All you need to know about Acute Radiation Syndrome.
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Here we come with Radiation Sickness today!
What is Radiation Sickness?
Radiation Sickness is also known as Acute Radiation Syndrome.
When a big dose of high-energy radiation goes into the body and enters your internal organs, radiation sickness occurs. It needs much more to cause it than what you would get from some medical care.
Since the atomic bombs that ended World War II, physicians have called the condition, which is technically known as acute radiation syndrome. It’s not clear how many of the 150,000 to 250,000 people killed in those attacks died from radiation sickness. But figures placed the figure in the hundreds or thousands at the time.
About 50 people have died from radiation poisoning since then. This includes the 28 staff and firefighters killed in the 1986 Chernobyl nuclear explosion in what is now Ukraine. About 100 others were afflicted with acute radiation syndrome at Chernobyl but survived.
During the Cold War, most of the other people who died from it were physicists or technicians at U.S. or Soviet nuclear plants. But in 1999, after an accident involving nuclear fuel in Japan, three employees experienced radiation sickness; two of them died. After the Fukushima Daiichi nuclear disaster in 2011, no reports of radiation sickness were confirmed.
Basics of Radiation:
In a foreign unit called a sievert (Sv), the amount of radiation your body absorbs is measured. Radiation sickness signs occur when you are exposed to quantities higher than or equal to 500 millisieverts (mSv) or half a sievert. It is possible that more than 4 or 5 Sv will be catastrophic. Doses measuring 700 mSv to 13 Sv were obtained by the employees who had radiation poisoning at Chernobyl.
In the air, in the sea, and in materials such as brick or granite, natural radiation is everywhere. Usually, you get just about 3 mSv of radiation from these natural sources every year — three one-thousandths of a sievert.
Man-made radiation sources from stuff like X-rays add in another 3 mSv. Around 10 mSv is given by a CT (computerised tomography) scan, which includes multiple X-rays obtained from various angles. It is not permitted for people who work in the nuclear industry to be subjected to more than 50 mSv a year.
What are the causes of Radiation sickness?
Harmful ionising radiation sources are mostly limited to high-energy x-rays used for diagnosis and treatment, as well as to radium and associated radioactive materials. Atom reactors, cyclotrons, linear accelerators, alternating gradient synchrotron, and enclosed supplies of cobalt and cesium for cancer treatment are existing sources of future radiation. Numerous artificial radioactive materials have been processed by neutron activation in reactors for use in medicine and manufacturing.
The unintended escape from reactors with moderate to high concentrations of radiation has happened many times. Years after the blast, radiation from the atomic bombs dropped from Hiroshima and Nagasaki caused hundreds of cases of tumours, abnormalities, and genetic defects. For starters, radiation contamination from reactor accidents such as Chernobyl resulted in 134 diseases and 28 deaths.
Very low radiation exposures, such as inevitable background radiation (approximately 0.1 rad/yr), have little detectable impact. For doses as low as 30 rad, moderate effects have been observed. If the dosage intensity and/or cumulative dose increases, the risk of measurable results increases.
Also an essential consideration is the region of the body subjected to radiation. It is possible that the entire human body will consume up to 200 rads acutely without fatality. However the mortality rate will be nearly 50 percent as the whole-body dose reaches 450 rads, and a cumulative entire-body dose of more than 600 rads obtained in a relatively short period will almost definitely be lethal. By comparison, as small tissue volumes are irradiated, several thousands of rads distributed over a long period of time (e.g. for cancer treatment) will be tolerated by the body. Also essential is the delivery of the dosage within the body. For example, bowel or bone marrow defence by adequate shielding would help the exposed person to recover from what would otherwise be a lethal whole-body dosage.
What are the symptoms of Radiation sickness?
Nausea, vomiting, diarrhoea, anorexia, headache, malaise and rapid heartbeat characterise acute radiation sickness (tachycardia). (tachycardia). For moderate ARS, after a few hours or days, the pain subsides. However there are three common types of extreme ARS that may occur at minor doses (e.g. frequent x-rays over a span of days or weeks) as a result of large doses (e.g. an atomic explosion):
The type of extreme ARS depends on the dosage, the dose rate, the region of the body affected, and the time span following exposure. In a brief amount of time, usually a few minutes, extreme ARS is due to penetrating radiation into any or more of the body. A patient with some form of extreme ARS typically goes through three phases: fatigue, diarrhoea and vomiting are the classic symptoms in the prodromal period. This stage may last up to a couple of days for a few minutes. A patient tends to progress in the next step, called the latent stage, to the point that they are normally stable for a few hours or even a few weeks. The last step, called the stage of overt or apparent sickness, is unique to each type. The sickness of the cardiovascular/central nervous system, stomach sickness and hematopoietic sickness are these.
