Radiation and Combined Injuries

General Radiation injury alone or in conjunction with other injuries or diseases will be common in nuclear warfare. Radiation injury can result from a single exposure to prompt radiation at the time of detonation of a nuclear weapon, from exposure to high levels of fallout radiation, or from repeated exposures to both with complex patterns of recovery from an accumulation of radiation damage.

Whole-body irradiation, where absorbed doses are high and acquired over short periods of time, will result in acute radiation sickness.

There are three characteristic syndromes which make up the typical clinical pattern of acute radiation sickness:

• Hematopoietic
• Gastrointestinal
• Neurovascular

The hematopoietic syndrome, or syndrome of bone-marrow depression, occurs at lower doses than the others and would be the most common form of radiation sickness seen in nuclear combat. Manifestations of bone-marrow depression are seen following doses of radiation in the low through mid-lethal range.

As the probability of lethality becomes 100 percent with higher doses, the gastrointestinal syndrome will predominate. This syndrome, which will also be common, develops from combined severe damage to bone marrow and the gastrointestinal tract.

The neurovascular syndrome is associated with absorbed doses in the supra-lethal range and would be seen quite rarely since heat and blast effects would cause immediate lethality in most situations where the required very high radiation doses would be sustained.