Common Radiation Injuries and How to Avoid Them
Like fire, radiation is a useful tool that needs to be respected. But what happens when it's not respected? Or what happens when it's used as a weapon? Aside from the panic and chaos, we see many different radiation injuries when either of these events occurs.
But just what do these injuries look like? How do you know if you have one? Let's see if we can answer these questions and more below.
TABLE OF CONTENTS
Whole-Body Exposure Radiation Injuries
Localized Exposure Radiation Injuries
How Can You Prepare for the Chance of Radiation Injuries?
Frequently Asked Questions
Whole-Body Exposure Radiation Injuries
Without a doubt, the worst types of radiation injuries are those that are caused by whole-body exposures. Why? Because they'll kill you. This comes in the form of severe acute radiation sickness, aka radiation poisoning. Of course, for radiation poisoning to occur, your entire body must absorb too much radiation.
And just how this acute radiation sickness plays out can take several forms…
Acute Radiation Sickness
Often referred to as ARS, acute radiation sickness happens when somebody has absorbed too much radiation in too short a period. This could occur by exposure to radioactive fallout, spending time around "leaky" radioactive machinery, or the like.
All forms of ionizing radiation can cause ARS, provided the dosage received is large enough. While gamma and neutron radiation can cause ARS by penetrating the skin, alpha, and beta radiation are typically responsible for causing ARS via inhalation or ingestion (albeit, they too can cause ARS by sitting on the skin for too long).
In the event of a nuclear explosion, medical facilities would quickly become overwhelmed (or destroyed). During "normal" times, hospitals regularly use chromosome aberration dosimetry, a form of "bio-dosimeter," to estimate how much radiation a person has absorbed. If a nuclear war a la Jericho is raging, these facilities with this technology and trained personnel are unlikely to be available.
(Image courtesy of The Castle Romeo detonation, 1954. An 11 Mt yield bomb. )
When this is the case, some rough guidelines can help to judge how much radiation a person has absorbed. And the key to this "rule of thumb" is to estimate the time till the victim vomits.
A NOTE OF INTEREST
Do you know how America uses feet and pounds while the rest of the world uses the metric system? Things are similar when it comes to the units used to measure radiation. While the United States uses the rad to measure radiation doses, the rest of the world uses the gray (Gy).
1 Gy = 100 rad
Let's say that there was a nearby nuclear explosion that brought radioactive fallout to your area. People are running for shelter, and you know that the detonation occurred at exactly 8:00 AM because that's when you heard it. You run to your shelter, and your neighbors follow quite a bit later, coated in dust that fell from the sky. They've both been frozen in indecision and panic for the past few hours, staring at the mushroom cloud and the horizon.
(Image courtesy of Your 1960 fallout shelter.)
If they begin vomiting:
2-3 hours after exposure, they've absorbed 1-2 Gy of radiation
1-2 hours after exposure, they've absorbed 3-4 Gy of radiation
Within one hour after exposure, they've absorbed more than 4 Gy of radiation.
If nobody is vomiting, they probably absorbed less than 1 Gy of radiation.
If somebody absorbs more than 3.5 Gy of radiation, there is a 50-50 chance of dying within the next two months, especially if they can't get professional medical help.In any case, where vomiting is involved, you are likely looking at a case of acute radiation sickness. While you probably won't have the specific amount of grays of radiation the person absorbed memorized based on how soon they threw up post-exposure, just remember that the sooner you vomit, the more radiation you absorbed.
It is worth noting that a nuclear event is an incredibly stressful and anxiety-ridden event. In the aftermath of the Hawaiian ICBM alert, there were numerous stories of Hawaiians saying their final goodbyes to loved ones. The same will take place on a larger scale after a nuclear detonation. Because of this, you have to be careful about determining if the presence of vomit isn't just a manifestation caused by the anxieties and fears of those who are seeking shelter or medical care.
The alert that Hawaiians received on their phones in 2018.
There's a reason that scientific studies have to factor in the placebo effect, and it's not entirely unheard of for somebody to throw up when they are incredibly nervous. However, suppose you also note an increasing body temperature (which means you would need a thermometer) and an increased frequency of vomiting. In that case, this is a sure sign that you are witnessing a case of ARS and not simply a panic attack.
The Three Types of ARS
Three types of acute radiation sickness are seen in sick individuals: hematopoietic, GI, and cerebrovascular. Each of these is incredibly serious and deserves to be treated as such.
