/90Sr ratios at Bikini Atoll. The mean (and its lower and upper 95% confidence limits) for effective half-life and for environmental-loss half-life (ELH) based on all the trees studied on Rongelap, Bikini, and Enewetak Atolls are 8.5 years (8.0 years, 9.8 years), and 12 years (11 years, 15 years), respectively. The ELH based on the 137Cs/90Sr ratios in soil in 1987 relative to the 137Cs/90Sr ratios at the time of deposition in 1954 is less than 17 years. The magnitude of the decrease below 17 years depends on the ELH for 90Sr that is currently unknown, but some loss of 90Sr does occur along with 137Cs. If the 15-year upper 95% confidence limit on ELH (corresponding to an effective half-life of 9.8 years) is incorporated into dose calculations projected over periods of 30, 50, or 70 years, then corresponding integral doses are 58, 46 and 41%, respectively, of those previously calculated based solely on radiological decay of 137Cs.
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Affiliation(s)
- William L Robison
- Lawrence Livermore National Laboratory, 7000 East Avenue, L-286, Livermore, CA 94550-9234, USA.
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Muramatsu Y, Hamilton T, Uchida S, Tagami K, Yoshida S, Robison W. Measurement of 240Pu/239Pu isotopic ratios in soils from the Marshall Islands using ICP-MS. THE SCIENCE OF THE TOTAL ENVIRONMENT 2001; 278:151-159. [PMID: 11669263 DOI: 10.1016/s0048-9697(01)00644-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Nuclear weapons tests conducted by the United States in the Marshall Islands produced significant quantities of regional or tropospheric fallout contamination. Here we report on some preliminary inductively coupled plasma-mass spectrometry (ICP-MS) measurements of plutonium isolated from seven composite soil samples collected from Bikini, Enewetak and Rongelap Atolls in the northern Marshall Islands. These data show that 240Pu/239Pu isotopic signatures in surface soils from the Marshall Island vary significantly and could potentially be used to help quantify the range and extent of fallout deposition (and associated impacts) from specific weapons tests. 137Cs and 60Co were also determined on the same set of soil samples for comparative purposes.
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Affiliation(s)
- Y Muramatsu
- Environmental and Toxicological Researches Group, National Institute of Radiological Sciences, Chiba, Japan.
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