Tag Archives: ARS

Radiation Background [see what I did, there?]

9 Nov

**Disclaimer**

This is NOT a super-detailed, comprehensive tutorial on radiation.  The subject has a lot of spiderwebbing topics, and I’m conveying just the very basics so we can get to the topic I actually want to talk about-The Dyatlov Pass Incident/Mystery.  Also, I have included sources for the information at the bottom.  Puh-leeze do not get after me about plagiarism.  The following info is not my own, the citations are not school-appropriate, but I am not trying to be sketchy and steal.  Please see the websites of the original works for so much, and better info.  I am just giving you the gist so we all have the same basic foundation for the topic I am actually trying to address:  Dyatlov Pass

Radiation is the energy released from atoms as either a wave or a tiny particle of matter. 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(1).

Possible sources of high-dose radiation include the following (1):

  • An accident at a nuclear industrial facility [or prior to regulations, ie radium girls]
    • Chernobyl
  • 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
    • Atomic bombings of Hiroshima and Nagasaki

OK, the next is for you to reference when you’re reading along and don’t understand the what the unit of measure means.  Radiation is measured in many ways so it can get confusing.  Don’t worry, there won’t be a test!

The units of measurement commonly used in determining radiation exposure or dose (2):

  • The roentgen (R) is a measure of quantity of x or gamma ionizing radiation in air.
  • The radiation absorbed dose (rad) is the amount of energy absorbed in any substance from exposure, and applies to all types of radiation.
    • The R and the rad are nearly equivalent in energy for practical purposes.
  • The rem is used to correct for the observation that some types of radiation, such as neutrons, may produce more biological effect for an equivalent amount of absorbed energy.
    • For x and gamma radiation the rem is equal to the rad.
      • Thus the rem is equal to the rad multiplied by a constant called the “quality factor”.
  • The rad and the rem are currently being replaced in the scientific nomenclature by two units that are compatible with the International System of Units, namely the gray (Gy), equal to 100 rads and the Sievert (Sv), equal to 100 rem.

Bottom line:  Amount of radiation determines severity of symptoms (more = worse).  The time elapsed also determines severity of outcome (faster = worse).

Type of Exposure

The severity of radiation sickness depends on how sensitive the affected tissue is. For instance, the gastrointestinal system and bone marrow are highly sensitive to radiation.  Sickness also depends on how much of the body is exposed (1).  Many thousands of rads delivered over a long period of time (e.g. for cancer treatment), can be tolerated by the body when small volumes of tissue are irradiated. The entire human body can probably absorb up to 200 rads acutely without fatality. However, as the whole-body dose approaches 450 rads the death rate will approximate 50%, and a total whole-body dose of greater than 600 rads received in a very short time will almost certainly be fatal (2).

The severity of signs and symptoms of radiation sickness depends on how much radiation you’ve absorbed. How much you absorb depends on the strength of the radiated energy, the time of your exposures, and the distance between you and the source of radiation (1).

Stages of radiation sickness/poisoning

It can’t be emphasized enough that a lot of variables influence how radiation might make a person sick.  The type of severe acute radiation syndrome (ARS) depends on dose, dose rate, affected area of the body, and the period of time elapsing after exposure. The severe ARS is due to penetrating radiation to most or all of the body in a short period of time, usually a few minutes (2).

A patient with any type of severe ARS usually goes through three stages (2):

  • In the prodromal stage, the classic symptoms are nausea, diarrhea and vomiting.
    • a. 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
    • a. for a few hours or even a few weeks.
  • The last stage, called the overt or manifest illness stage is specific to each type (which will be discussed in more detail further ahead):
    • a. cardiovascular
    • b. central nervous system sickness
    • c. gastrointestinal sickness
    • d. and hematopoietic sickness.

Symptoms of Radiation

The initial signs and symptoms of treatable radiation sickness are usually nausea and vomiting. The amount of time between exposure and when these symptoms develop is a clue to how much radiation a person has absorbed.  After the first round of signs and symptoms, a person with radiation sickness may have a brief period with no apparent illness, followed by the onset of new, more-serious symptoms.  With mild exposure, it may take hours to weeks before any signs and symptoms begin. But with severe exposure, signs and symptoms can begin minutes to days after exposure (1).