The sickness of the cardiovascular/central nervous system is the kind of ARS caused by exceptionally high total body radiation doses (greater than 3000 rads). This form is the most serious kind and is often catastrophic. In addition to nausea and vomiting in the prodromal phase, the latent cycle will occur in patients with the cerebral syndrome who will also suffer agitation, confusion, and lack of consciousness for a few hours. 5 to 6 hours after the initial exposure to radiation, tremors and convulsions occur, and within 3 days, coma and death are imminent.
The type of ARS that can arise where the overall radiation exposure is smaller but still high is gastrointestinal sickness (400 or more rads). It is marked by intractable nausea, vomiting, electrolyte deficiency, and diarrhoea that results in extreme dehydration, reduced plasma capacity, vascular breakdown, inflammation, and risks that are life-threatening.
The type of ARS occurs at the exposure of between 200 and 1000 rads. Hematopoietic sickness (bone marrow sickness) It is initially characterised by a lack of appetite (anorexia), fever, malaise, nausea and vomiting that can arise within 6 to 12 hours of exposure at the most. Symptoms then subside in such a manner that they are revealed within 24 to 36 hours. The lymph nodes, spleen and bone marrow tend to atrophy during the latent phase of this type, leading to underproduction of all forms of blood cells (pancytopenia). A loss of lymph cells (lymphopenia) begins immediately in the peripheral blood, reaching a plateau within 24 to 36 hours. A type of white blood cell, neutrophil absence, grows more slowly. Within 3 or 4 weeks, the loss of blood platelets (thrombocytopenia) may become prevalent. Owing to a reduction of granulocytes and lymphocytes, impairment of the production of antibodies and movement of granulocytes, reduced ability to fight and destroy bacteria, decreased tolerance to diffusion in subcutaneous tissues, and bleeding (hemorrhagic) areas of the skin and intestines that facilitate the entry and development of bacteria, there is an increased propensity to infection. Bleeding happens mostly due to the loss of platelets in the blood.
Intermediate effects and late somatic and genetic effects may result from delayed radiation effects. A loss of menstruation (amenorrhea), decreased fertility in both sexes, decreased libido in women, anaemia, decreased white blood cells (leukopenia), decreased blood platelets (thrombocytopenia), skin redness (erythema), and cataracts may result from intermediate symptoms from extended or repetitive exposure to low radiation exposures from a variety of sources. Hair loss, skin atrophy and ulceration, skin thickening (keratosis), and vascular changes in the skin are caused by more extreme or extremely localised contact (telangiectasia). Ultimately, a type of skin cancer called squamous cell carcinoma may have caused.
A reduction in renal plasma flow, glomerular filtration rate (GFR), and tubular function are involved in kidney function changes. Proteins in the urine, kidney disease, anaemia and high blood pressure may develop after a latent duration of six months to one year after exceptionally high radiation levels. In about 37 percent of cases, kidney failure with reduced urine production may occur if total kidney exposure is greater than 2,000 rads in less than 5 weeks.
Big cumulative doses of muscle radiation can result in painful atrophy and calcification myopathy.
Extensive radiotherapy of the middle area between the lungs has caused inflammation of the sac around the heart (pericarditis) and the heart muscle (myocarditis) (mediastinum).
After a portion of the spinal cord has received cumulative doses of greater than 4000 rads, myelopathy may occur. Fibrosis and bowel perforation may develop after intensive treatment of abdominal lymph nodes for seminoma, lymphoma, ovarian carcinoma, or chronic ulceration.
The genes in proliferating body cells and germ cells may be affected by late somatic and genetic radiation effects. This can eventually be expressed in body cells as somatic diseases such as cancer (leukaemia, thyroid, skin, bone), or cataracts. Years after swallowing radioactive bone-seeking nuclides including radium salts, another type of cancer, osteosarcoma, can occur. After intense radiation therapy for cancer care, damage to exposed organs can occur periodically.
The number of mutations is elevated as cells are subjected to radiation exposure. This will cause genetic abnormalities in the offspring if genes are passed on to infants.
What are the complications of Radiation sickness?
