Radiation Sickness

What is radiation sickness?

Radiation sickness, also known as acute radiation syndrome (ARS) or “radiation poisoning,” is a life-threatening condition that results from prolonged or significant exposure to ionizing radiation. Ionizing radiation is energy used to generate power in manufacturing, industrial and military settings. It’s used in small doses for some medical procedures.

Radiation sickness is generally associated with acute (sudden and severe) exposure, like from a nuclear power plant accident. Its severity depends on:

• The amount of radiation your body absorbs (measured in units called Gray, or Gy).
• How long you were exposed.
• If all or a certain part of your body was exposed.

Exposure to a high, single dose over minutes to hours is more damaging than several smaller doses given over weeks or months to a small area of your body (such as with radiation therapy for cancer). Large doses of ionizing radiation can lead to death within hours or several months after exposure.

What are the types of radiation sickness (ARS)?

After acute exposure to a high dose of radiation, three distinct syndromes may occur:

• Cerebrovascular syndrome: Affects blood flow to your brain. It happens after extremely high whole-body doses of radiation (more than 30 Gy).
• Gastrointestinal (GI) syndrome: Affects the passageway of your digestive system. GI syndrome happens after whole-body radiation doses of about 6 to 30 Gy.
• Hematopoietic syndrome: Affects the formation of all types of blood cells. Hematopoietic syndrome happens after whole-body radiation doses of about 1 to 6 Gy.

How common is radiation sickness?

Radiological or nuclear emergencies that can lead to radiation sickness are rare, but they can harm large numbers of people. Catastrophic incidents of radiation exposure in recent memory include the aftermath of the atomic bombings of Japan in WWII and the power plant disaster in Chernobyl in 1986. In addition to the initial deaths, thousands of people later died from radiation-induced cancer.

What are the symptoms of radiation sickness?

Symptoms may begin right after exposure or over the next few days, weeks or months. While symptoms vary based on the syndrome type, the first signs and symptoms of radiation sickness include:

• Weakness or fatigue.
• Nausea and vomiting.
• Vomiting blood.
• Rectal bleeding (bloody stools).
• Diarrhea.
• Fever.
• Confusion.
• Hair loss.
• Tenderness, discoloration, swelling or a burning sensation in your skin.

Later, symptoms and complications unfold in stages related to the three ARS syndromes.

What are the stages of radiation sickness?

Each acute radiation syndrome (ARS) has distinct stages. They are the:

• Prodromal stage: Initial symptoms start minutes to two days after exposure.
• Latent asymptomatic stage: A period with no symptoms begins hours to 21 days after exposure.
• Systemic illness stage: More severe symptoms and changes in your body start hours to fewer than 60 days after exposure. Symptoms vary based on the type of syndrome.

What causes radiation sickness?

Radiation sickness (acute radiation syndrome) can occur after direct exposure or contamination by high doses of radioactive materials. Think of it this way: Low doses of radiation can interfere with cell repair systems, growth and division. But large doses cause cell death.

A nuclear blast, radiation accidents and fallout from nuclear weapons testing can result in direct exposure. Contamination can result from consuming nuclear-contaminated food and water and skin contact with nuclear material.

Is acute radiation syndrome (ARS) contagious?

If someone who’s been exposed to a high dose of radiation is decontaminated — their clothes are removed and their body is washed — they’re not “contagious.” You’re not at risk of radiation exposure from them because the radiation is internalized (inside their bodies).

But you are at risk of radiation poisoning if you’re near someone with radiation exposure who hasn’t been decontaminated. First responders to nuclear emergencies, for example, are at higher risk of exposure from other people.

How is radiation sickness diagnosed?

Healthcare providers diagnose radiation sickness by considering the following:

• History of radiation exposure.
• Symptoms and signs.
• Lab test results.

Knowing the onset, timeframe and severity of symptoms helps providers determine the radiation dose and predict future symptoms and complications.

After acute radiation exposure, your provider will likely order lab tests like a complete blood count (CBC) and follow your results over time to estimate your initial radiation dosage and prognosis (outcome).

When providers suspect radioactive contamination, they test your entire body with a tool called a Geiger-Muller counter to detect and measure ionizing radiation. To detect possible internal contamination, a provider will wipe your ears, mouth and wounds with swabs. Then, they’ll test the swabs with the counter. They may also test your pee and poop for radioactivity.

What is the treatment for radiation sickness?

The treatment for radiation sickness varies based on its severity. As significant exposure usually results from radiological or nuclear emergencies, healthcare providers and first responders prioritize care based on the severity of symptoms and injuries.

General treatment strategies include:

• Decontamination. Removing clothing and washing your body protects others from further exposure.
• Surgical procedures. Life-threatening injuries may require surgery.
• Supportive care. This may involve getting fluids and electrolytes, taking medications to manage pain associated with burns or other injuries, and getting treated for any signs of infection with antibiotics.
• Prevention of thyroid cancer. Providers typically recommend that all children and people who are pregnant who were exposed take potassium iodide to protect their thyroid from the uptake of radioactive iodine.
• Management of psychological trauma. Treatments include psychotherapy (talk therapy) and medication.

Can radiation sickness be prevented?

There’s nothing you can do to prevent emergencies that lead to unexpected significant radiation exposure and radiation sickness. But there are steps you can take to protect yourself if a nuclear emergency happens. You can:

• Avoid the exposure area. Leave (or don’t enter) the area where the exposure occurred.
• Decontaminate. Remove contaminated clothing as soon as possible and store it in a sealed container. Wash yourself thoroughly with soap and water.
• Get treated. Seek emergency medical treatment as soon as possible.

What is the prognosis of radiation sickness?

The prognosis (outlook) of radiation sickness depends on several factors, including:

• How much radiation your body absorbed.
• How much of your body was affected.
• If you were able to get immediate medical care.

Radiation sickness is often fatal. The time to death decreases as the dose of radiation increases.

With survivors, long-term complications may occur. Survivors have an increased likelihood of radiation-induced cancer, including leukemia and thyroid cancer.

When should I seek care?

An incident involving high doses of radiation exposure is always an emergency that requires immediate medical care. Get away from the radiation source as soon as it’s safe to do so, and get help ASAP.