Possible symptoms include (1):

  • Nausea and vomiting
  • Diarrhea
  • Headache
  • Dehydration
  • Fever
  • Dizziness and disorientation
  • Weakness and fatigue
  • Burns
  • Sores or ulcers
  • Hair loss
  • Bloody vomit and stools from internal bleeding
  • (bacterial) Infections
  • Low blood pressure
Oral complications caused by radiation therapy to the head and neck include the following (3):

  • Pain.
  • Changes in dental growth and development in children.
  • Taste changes.
  • Dry mouth.
  • Inflamed mucous membranes in the mouth.
  • Tooth decay and gum disease.
  • Fibrosis (growth of fibrous tissue) in the mucous membrane in the mouth.
  • Fibrosis of muscle in the area that receives radiation.
  • Malnutrition (not getting enough of the nutrients the body needs to be healthy) caused by being unable to eat.
  • Dehydration (not getting the amount of water the body needs to be healthy) caused by being unable to drink.
  • Breakdown of tissue in the area that receives radiation.
  • Breakdown of bone in the area that receives radiation.
  • Problems in the mouth and jaw caused by loss of tissue and bone.
  • Infections in the mouth or that travel through the bloodstream. These can reach and affect cells all over the body.
  • Problems in the mouth and jaw caused by the growth of benign tumors in the skin and muscle.
When radiation therapy is used to treat cancer, a very large dose of radiation, about 5,000,000 millirem (or 5,000 rem) is delivered to the tumor site (4).  For reference, researchers measured the radiation in a jawbone collected from the Hiroshima atomic bombing:  It had absorbed 9.46 grays of radiation . To place this in context: A cancer patient receiving radiotherapy treatment is exposed to about 2 to 3 grays on a very localized part of the body where a tumor is located.  It takes whole-body radiation of about 5 grays (nearly half of the amount calculated from the jawbone) to kill a person, Oswaldo Baffa, one of the researchers and a professor at the University of São Paulo, told The Washington Post (5).

I realize the following is a large block of text :-/ I have bolded all the symptoms for those that just wish to scan. Though I do suggest reading the whole thing at some point, as it’s pretty interesting how radiation on the various body parts show differing symptoms and complications over time, depending on tissue, dose, exposure time, distance of radiation–everything discussed above, repeatedly.

Radiation therapy can directly damage oral tissue, salivary glands, and bone. Areas treated may scar or waste awayTotal-body radiation can cause permanent damage to the salivary glands. In addition, slow healing and infection are indirect complications of cancer treatment. Both chemotherapy and radiation therapy can stop cells from dividing and slow the healing process in the mouth. Chronic complications are ones that continue or appear months to years after treatment ends. Radiation can cause acute complications but may also cause permanent tissue damage that puts you at a lifelong risk of oral complications (3). 

Cardiovascular/central nervous system sickness is the type of ARS 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 (2).

Gastrointestinal sickness is the type of ARS 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 (2).

Hematopoietic sickness (bone marrow sickness) is the type of ARS 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 (2).

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 (2).

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 (2).

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 (2).

Large accumulated doses of radiation to muscles may result in painful myopathy with atrophy and calcification (2).

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) (2).

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 (2).

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 years 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 (2).

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 (2).

A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks (1).

Information important for determining an absorbed dose of radiation includes (1):

  • 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.
  • Dosimeter. 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.

Very low doses of radiation such as unavoidable background radiation (about 0.1 rad/yr), produce no measurable effect. Mild symptoms have been observed with doses as low as 30 rad. The probability of measurable effects increases as the dose rate and/or total dose increases(2).

Next time, we’ll talk about my theory!

Sources:

(1) https://www.mayoclinic.org/diseases-conditions/radiation-sickness/symptoms-causes/syc-20377058

(2) https://rarediseases.org/rare-diseases/radiation-sickness/

(3) https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-pdq#_5

(4) https://www.health.ny.gov/publications/4402/

(5) https://www.washingtonpost.com/news/retropolis/wp/2018/05/02/a-single-jawbone-has-revealed-just-how-much-radiation-hiroshima-bomb-victims-absorbed/