People who absorb too much radiation (20-40 Gy) are guaranteed to die within hours (48 max) and will exhibit signs and symptoms of cerebrovascular syndrome within ARS. Nausea, vomiting, delirium, bloody diarrhea, tremors, and shock will all be present until the person passes away.
This starts within one hour of being exposed to 6+ Gy of radiation. This can come from either ingesting radioactive particles (Russian assassinations have utilized this method) or exposure of the stomach region to too much radiation.
The signs and symptoms typically resolve for two days after the prodromal stage, after which they return with a vengeance. During this latent stage, all of the linings inside the GI tract will have died and passed through the body via pooping without being replaced. No more protective linings mean the patient is at an incredibly high risk of serious infections. Severe dehydration accompanies this type of ARS, and the patient has a 50-50 chance of living without professional medical help. And even with that level of care, things are still grim. Deaths with GI syndrome are common.
After exposure to 1-6 Gy of radiation, they will likely develop hematopoietic syndrome within the next 1-6 hours. This person will feel terrible for the first day or two after exposure. The stock ARS signs and symptoms will be there but will all disappear after the prodromal days. Then, for about a week, the person will feel just fine.
They won't realize that their blood cells are dying off and not being replaced. Seven days after exposure, they'll come to terms with this as the full effects of hematopoietic syndrome will kick in. The patient will feel terrible, get infections, have difficulty breathing upon exertion, and have uncontrollable bleeding.
If they live, their body will have produced new blood in about 4-5 weeks, but they'll still feel weak, lethargic, and "not themselves" for the next several months. And then, after that, they'll have an increased cancer risk.
The Three Stages of ARS
All forms of ARS have three specific and distinct stages: prodrome, latent, and syndrome-specific signs and symptoms.
The prodrome stage is the initial signs of illness exhibited immediately after radiation exposure. How soon the prodrome stage manifests is a marker of how much radiation was absorbed, and how long the prodrome stage lasts is very much determined by how much was absorbed as well.
With relatively lower doses of radiation absorbed, the prodrome stage will give way to the latent stage. During this time, virtually all signs and symptoms disappear, and the patient begins to think they are fine. Maybe it was just their nerves or something they ate that had them vomiting so much, they hoped. But what's really happening is that the body is gearing up for the next wave.
During the latent phase, whatever the radiation killed in the body (typically fast-multiplying cells such as the lining of the digestive tract or blood cells) dies. After enough of those cells have been killed to cause a feelable outcome, ARS enters the next stage: syndrome-specific signs and symptoms.
It's here that the outcomes listed in the various syndromes discussed above will take place.
A NOTE OF INTEREST
In July 2022, New York City randomly released the first nuclear public service announcement, detailing what New Yorkers should do in the event of a nuclear attack in decades.
Localized Exposure Radiation Injuries
Not every radiation injury is a whole-body exposure. Many are just relegated to a small portion of the body. The X-ray technician working with a "leaky" piece of equipment can quickly end up with a localized exposure to his hand and fingers that won't cause the same problems as a whole body exposure but still can cause significant damage and pain.
And when this happens, we call it a cutaneous radiation injury.
(Image courtesy of Otis Historical Archives at Wikimedia Commons. )
Cutaneous Radiation Injury (CRI)
Virtually all localized radiation injuries are cutaneous radiation injuries. Other radiation injuries, such as fluoroscopy-induced chronic radiation dermatitis, affect the skin. Still, the argument could be made that this is a debate over semantics, and we are predominantly interested in radiation injuries following some type of nuclear explosion or radiological release.
All cutaneous radiation injuries are caused by skin radiation exposure - when radiation damages the skin and tissues underneath it. Typically, CRI accompanies ARS though having one without the other is possible. For example, somebody who wore the same tennis shoes inside a shelter for several hours that they also used to walk through radioactive fallout could get a CRI on their feet. Still, they would have minimal whole-body exposure if they washed off well enough and sought shelter fast enough.
Most of the time, somebody gets a cutaneous radiation injury because they were exposed to beta radiation or low-energy X-rays. Gamma radiation is typically associated with ARS instead.
In "normal" life, people with a CRI have been around some type of "leaky" radiological equipment or have not been following proper safety protocols around this equipment.
Like ARS, there are three distinct phases of a CRI: the prodromal stage, the latent stage, the manifest illness stage, and the third wave.
