Definition

What is radiation sickness?

Radiation sickness describes the harmful effects–acute, delayed, or chronic–produced by exposure to ionizing radiation. An observable effect due to radiation exposure becomes quite certain after a single dose of several hundred rads. As a rule, large doses of radiation are of concern because of their immediate effects on the body (somatic), while low doses are of concern because of the potential for possible late somatic and long-term genetic effects. The effects of radiation exposure on an individual are cumulative.

How common is radiation sickness?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of radiation sickness?

The common symptoms of acute radiation sickness are:

With mild acute radiation sickness, the discomfort subsides within a few hours or days. However, there are three different types of severe acute radiation sickness, which can develop as a result of high doses (e.g., an atomic explosion) to small doses (e.g., repeated x-rays over a period of days or weeks):

The type of severe acute radiation sickness depends on dose, dose rate, affected area of the body, and the period of time elapsing after exposure. The severe acute radiation sickness is due to penetrating radiation to most or all of the body in a short period of time, usually a few minutes. A patient with any type of severe acute radiation sickness usually goes through three stages: In the prodromal stage, the classic symptoms are nausea, diarrhea and vomiting. This stage can last for a few minutes up to a few days. In the next stage, called the latent stage, a patient seems to improve to the point where they are generally healthy for a few hours or even a few weeks. The last stage, called the overt or manifest illness stage is specific to each type. They are cardiovascular/central nervous system sickness, gastrointestinal sickness, and hematopoietic sickness.

Cardiovascular/central nervous system sickness is the type of acute radiation sickness produced by extremely high total body doses of radiation (greater than 3000 rads). This type is the most severe and is always fatal. In addition to nausea and vomiting in the prodromal stage, patients with cerebral syndrome will also experience anxiety, confusion, and loss of consciousness within a few hours, the latent period will occur. 5 or 6 hours after the initial radiation exposure, tremors, and convulsions will begin, and eventually coma and death are inevitable within 3 days.

Gastrointestinal sickness is the type of acute radiation sickness that can occur when the total dose of radiation is lower but still high (400 or more rads). It is characterized by intractable nausea, vomiting, imbalance of electrolytes, and diarrhea that lead to severe dehydration, diminished plasma volume, vascular collapse, infection and life-threatening complications.

Hematopoietic sickness (bone marrow sickness)is the type of acute radiation sickness occurs at exposure of between 200 to 1000 rads. Initially it is characterized by lack of appetite (anorexia), fever, malaise, nausea and vomiting, which may be maximal within 6 to 12 hours after exposure. Symptoms then subside so that within 24 to 36 hours after exposure. During the latent period for this type, the lymph nodes, spleen and bone marrow begin to atrophy, leading to underproduction of all types of blood cells (pancytopenia). In the peripheral blood, lack of lymph cells (lymphopenia) commences immediately, reaching a peak within 24 to 36 hours. Lack of neutrophils, a type of white blood cell, develops more slowly. Lack of blood platelets (thrombocytopenia) may become prominent within 3 or 4 weeks. Increased susceptibility to infection develops due to a decrease in granulocytes and lymphocytes, impairment of antibody production and granulocyte migration, decreased ability to attack and kill bacteria, diminished resistance to diffusion in subcutaneous tissues, and bleeding (hemorrhagic) areas of the skin and bowel that encourage entrance and growth of bacteria. Hemorrhage occurs mainly due to the lack of blood platelets.

Delayed effects of radiation can lead to intermediate effects and late somatic and genetic effects. Intermediate effects from prolonged or repeated exposure to low radiation doses from a variety of sources may produce absence of menstruation (amenorrhea), decreased fertility in both sexes, decreased libido in the female, anemia, decreased white blood cells (leukopenia), decreased blood platelets (thrombocytopenia), skin redness (erythema), and cataracts. More severe or highly localized exposure causes loss of hair, skin atrophy and ulceration, thickening of the skin (keratosis), and vascular changes in the skin (telangiectasia). Ultimately it may cause a type of skin cancer called squamous cell carcinoma.

Kidney function changes include a decrease in renal plasma flow, glomerular filtration rate (GFR), and tubular function. Following a latent period of six months to one year after extremely high does of radiation, protein in the urine, kidney insufficiency, anemia and high blood pressure may develop. When cumulative kidney exposure is greater than 2000 rads in less than 5 weeks, kidney failure with diminished urine output may occur in about 37% of cases.

Large accumulated doses of radiation to muscles may result in painful myopathy with atrophy and calcification.

Inflammation of the sac around the heart (pericarditis) and of the heart muscle (myocarditis) have been produced by extensive radiotherapy of the middle region between the lungs (mediastinum).

Myelopathy may develop after a segment of the spinal cord has received cumulative doses of greater than 4000 rads. Following vigorous therapy of abdominal lymph nodes for seminoma, lymphoma, ovarian carcinoma, or chronic ulceration, fibrosis and perforation of the bowel may develop.

Late somatic and genetic effects of radiation can alter the genes in proliferating cells of the body and germ cells. With body cells this may be manifested ultimately as somatic disease such as cancer (leukemia, thyroid, skin, bone), or cataracts. Another type of cancer, osteosarcoma, may appear yeacute radiation sickness after swallowing radioactive bone-seeking nuclides such as radium salts. Injury to exposed organs may occur occasionally after extensive radiation therapy for treatment of cancer.

When cells are exposed to radiation, the number of mutations is increased. If mutations are passed down to children, this can cause genetic defects in the offspring.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

You know you’ve been overexposed to radiation

Causes

What causes radiation sickness?

Radiation is the energy released from atoms as either a wave or a tiny particle of matter. Radiation sickness is caused by exposure to a high dose of radiation, such as a high dose of radiation received during an industrial accident. Common exposures to low-dose radiation, such as X-ray exams, don’t cause radiation sickness.

