[An epidemiological survey on clinical features, self-management and cognitive level of elderly asthmatics in China].

Objective: To investigate the prevalence of asthma among the elderly people in China and to analyze the clinical features, self-management and cognitive level of elderly asthma patients. Methods: According to the multi-stage random cluster sampling methods, a total of 164 215 subjects were visited by a questionnaire in the last epidemiology survey from eight provinces (Beijing, Shanghai, Guangdong, Liaoning, Henan, Shanxi, Jiangsu, Sichuan provinces) and seven regions (north, northeast, southern china, east, south, southwest and northwest) in China from February 2010 to August 2012. 2 034 were diagnosed as asthma. The elderly patients aged ≥65 years were selected from the 2 034 asthma patients. The clinical characteristics, comorbidities, the status of asthma control and self-management and insights of the disease in elderly asthma patients were analyzed. Results: Among the 2 034 asthma patients, 584 (28.7%) were elderly asthmatics aged ≥65 years old and 1 450 (71.3%) were<65 years old. In the elderly asthma group, Early-onset asthma accounted for 439 (75.2%) and 145 (24.8%) were late-onset. The common clinical manifestations of elderly asthma patients were: chest distress 395 (67.6%), wheezing 304 (52.1%), cough 298 (51.0%). Common comorbidities of elderly asthmatics were: chronic obstructive pulmonary disease 144 (24.7%), allergic rhinitis 122(20.9%), gastroesopheal reflux disease (GERD) 114(19.5%), allergic conjunctivitis 86 (14.7%), eczema 82 (14.0%), chronic bronchitis 76 (13.0%). The Asthma Control Test (ACT) scores of elderly asthmatics and non-elderly asthmatics were (18.5±3.2) and (21.7±3.4) respectively. There was a significant difference between the two groups (P=0.042). Of the elderly asthmatics, only 13 (2.2%) patients monitored daily using a peak flow meter. 93 (15.9%) patients aware that asthma was characterized by chronic airway inflammation. 64 (11.0%) asthmatics understood that the treatment goal. Conclusions: The clinical manifestations of elderly asthmatics are atypical, especially paroxysmal wheezing. Asthma in elderly people causes more comorbidities and mortality. The self-management and cognitive level of patients with asthma needs to be improved.

137Cs exposure in the Marshallese populations: an assessment based on whole-body counting measurements (1989-1994).

The Marshall Islands were the site of numerous tests of nuclear weapons by the United States. From 1946 to 1958, nuclear devices were detonated at Enewetak and Bikini Atolls. Following the inadvertent contamination of the northern islands downwind of the 1954 Bravo Test, Brookhaven National Laboratory became involved in the medical care and the radiological safety of the affected populations. One important technique employed in assessing the internally deposited radionuclides is whole-body counting. To estimate current and future exposures to 137Cs, data from 1989 to 1994 were analyzed and are reported in this paper. During this period, 3,618 measurements were made for the Marshallese. The cesium body contents were assumed to result from a series of chronic intakes. Also, it was assumed that cesium activity in the body reaches a plateau that is maintained over 365 d. We estimated the annual effective dose rate for each population, derived from the recommendations of the International Commission on Radiological Protection. The average 137Cs uptake measured by the whole-body counting method varies from one population to another; it was consistent with measurements of external exposure rate. The analysis, though based on limited data, indicates that there is no statistical support for a seasonal effect on 137Cs uptake. The critical population group for cesium uptake is adult males. Within the 5-y monitoring period, all internal exposures to 137Cs were less than 0.2 mSv y(-1). Similarly, a persistent average cesium effective dose rate of 2 microSv y(-1) was determined for Majuro residents.

Assessment of plutonium exposure in the Enewetak population by urinalysis.

Since 1980, the inhabitants of Enewetak Atoll have been monitored periodically by scientists from Brookhaven National Laboratory for internally deposited radioactive material. In 1989, the establishment of fission track analysis and of a protocol for shipboard collection of 24-h urine samples significantly improved our ability to assess the internal uptake of plutonium. The purpose of this report is to show the distribution of plutonium concentrations in urine collected in 1989 and 1991, and to assess the associated committed effective doses for the Enewetak population based on a long-term chronic uptake of low-level plutonium. To estimate dose, we derived the plutonium dose-per-unit-uptake coefficients based on the dosimetric system of the International Commission on Radiological Protection. Assuming a continuous uptake, an integrated Jones's plutonium urine excretion function was developed to interpret the Enewetak urine data. The Appendix shows how these values were derived. The committed effective doses were 0.2 mSv, calculated from the 1991 average plutonium content in 69 urine samples.

Assessment of plutonium exposures in Rongelap and Utirik populations by fission track analysis of urine.

A nuclear device, code-named Bravo, detonated at Bikini Atoll at 6:45 a.m. on 1 March 1954, unexpectedly released a large amount of radioactivity. Over 40 years after this incident, the study of its impact on the radiological health and environmental safety of the residents of Rongelap and Utirik Atolls continues. In 1987, researchers at Brookhaven National Laboratory established a fission track analysis (FTA) method for low-level 239Pu urinalysis. Two years later, a new shipboard protocol was developed for collecting 24-h radiologically clean urine samples. The purpose of this paper is to update information on the FTA method for measuring low-levels of plutonium, and to summarize results on the distribution of 239Pu in the populations of Rongelap and Utirik between 1981-1991. Plutonium detection levels (99% confidence level) in these samples were 2-3 microBq, which is equivalent to 0.2-0.3 mSv effective dose equivalent (EDE) to age 70 for Marshallese. The latest 1991 FTA data indicate average EDE of 0.62 mSv and 1.6 mSv for the people of Rongelap and Utirik, respectively, which both are the highest values since 1988.