The Prodromal Stage of a CRI
This happens almost immediately after exposure. A few hours after exposure to the radiation source, they will experience itching, tingling, swelling, and skin redness. This will typically last for 1-2 days.
Radiation burns caused by fluoroscopy (Image courtesy of LK Wagner, PhD a Wikimedia Commons. )
The Latent Stage of a CRI
Radiation has a funny way of harming people. Just like with ARS, a cutaneous radiation injury also seemingly abates, leaving the victim to believe they are okay. This latent phase can last anywhere from a few days to several weeks.
The Manifest Illness Stage of a CRI
There is no denying that there has been a radiation injury at this point. The latent phase disappears and becomes nothing more than a memory. The skin will turn red, blisters will develop, and intense pain can accompany them. The impacted area will swell, and the skin will be warm to the touch.
The only thing that a doctor can do at this point is to help the patient manage their pain and do what he can to prevent an infection from spreading throughout the impacted area.
Radiation burns caused by fluoroscopy (Image courtesy of Otis Historical Archives National Museum of Health and Medicine at Wikimedia Commons. )
The Third Wave of a CRI
Depending on the amount of radiation absorbed, it's common for a CRI to be accompanied by a third wave 10-16 weeks later, if not several others as well. After the manifest illness stage has subsided, the patient will once more enter a latent stage. Then, weeks to years later, the signs and symptoms of the CRI can reappear in the area once more.
Usually, a CRI will heal of its own accord, but it is possible for there to be permanent hair loss, fibrosis, changes in skin color, or even tissue death around the affected area. Increased risk of cancer can also result.
An early radiologist’s hands.
How Do I Know the Severity of a CRI Without a Doctor?
Obviously, judging any kind of medical condition – especially something as severe as a radiation injury – without a doctor is something of a guesstimate. However, if there is some type of nuclear explosion, there's a good chance that you won't be able to find a doctor, and if you do, they'll be overloaded with patients.
The aftermath of Hiroshima.
Knowing this, it's a good idea to have a general guideline that one can use to give a reasonable guess as to how severe their CRI is if they find themselves in an austere environment. While ARS uses vomiting as its bench marker, a CRI uses something else: skin redness.
If you note redness of the skin:
12-24 hours post-exposure, they probably absorbed 8-15 Gy of radiation.
8-15 hours post-exposure, they probably absorbed 15-30 Gy of radiation
3-6 hours post-exposure, they probably absorbed more than 30 Gy of radiation
The sooner the redness, the more radiation was absorbed.
It's important to note that localized exposure differs significantly from whole-body exposure. If your whole body is exposed to 20 Gy of radiation, there's an excellent chance you'll die. If your feet are exposed to 20 Gy of radiation, that's a different story. You're still not going to have a fun time, but this isn't nearly as dangerous of a situation as if your significant organs were affected.
Doctors use a graded scale to determine how bad a CRI is. The higher your number on the scale, the worse off you are, with the scale being ranked from a 1 to a 4. They appear as the following:
|GRADE*||PRODROMAL||LATENT STAGE||MANIFEST ILLNESS||THIRD WAVE|
|1||1-2 days||2-5 weeks||2-5 weeks||None|
|2||6-24 hours||1-3 weeks||1-6 weeks||10-16 weeks|
|3||4-24 hours||0-2 weeks||1-2 weeks||10-16 weeks|
|4||Immediate damage-||None||1-4 days||Tissue death|
*All information is from the CDC
A NOTE OF INTEREST
In January 2023, the World Health Organization suddenly decided it was time to update the list of medications nations should stockpile to treat people before and after a radiological or nuclear emergency. Stable iodine, Prussian blue, cytokines, and antidiarrheals were some medications.
How Can You Prepare for the Chance of Radiation Injuries?
Thankfully, there are a couple of things that you can do to drastically minimize your risk of developing a radiation injury. Here are a few steps to consider.
Know what proper shelter looks like and seek it fast.
As nuclear war scientist Cresson Kearny pointed out in his seminal work Nuclear War Survival Skills (written based on his findings while working at the Oak Ridge National Laboratory for the US government), your most pressing concern when radiation is present is to find suitable shelter fast.
To do this, however, you must know what a suitable shelter looks like. Most residential buildings within the United States offer little-to-no protection against radioactive fallout. If you don't want to absorb massive amounts of radiation as you hide in your living room, you will need to know where it is safe to shelter and where it is not.
A fallout shelter (Image courtesy of NAC at Wikimedia Commons)
Carry a dosimeter.
