Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation.
There are two basic types of radiation: ionizing and nonionizing.
- Nonionizing radiation comes in the form of light, radio waves, microwaves and radar. This kind of radiation usually does not cause tissue damage.
- Ionizing radiation is radiation that produces immediate chemical effects on human tissue . X-rays, gamma rays, and particle bombardment (neutron beam, electron beam, protons, mesons, and others) give off ionizing radiation. This type of radiation can be used for medical testing and treatment, industrial and manufacturing purposes, weapons and weapons development, and more.
Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation.
Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. Chronic exposure is usually associated with delayed medical problems such as cancer and premature aging, which may happen over a long period of time.
The risk of cancer depends on the dose and begins to build up, even with very low doses. There is no "minimum threshold".
Exposure from x-rays or gamma rays is measured in units of roentgens. For example:
- Total body exposure of 100 roentgens/rad or 1 Gray unit (Gy) causes radiation sickness.
- Total body exposure of 400 roentgens/rad (or 4 Gy) causes radiation sickness and death in half of the individuals who are exposed. Without medical treatment, nearly everyone who receives more than this amount of radiation will die within 30 days.
- 100,000 roentgens/rad (1,000 Gy) causes almost immediate unconsciousness and death within an hour.
The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur immediately after exposure, or over the next few days, weeks, or months. Bone marrow and the gastrointestinal tract are especially sensitive to radiation injury. Children and babies still in the womb are more likely to be severely injured by radiation.
Because it is difficult to determine the amount of radiation exposure from nuclear accidents, the best signs of the severity of the exposure are: the length of time between the exposure and the onset of symptoms, the severity of symptoms, and severity of changes in white blood cells. If a person vomits less than an hour after being exposed, that usually means the radiation dose received is very high and death may be expected.
Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples.
- Accidental exposure to high doses of radiation, such as radiation from a nuclear power plant accident
- Exposure to excessive radiation for medical treatments
You may have symptoms such as:
- Bleeding from the nose, mouth, gums, and rectum
- Bloody stool
- Hair loss
- Inflammation of exposed areas (redness, tenderness, swelling, bleeding)
- Mouth ulcers
- Nausea and vomiting
- Open sores on the skin
- Skin burns (redness, blistering)
- Sloughing of skin
- Ulcers (sores) in the esophagus (food pipe), stomach or intestines
- Vomiting blood
Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections.
Unfortunately, giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated as part of the resuscitation process so that they do not cause radiation injury to others. This may complicate the first aid and resuscitation process.
- Check the person's breathing and pulse.
- Start CPR, if necessary.
- Remove the person's clothing and place the items in a sealed container. This stops ongoing contamination.
- Vigorously wash the victim with soap and water.
- Dry the victim and wrap with a soft, clean blanket.
- Call for emergency medical help or take the person to nearest emergency medical facility if you can do so safely
- REPORT EXPOSURE TO EMERGENCY OFFICIALS.
If symptoms occur during or after medical radiation treatments:
- Tell the provider or seek medical treatment.
- Handle affected areas gently.
- Treat symptoms or illnesses as recommended by the provider.
- DO NOT remain in area where exposure occurred.
- DO NOT apply ointments to burned areas.
- DO NOT remain in contaminated clothing.
- DO NOT hesitate to seek emergency medical treatment.
Preventive measures include:
- Avoid unnecessary exposure to radiation.
- Persons working in radiation hazard areas should wear badges to measure their exposure level.
- Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy.
Radiation poisoning; radiation injury; rad poisoning
Feldman R. Radiation injury. In: Schaider JJ, Hayden SR, Wolfe RE, Barkin RM, Rosen P, eds. Rosen and Barkin's 5-Minute Emergency Medicine Consult. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007.
Schultz CH, Koenig KL. Weapons of mass destruction. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 194.
Update Date 1/12/2015
Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.