Treatments for Nuclear Fallout

Radiation Exposure Level and Effects

includes OTC treatments for internal contamination with some radioactive elements

Radiation Exposure Level and Effects

		This booklet (now available at Amazon.com) examines different levels of radiation exposure and their effects. The radiation might be from a nuclear power plant disaster, or a dirty bomb, or fallout from a nuclear explosion. The different levels of radiation are categorized by the associated negative health effects, risk of cancer, and risk of death. See also: U.S. CDC Radiation Emergency Countermeasures This booklet also proposes a new method of classifying radiation exposure level (REL), based on the range of accumulated dosage. Each level of exposure is designated by a letter, a word or phrase, a color code, and a range of accumulated radiation exposure in sieverts. REL = Radiation Exposure Level A: Normal -- less than 15 mSv/year [green] B: Elevated -- 15 to 50 mSv [green] C: Caution -- 50 to 100 mSv [yellow] D: Danger -- 100 to 500 mSv [yellow] E: Emergency -- 500 to 1,500 mSv (0.5 to 1.5 Sv) [orange] F1: Fatality Threshold -- 1.5 to 2.0 Sv [red] F2: Many Fatalities -- 2.0 to 5.0 Sv [red] F3: near 100% Fatal -- 5.0 to 6.0 Sv and higher [black]

Later sections in the booklet discuss treatment for exposure to radioactive isotopes -- including radioactive iodine, cesium, plutonium, americium, curium, strontium, radium, and uranium -- using various Over-The-Counter and prescription medications. Of particular interest is possible treatment for exposure to certain radioactive isotopes using widely available OTC antacids and calcium supplements. The final section discusses the decision to evacuate an area, based on the anticipated Radiation Exposure Level.

Table of Contents:
Introduction
1. Lethal Dose (LD50)
2. Cancer Risk
3. Level of Exposure and Effects
4. Classification of Radiation Exposure Level
5. Current Reading and Accumulated Exposure
6. Treatment with Potassium Iodide
7. Treatment with Prussian Blue
8. Treatment with DTPA
9. Treatment with Antacids and Calcium Supplements
10. Treatment with Sodium Bicarbonate
11. A Word of Caution
12. Evacuation of a Contaminated Area
Endnotes

Information in the booklet is taken from a variety of authoritative and reliable sources, including: government agencies (Nuclear Regulatory Commission, EPA, CDC, FDA, HHS), the book Medical Implications of Nuclear War, the National Council on Radiation Protection, and various university and medical publications. If a radiation emergency occurs, this brief inexpensive booklet could help save your life. Now available at Amazon.com

Radiation Exposure Level (REL) and Effects
Level	Dose	Description of Effects
REL A Normal	0 to 15 mSv	Within normal limits for radiation exposure. Safe indefinitely. No elevated risk of cancer. 3.1 mSv/year = average U.S. natural background radiation level 6 to 8 mSv = CT scan of spine, or pelvis, or chest, or abdomen
REL B Elevated	15 to 50 mSv	Elevated above normal limits, but not unusual for some members of the population. Slight theoretical increase in cancer risk. 20 mSv = same level of radiation as a full body CT scan 40.7 mSv = nuclear imaging, cardiac stress test
REL C Caution	50 to 100 mSv	50 mSv = NRC limit for occupational radiation exposure per year Tolerable for healthy adults. Risky for pregnant women, the young, the elderly, and anyone in ill health. Small theoretical increase in risk of cancer. No radiation sickness at this level.
REL D Danger	100 to 500 mSv	100 mSv = threshold dose for harm to a developing fetus Significant statistically-verifiable increase in risk of cancer. Few, if any, symptoms of radiation sickness in healthy adults, but adverse effects may be seen in pregnant women, the young, the elderly, and anyone in ill health.
REL E Emergency	500 to 1500 mSv (0.5 to 1.5 Sv)	Emergency care needed. Symptoms of radiation sickness begin at 500 mSv and increase with greater exposure: blood count changes, nausea, fatigue, vomiting, hair loss (in 2 to 3 weeks), diarrhea due to intestinal damage, bleeding. Further increase in risk of cancer.
REL F1 Fatality Threshold	1.5 to 2.0 Sv	Threshold for death in some healthy adults. Significant risk of death for the very young, the elderly, and anyone in poor health. Increased risk of infection; suppression of immune system. Increase in symptoms of radiation sickness. Substantial increase in risk of cancer.
REL F2 Many Fatalities	2.0 to 5.0 Sv	Even greater risk of cancer, for those who survive. At the low end of this range, less than 50% of the exposed population will die. At the high end, more than 50% of the exposed population will die. Chance of fatality increases sharply with exposure level. Greater risk of death for the very young, the elderly, and anyone in poor health.
REL F3 near 100% Fatal	5.0 to 6.0 Sv and higher	Range of dose that is almost always fatal, even with advanced medical care (based on data from Chernobyl). Higher dose means sooner death. Depending on the severity of exposure, death can occur within hours, days, or weeks.

For sources supporting the above radiation exposure levels and effects, see the booklet.

For treatment in cases of internal contamination with radioactive elements, see below:

HHS, National Library of Medicine, Radiation Emergency Medical Management
Managing Internal Contamination [PDF file]
Radiation Countermeasures for Treatment of Internal Contamination

Tables of data below are from:
Management of Persons Contaminated with Radionuclides: Handbook
NCRP Report No. 161
National Council on Radiation Protection and Measurements, Bethesda, MD, 2008

NCRP, Report 161, Table 12.18
Drugs to block absorption of radium or strontium

NCRP, Report 161, Table 12.19
Calcium compounds to use after absorption of strontium

NCRP, Report 161, Table 12.22
Medical Treatment for Uranium Isotopes: U-234, U-235, U-238, and DU (depleted uranium)

NCRP, Report 161, Table 12.2, Summary
Decorporation therapy recommendations in the United States for radionuclides of concern:

For further information on the above-mentioned drugs, see:
Drugs.com: A - Z drug list
Drugs.com: Drug Interactions Checker

See also:
Koenig and Schultz's Disaster Medicine: Comprehensive Principles and Practices
Edited by Kristi L. Koenig, Carl H. Schultz, (Cambridge University Press, 2009) p. 498, table 30.18.

For treatments using OTC medications,
do not exceed maximum daily dosage on the product label,
unless directed to do so by a physician or public health authorities.