One of the problems with radiation is that you can't see, hear, or smell it. You're simply in it; people often only recognize this once it's too late. This is one of the reasons that it is so vital to make sure that you can detect radiation if it's around you.
This is where the MIRA Safety Geiger-2 Portable Dosimeter/Geiger Counter comes into play. Roughly the size of a ballpoint pen (though slightly thicker), this personal dosimeter/Geiger counter will alert you when standing in areas with dangerously high levels of ionizing radiation.
Weighing next to nothing, this makes for an incredibly convenient means of always keeping this knowledge right at your fingertips should you be forced to shelter in place at work. Nuclear events don't wait till you're at home with all your preps.
Have some means of monitoring current events.
While nuclear explosions also involve electromagnetic pulses, there's no guarantee that every electronic you own will be fried post-blast. Fallout can travel in the wind, and you don't necessarily have to be within EMP range of a ground detonation to still fall victim to radioactive fallout.
It's also important to know that radiologic weapons exist that don't require a massive detonation that would be heard by all in the vicinity. This is why it is wise to ensure you have some degree of knowledge about what is happening in the world around you. Whether it's an app, social media, or the radio, having some way to know there was some type of attack on the town two hours' drive west of you is a crucial part of finding suitable shelter in time.
Stock preventative treatment
As the World Health Organization has suddenly recommended, potassium iodide protects your thyroid from absorbing dangerously high levels of ionizing radiation. At MIRA Safety, our Thyrosafe can help you in that regard.
This FDA-approved potassium iodide will flush your thyroid with non-radioactive iodine in the event of a nuclear emergency so that radioactive iodine won't be able to bind there instead. Cresson Kearny highly recommended that Americans keep a small supply of potassium iodide tablets on hand, and we do as well.
We do recommend buying Thyrosafe while you still can. There have been several runs on supplies of late that have caused drastic shortages of potassium iodide on the market.
A recent, and more cost-effective alternative to the Thyrosafe is the MIRA Safety Potassium Iodide Tablets. This is effectively the same supplement but offered in a greater quantity–for a few dollars less.
Take contaminated clothes off and rinse off ASAP post-blast.
There's a good chance you could end up with radioactive fallout on your clothes, skin, and hair after a nuclear blast. If left there, this radiation source can cause severe illness or death. This is why after you find suitable shelter, you do what you can to get as much of that radioactive dust off of you as possible. The sooner you can do this, the less radiation you will absorb.
It may be a good idea to keep a few changes of clothes wherever you intend to shelter.
The Upshot-Knothole Grable Atomic Bomb. 1953.
A NOTE OF INTEREST
"Once the Third World War breaks out, unfortunately, it will not be on tanks or even on fighter jets. Then everything will definitely be turned to dust." – Russian Security Council Deputy Chairman Dmitry Medvedev, January 2023
Keep a gas mask at the ready.
If you're maneuvering through a heavy fallout area, you will want to protect your lungs - perhaps to move to a new shelter. Alpha and beta radiation will kill you if they find a passageway into your lungs, and this is where having a high-quality gas mask and appropriate filter is a must.
Consider the detonation of a dirty bomb. If you do not have the proper protection, things will be grim. The air will be full of radiation, and you must actively protect yourself. We highly recommend keeping a high-quality gas mask on hand for each family member. Combining the MIRA Safety CM-6M gas mask with an NBC-77 filter will do a fantastic job of keeping your lungs safe from inhaled radioactive threats.
The Final Wave
People like to avoid learning anything about radiation injuries and nuclear bombs because they often feel that to attempt to learn something here would be to succumb to fear-mongering. This is absurd, and being mentally aware that something terrible could happen does not make one a Chicken Little. People carry pistols every day. Is that fear-mongering? Is purchasing health insurance, putting a fire extinguisher in your kitchen, or locking your doors at night?
By no means.
In the same vein, knowing about nuclear preparedness is nothing more than taking intelligent steps to ensure that you are prepared and know what to do should there be some type of nuclear attack or emergency in the future. It only takes a minimal investment, but the dividends that it pays out are enormous.
So check out what MIRA Safety has to offer. We are positive you'll find the gear you want to help keep your family safe.
