Acute radiation syndrome (Radiation sickness)

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 13, 2016
StartDiseasesAcute radiation syndrome (Radiation sickness)

Radiation sickness, medically known as acute radiation syndrome, is a direct result of exposure to ionizing radiation. This form of radiation damages human tissue when the exposure is excessive. While ionizing radiation can be used for medical purposes, receiving uncontrolled amounts can cause illness and even death.

Contents

Definition & Facts

During exposure occurring in one incident, a very large dose of ionizing radiation causes acute radiation syndrome. When a multitude of small exposures occur over a period of time, it is referred to as chronic radiation syndrome. This exposure may be purposeful or accidental. Chronic radiation syndrome results in long-term and less predictable symptoms ranging from premature aging to cancer.

Particularly vulnerable to radiation are bone marrow and the gastrointestinal tract. Babies still in the womb and children also suffer greatly from radiation.

Symptoms & Complaints

The degree to which symptoms of acute radiation sickness appear varies according to the type of radiation received, body parts exposed and the amount. Symptoms can occur right away or may take anywhere from days to months to manifest.

Sickness from acute radiation syndrome usually starts with nausea and vomiting. After this phase begins, there may be a period of time wherein no other symptoms appear, then a resurgence of symptoms in greater strength and with new signs of radiation sickness.

The higher the level of radiation exposure, the more quickly and severely acute radiation syndrome symptoms will occur.

Symptoms may include:

Causes

Caused by exposure to a high dose of radiation, acute radiation syndrome may be as a result of an industrial accident or other major occurrence. Acute radiation sickness does not occur from common exposure to x-ray machines, for example. Some sources of such radiation are:

  • Nuclear industrial accident
  • Attack on a nuclear facility
  • Detonation of a radioactive device
  • Dirty bomb detonation
  • Nuclear weaponry detonation

Diagnosis & Tests

Doctors use the timing of onset of symptoms to help determine how much of the harmful energy impacted the body. Severity of those symptoms, changes in the white blood cells and when vomiting starts are additional indicators of prognosis and how much radiation occurred. If vomiting begins within an hour of exposure, the patient usually dies. Blood cell counts and symptoms help doctors determine how best to treat children who receive radiation for medical purposes, or those who suffer a nuclear accident.

Medical personnel take certain steps following probable exposure of humans to high doses of radiation. These steps help them determine the level of exposure, prognosis, treatment options and other important information.

Tests utilized to help determine how much radiation the patient absorbed include:

  • Blood tests over several days to count white blood cells and observe changes in blood cell DNA.
  • Dosimeter testing measures absorbed radiation if the meter was on site at the time of the accident or exposure.
  • Survey meters such as Geiger counters can survey the human body and provide the physical location of radioactive particles on the body.

Treatment & Therapy

When a patient suffers acute radiation syndrome, the objectives are usually:

  • To prevent further radioactive contamination
  • Treat life-threatening injuries, such as from burns and trauma
  • Reduce symptoms
  • Pain management

Decontamination is performed to remove external radioactive particles from the person experiencing acute radiation syndrome. Clothing and shoes carry about 90 percent of these contaminants, so those are immediately removed. Additional particles can be eliminated from the body during a gentle soap and water wash.

Radiation sickness affecting bone marrow can sometimes be countered through medication containing granulocyte colony-stimulating factor. This promotes the growth of healthy white blood cells, which in turn help fight infections.

Red blood cell or platelet transfusions may also be given to counter severe damage to bone marrow. Other treatments help reduce damage to internal organs by reducing the amount of radioactive material absorbed in the body. These treatments include provision of the following:

  • Potassium iodide to prevent thyroid absorption of radioiodine, which can then be flushed through the system by means of the urinary tract.
  • Prussian blue dye to bind to radioactive cesium and thallium, for excretion of those elements from the body.
  • Diethylenetriamine pentaacetic acid (DTPA) for binding to particles of radioactive plutonium, americium and curium, with those elements then being passed through the urinary tract and out of the body.

Prevention & Prophylaxis

When a radiation emergency occurs, remaining away from the source of the radiation is critical. Evacuations may occur or people will be urged to stay indoors. People urged to stay indoors should take the following precautions:

  • Close and lock all windows and doors
  • Turn off air conditioners, heaters and fans bringing outside air into the space
  • Close dampers in the fireplace
  • Bring pets inside
  • Remain within an interior room or basement with doors closed
  • Tune into emergency response alerts

If evacuation is urged by authorities, instructions will be provided. It is important to remain calm and do as advised, both quickly and in an orderly fashion.