Ionizing Radiation Injuries and Illnesses - 25/11/13

Doi : 10.1016/j.emc.2013.10.002

Doran M. Christensen, DO ^⁎ , Carol J. Iddins, MD, Stephen L. Sugarman, MS, CHP, CHCM
Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge Institute for Science and Education (ORISE), U.S. Department of Energy (DOE), Oak Ridge Associated Universities (ORAU), PO Box 117, MS-39, Oak Ridge, TN 37831, USA

^∗Corresponding author.

Résumé

Although the spectrum of information related to diagnosis and management of radiation injuries and illnesses is vast and as radiation contamination incidents are rare, most emergency practitioners have had little to no practical experience with such cases. Exposures to ionizing radiation and internal contamination with radioactive materials can cause significant tissue damage and conditions. Emergency practitioners unaware of ionizing radiation as the cause of a condition may miss the diagnosis of radiation-induced injury or illness. This article reviews the pertinent terms, physics, radiobiology, and medical management of radiation injuries and illnesses that may confront the emergency practitioner.

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Keywords : Acute radiation syndrome, Hematopoietic syndrome, Cutaneous syndrome, Cutaneous radiation syndrome, Acute local radiation injury, Radiological, Nuclear

Plan

Key points

Introduction

Applicable physics

Types of Ionizing Radiation

Deterministic Effects of Ionizing Radiation

Stochastic Effects of Ionizing Radiation

Exposure or Irradiation Versus Contamination

Radiation Protection and ALARA

Radiosensitivity and Radioresistance

Median Lethal Dose 50/60 (LD_50/60)

Chromatid Breakage and Mitotic Death

Apoptosis

Direct Ionization and Indirect Cellular Interactions

Initial management of radiation casualties

Overall medical management of radiological exposures

Acute Radiation Syndrome

Hematopoietic Syndrome

Cutaneous Radiation Syndrome or Local Radiation Injury

Gastrointestinal Subsyndrome

Neurovascular Syndrome

Internal Contamination with Radioactive Materials

Radiological and nuclear incidents of medical and public health concern

Radiological Exposure Device

Radiological Dispersal Device

Nuclear Power Plant Incident

Improvised Nuclear Device/Nuclear Weapon

Summary

	Funding Sources: ORAU.
	Conflict of Interest: None.
	Declarations and disclaimers: This work was performed under Contract # DE-AC05-06OR23100 between Oak Ridge Associated Universities (ORAU) and the US Department of Energy (USDOE). REAC/TS is a program of the Oak Ridge Institute for Science & Education (ORISE), which is operated for the USDOE by ORAU. The opinions expressed herein are those of the authors and are not necessarily those of the US Government (USG), the USDOE, ORAU, or sponsoring institutions of ORAU. Neither the USG nor the USDOE, nor any of their employees, makes any warranty, expressed or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of the information contained herein or represents that its use would not infringe on privately owned rights.