Frequently Asked Questions
Conventional injuries are always treated before radiological injuries, as one will die from blood loss in seconds while dying from radiation can take months to years. Because of this, burns, lacerations, crushing injuries, and the like are always treated before a radiological injury. After a nuclear event, both types of injuries will be expected, and many people will have both conventional and radiation injuries. For example, over 50% of those killed at Hiroshima were found to have died explicitly due to burns. Several others didn't die at Hiroshima, yet were nearby and burned.
After triage has placed the conventional injuries aside, radiation injuries are typically further divided into three groups: those with whole-body exposures, those with local vulnerabilities, and those contaminated with radionuclides.
If it's a nuclear bomb we're talking about, local exposures will be minimal. The whole body exposure and those who have inhaled radioactive fallout or are covered with it will be the primary sole radiation injuries.
The people near Chernobyl didn't think they needed to prepare either. Nor did the people of Sweden, who first detected and alerted the world that dangerously high radiation levels were in the area.
What about those in Goiania, Brazil, in September 1987? There were 249 cases of radioactive contamination there simply after somebody removed the protective housing from an abandoned teletherapy machine. Do any of the doctors in your vicinity use that type of equipment?
What about 1989 San Salvador, where an industrial sterilization facility had an accident with radioactive cobalt? Three cases of ARS resulted, one of which was a death.
What about Fukushima, Japan? What about Three Mile Island? What about the constant threats of being nuked by North Korea, Iran, Russia, or China?
Being prepared for a nuclear accident or explosion isn't preparing for a far-off possibility. It's preparing for something we have already seen happen.
Gamma radiation is the winner here. This type of radiation is most likely to cause genetic damage. Some would argue that neutron radiation is even more dangerous because it can make other things radioactive, but it's so rare that we'll say that gamma radiation is the winner.
The least damaging type of ionizing radiation is alpha radiation. This type of radiation can be stopped with a barrier of the skin. Of course, if left on the skin for an extended period, this can still result in radiation burns and illnesses. Just because alpha radiation is the least damaging of them, it doesn't mean that it's not dangerous. It's still ionizing radiation.
Radiation injuries are the most severe in body parts, where cells reproduce quickly. Muscles and nerves don't exhibit rapid cell reproduction, so they are the parts of the body most resilient to radiation.
As far as organs, however, the brain is considered relatively insensitive to radiation compared to other organs in the body. Does this mean that high levels of radiation won't harm your brain?
It simply means that other organs are likely to show damage first.
As discussed above, greater cell reproduction rates mean radiation has a greater chance of causing harm. The skin, GI tract, and bone marrow are three body parts with extremely fast cell reproduction, meaning all these areas are especially susceptible to radiation injuries.
If somebody is covered in radioactive fallout, the radiation will stay on their body until they wash it off. They will still likely bear the effects of that radiation, but they won't have radiation on their body.
The same principle applies to being hit with gamma or X-ray radiation. Once it hits you, it's gone. It's not in your body; it's already done its damage and gone away.
If you inhale or ingest radiation, you will end up with it in your body until it has decayed. This time will depend on the half-life of whatever type of radioactive substance is in your body. Some treatments help to minimize this time (such as Prussian blue), but outside of those treatments, you're looking at half-life as the main factor.
A radiation oncologist is likely the doctor most suited to treating radiation injuries, as they are apt to be the ones that have come into the most contact with these types of injuries in their daily practice.
However, after a large-scale nuclear disaster, you probably won't be able to be too particular with the healthcare you receive. American doctors are generally capable of treating a wide range of conditions.
Burns, blunt-force trauma, lacerations, crushing injuries, and blast injuries would likely be present. The burns would come from the heat of the blast, blunt force trauma would come from getting creamed with high-velocity projectiles, lacerations would mainly come from flying glass, crushing injuries would occur when people became trapped under rubble, and blast injuries would come as a direct result of the shockwave from the explosion.
One commonly known interesting tidbit about radiation is that bananas are radioactive. This is caused by a tiny amount of radioactive potassium called K-40. Each banana emits about one microsievert of radiation as a result.
Sitting down at one meal and consuming 10 million bananas at once could kill you from the amount of radiation in your body. Of course, eating 10 million of anything at once would likely kill you for reasons other than radiation poisoning.
This depends on the dose absorbed and over what period it was absorbed. We'll assume you want to know about whole-body exposures. The time to death can be hours to weeks if we don't consider cancer a direct "radiation death." If we do consider cancer to be a radiation death, then it can potentially take years until it kills you.
Generally, vomiting is the chief sign. Nausea, weakness, tremors, shock, and delirium are also possible.