Radiation sickness: Horrible symptoms, horrible death

Meryl Streep starred in Silkwood in 1983, a movie about Karen Silkwood, who was purposely contaminated with radiation in a plutonium processing plant. This was not a Homer Simpson moment, eating a donut at a nuclear power plant. I was scared to death when Streep lit up the radiation exposure detector at work.

What does radiation poisoning do to a person?

The earthquake and tsunami in Japan is a horrible tragedy. In addition to all the death and destruction, imagine all the survivors who live near the nuclear power plants!

Since 1944, more than 400 radiation accidents have been reported. In 1986, the Chernobyl nuclear accident caused 28 immediate deaths and thousands of exposures. And don't forget Three Mile Island! More than 750,000 persons have been exposed to radiation contamination since 1961.

Acute Radiation Syndrome occurs from large doses of radiation, which is more than 2Gy. To give an idea of how much radiation that is, a "normal" person is exposed to 0.001Gy a year. A full-body CT scan might deliver up to 0.045Gy.

Mild symptoms can start within five days of exposure: nausea, vomiting and diarrhea. Severe symptoms occur 21-60 days later, caused by damage to the gut. Because the lining of the GI tract is stripped away, bloody diarrhea can lead to hypovolemic shock (loss of fluid in the body so the blood pressure drops low). Dehydration or direct insult to the kidneys can cause kidney failure.

Because the GI tract is so damaged, bacteria can creep into the blood to cause sepsis. Severe diarrhea can lead to low potassium, sodium level changes, and acidosis (meaning the blood becomes acidic like orange juice).

Bone marrow destruction is bad news! Without red blood cells, anemia causes weakness from lack of oxygen to the body. Without white blood cells, the radiation-poisoned person can’t fight infection.

So what do we do if a nuclear power plant melts down? Run! Yes, literally, you need to get as far away as possible and as fast as possible. Radiation levels decrease by a squared amount of the distance. So if one doubles the distance from the nuclear disaster area, the dose of radiation drops by four. Less time of exposure means less radiation poisoning. Wearing shields offers some protection, especially for the thyroid gland, but overall they aren't effective. N-95 masks help reduce radioactive material entering the nose and mouth.

Folks living within 10 miles of a nuclear power plant are supposed to have been supplied with potassium iodide tabs to reduce the risk of thyroid cancer. Believe it or not, back in the Wild Wild West days of dermatology, radiation therapy was used to treat acne– and these folks got thyroid cancer. However, potassium iodide is not going to protect the rest of the body from radiation poisoning. Chelating agents are chosen depending on the type of radiation used in the nuclear power plant, such as Prussian blue for Cesium-137.

If you are exposed to radiation, clothes should be immediately removed and put in labeled plastic bags, so to not contaminate anyone else. Alpha and Geiger counters are used to evaluate radioactivity, and the exposed person is cleaned with lukewarm water, mild soap, and sponges.

Eyes, ears, nose, mouth, and wounds all need to be checked for contamination. A crewcut might be necessary if the radiation can't be washed out of the hair, but not shaved off like Kojak because we don't want to cut the skin and introduce any contaminant.

Of course for the survivors, there is the significant worry about cancer, as well as cataracts and other chronic medical problems. These serious issues are way beyond the scope of this short article. Information is available on-line at http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismanddrugPrepar...
Dr. Hook tells a joke or two, but he is a respected physician with a large practice in Cape May, NJ. Read more of his insights at drjohnhong.com.