Radiation sickness may lead to mental health issues in both the short and long term, such as grief, panic and anxiety about:
- Experiencing a radioactive attack or injury
- Mates in mourning or relatives who have not survived
- Dealing with the confusion of a rare and probably deadly disease
- Worrying over the potential possibility of cancer due to exposure to radiation
How is Radiation sickness diagnosed?
Diagnosis is typically made based on a history of significant radiation exposure. The time between exposure and vomiting also can give good estimates of exposure levels in a patient.
Clinical Testing and Work-Up
Monitoring of exposed patients is mandatory, using Geiger counters or sophisticated whole-body counters. Urine should be analyzed for non-gamma-emitting radionuclides if exposure to these agents is suspected. Radon breath analysis can be done in cases of suspected radium ingestion.
What is the treatment for Radiation sickness?
Copious rinsing with water and special solutions containing an agent such as EDTA (ethylenediaminetetraacetic acid), a chelating agent that binds several radioactive isotopes, can instantly eliminate skin contamination from radioactive materials. To remove contamination, minor puncture wounds must be washed vigorously. When the wound is free of radioactivity, rinsing and removal of infected tissue is important. If contamination is new, absorbed substance should be deleted immediately by induced vomiting or by washing out the stomach.
If excessive amounts of radioiodine are inhaled or swallowed, potassium iodide should be given to the patient for days to weeks to block thyroid absorption, and diuresis should be encouraged.
Neupogen (filgrastim) was approved in 2015 for the treatment of adult and paediatric patients with acute exposure to myelosuppressive radiation doses (hematopoietic syndrome of acute radiation syndrome, or radiation sickness). Neupogen is made by Amgen, Inc.
Prussian blue is a dye that has been used for decades in industry and is now licenced by the FDA for the treatment of exposure to radioactive cesium and non-radioactive thallium. Prussian blue traps these components in the stomach such that instead of being ingested, they can be transferred out of the body as faeces.
Ca-DTPA and Zn-DTPA are also medications licenced by the FDA that accelerate the body’s excretion of elements such as uranium, americium, and curium. As it is more reliable, Ca-DTPA is offered as the first dosage, but both are similarly effective after the initial 24 hours and Zn-DTPA becomes preferred because it eliminates fewer critical metals, such as zinc.
Therapy is symptomatic and helpful for cardiovascular/central nervous system illness. It helps to combat shock and oxygen deprivation, alleviate pain and anxiety, and control convulsions with sedation.
The type and degree of treatment would be determined by the severity of the symptoms whether the gastro-intestinal condition occurs following external whole-body irradiation. Antiemetics and sedation can suffice after modest exposure. If it is practicable to begin oral feeding, a bland diet is better tolerated. In big quantities, fluid, electrolytes, and plasma may be required. Blood chemical studies (particularly electrolytes and proteins), blood pressure, pulsation, urine production, and skin turgor can determine the quantity and form.
Hematopoietic sickness care, with its apparent possibly fatal causes of inflammation, haemorrhage and anaemia, is similar to therapy for the source of marrow hypoplasia and pancytopenia. The primary clinical supports include vaccines, new blood, and platelet transfusions. However, creating an allergic response to potential platelet transfusions can be a side effect of platelet transfusions. Rigid germ-free conditions (asepsis) are mandatory for all skin-puncturing operations, as strict separation is necessary to minimise exposure to germs causing disease.
Simultaneous anticancer chemotherapy or the use of other medications that kill marrow should be discouraged.
Surgical removal and plastic repair are needed for radiation ulcers and cancers. Leukaemia caused by radiation is treated as any related leukaemia that develops naturally. Via blood transfusion, anaemia is corrected. Via platelet transfusions, bleeding due to lack of platelets (thrombocytopenia) can be minimised.
There is currently no proven medication available for sterility or for ovarian and testicular dysfunction (with the exception of hormone supplementation in some cases).
Prevention :
- Keep tuned to the radio or television in the case of a radiation alert to hear what preventive measures local, state and federal officials suggest. Recommended activities will depend on the situation, but either remain in position or evacuate the area will be told to you.
References:
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https://www.mayoclinic.org/diseases-conditions/radiation-sickness/symptoms-causes/syc-20377058
https://medlineplus.gov/ency/article/000026.htm
https://rarediseases.org/rare-diseases/radiation-sickness/
https://www.webmd.com/cancer/radiation-sickness-facts#1
https://www.medicalnewstoday.com/articles/219615