Sources of high-dose radiation

Possible sources of high-dose radiation include the following:

  • An accident at a nuclear industrial facility
  • An attack on a nuclear industrial facility
  • Detonation of a small radioactive device
  • Detonation of a conventional explosive device that disperses radioactive material (dirty bomb)
  • Detonation of a standard nuclear weapon

Radiation sickness occurs when high-energy radiation damages or destroys certain cells in your body. Regions of the body most vulnerable to high-energy radiation are cells in the lining of your intestinal tract, including your stomach, and the blood cell-producing cells of bone marrow.

Risk factors

What increases my risk for radiation sickness?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is radiation sickness diagnosed?

When a person has experienced known or probable exposure to a high dose of radiation from an accident or attack, medical personnel take a number of steps to determine the absorbed radiation dose. This information is essential for determining how severe the illness is likely to be, which treatments to use and whether a person is likely to survive.

Information important for determining an absorbed dose includes:

  • Known exposure. Details about distance from the source of radiation and duration of exposure can help provide a rough estimate of the severity of radiation sickness.
  • Vomiting and other symptoms. The time between radiation exposure and the onset of vomiting is a fairly accurate screening tool to estimate absorbed radiation dose. The shorter the time before the onset of this sign, the higher the dose. The severity and timing of other signs and symptoms also may help medical personnel determine the absorbed dose.
  • Blood tests. Frequent blood tests over several days enable medical personnel to look for drops in disease-fighting white blood cells and abnormal changes in the DNA of blood cells. These factors indicate the degree of bone marrow damage, which is determined by the level of an absorbed dose.
  • A device called a dosimeter can measure the absorbed dose of radiation but only if it was exposed to the same radiation event as the affected person.
  • Survey meter. A device such as a Geiger counter can be used to survey people to determine the body location of radioactive particles.
  • Type of radiation. A part of the larger emergency response to a radioactive accident or attack would include identifying the type of radiation exposure. This information would guide some decisions for treating people with radiation sickness.

How is radiation sickness treated?

The treatment goals for radiation sickness are to prevent further radioactive contamination; treat life-threatening injuries, such as from burns and trauma; reduce symptoms; and manage pain.

Decontamination

Decontamination is the removal of as much external radioactive particles as possible. Removing clothing and shoes eliminates about 90 percent of external contamination. Gently washing with water and soap removes additional radiation particles from the skin.

Decontamination prevents further distribution of radioactive materials and lowers the risk of internal contamination from inhalation, ingestion or open wounds.

Treatment for damaged bone marrow

A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, may counter the effect of radiation sickness on bone marrow. Treatment with this protein-based medication, which includes filgrastim (Neupogen), sargramostim (Leukine) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections.

If you have severe damage to bone marrow, you may also receive transfusions of red blood cells or blood platelets.

Treatment for internal contamination

Some treatments may reduce damage to internal organs caused by radioactive particles. Medical personnel would use these treatments only if you’ve been exposed to a specific type of radiation. These treatments include the following:

  • Potassium iodide (Thyroshield, Iosat). This is a nonradioactive form of iodine. Because iodine is essential for proper thyroid function, the thyroid becomes a “destination” for iodine in the body. If you have internal contamination with radioactive iodine (radioiodine), your thyroid will absorb radioiodine just as it would other forms of iodine. Treatment with potassium iodide may fill “vacancies” in the thyroid and prevent absorption of radioiodine. The radioiodine is eventually cleared from the body in urine. Potassium iodide isn’t a cure-all and is most effective if taken within a day of exposure.
  • Prussian blue (Radiogardase). This type of dye binds to particles of radioactive elements known as cesium and thallium. The radioactive particles are then excreted in feces. This treatment speeds up the elimination of the radioactive particles and reduces the amount of radiation cells may absorb.
  • Diethylenetriamine pentaacetic acid (DTPA). This substance binds to metals. DTPA binds to particles of the radioactive elements plutonium, americium and curium. The radioactive particles pass out of the body in urine, thereby reducing the amount of radiation absorbed.

Supportive treatment

If you have radiation sickness, you may receive additional medications or interventions to treat:

  • Bacterial infections
  • Headache
  • Fever
  • Diarrhea
  • Nausea and vomiting
  • Dehydration
  • Burns

End-of-life care

A person who has absorbed large doses of radiation (10 Gy or greater) has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting and diarrhea. They may also benefit from psychological or pastoral care.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage radiation sickness?

The following lifestyles and home remedies might help you cope with radiation sickness:

In the event of a radiation emergency, stay tuned to your radio or television to hear what protective actions local, state and federal authorities recommend. Recommended actions will depend on the situation, but you will be told to either stay in place or evacuate your area.

Shelter in place

If you’re advised to stay where you are, whether you’re at home or work or elsewhere, do the following:

  • Close and lock all doors and windows.
  • Turn off fans, air conditioners and heating units that bring air in from outside.
  • Close fireplace dampers.
  • Bring pets indoors.
  • Move to an inner room or basement.
  • Stay tuned to your emergency response network or local news.
  • Evacuate

If you’re advised to evacuate, follow the instructions provided by your local authorities. Try to stay calm and move quickly and in an orderly manner. In addition, travel lightly, but take supplies, including:

  • Flashlight
  • Portable radio
  • Batteries
  • First-aid kit
  • Necessary medicines
  • Sealed food, such as canned foods, and bottled water
  • Manual can opener
  • Cash and credit cards
  • Extra clothes

Be aware that most emergency vehicles and shelters won’t accept pets. Take them only if you’re driving your own vehicle and going someplace other than a shelter.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 11, 2017 | Last Modified: September 11, 2017

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