How to Recognize Radiation Sickness

Co-authored by Chris M. Matsko, MD

Last Updated: September 10, 2024 References

Radiation sickness occurs after exposure to a large amount of ionizing radiation over a short period of time. The symptoms of radiation sickness generally present in a predictable or orderly manner, most often after a sudden and unexpected exposure to high levels of radiation. In medical terms, radiation sickness is known as acute radiation syndrome, radiation poisoning, radiation injury, or radiation toxicity. The symptoms develop rapidly and are related to the level of exposure. Exposure to enough radiation to cause sickness is rare.

Part 1

Part 1 of 3:

Recognizing the Symptoms

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1
Watch for symptom progression. Pay attention to the symptoms that develop, their severity, and their timing. It is possible for doctors to predict the level of radiation exposure from the timing and the nature of the symptoms. The severity of symptoms will vary depending on the radiation dose received, and the parts of the body that absorbed the emissions.^{[1]
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- The determining factors in the degree of radiation sickness are the type of exposure, the exposed parts of the body, the duration of exposure, the strength of the radiation, and how much your body has absorbed.
- The cells in your body that are most sensitive to radiation include the lining of your stomach and intestinal tract, and the cells found in your bone marrow that produce new blood cells.
- The degree of exposure guides the presentation of symptoms. Initial symptoms involving the gastrointestinal tract can appear within ten minutes.
- If the skin was directly exposed or contaminated, redness, rash, and burning can begin almost immediately.
2
Identify the symptoms. There is no way to predict the exact course of a radiation exposure event that leads to radiation sickness since there are many variables involved. The symptom presentation is, however predictable. The degree of exposure, ranging from mild to very severe, can alter the timing of symptom development. The following symptoms are consistent with radiation sickness.^{[2]
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- Nausea and vomiting
- Headache
- Fever
- Dizziness
- Disorientation
- Weakness and fatigue
- Hair loss
- Bloody vomit and stools
- Infections and poor wound healing
- Low blood pressure
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3
Consider the level of exposure. Four categories and their ranges of exposure are used to diagnose the levels of severity for radiation sickness. The levels are based on a sudden exposure over a short amount of time. The severity is determined by the degree of exposure and the onset of symptoms.^{[3]
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- Mild severity is exposure to radiation that resulted in a body absorption of 1 to 2 gray units (Gy).
- Moderate severity results after exposure that causes the body to absorb 2 to 6 Gy.
- Severe exposure results in an absorbed level measured at 6 to 9 Gy.
- Very severe exposure is absorption at 10 Gy or higher.
- Doctors can gauge the absorbed dose by measuring the time between exposure and the first signs of nausea and vomiting.
- Nausea and vomiting that begins within ten minutes of exposure is considered very severe exposure. Mild exposure involves the onset of nausea and vomiting within six hours.
4
Know what the numbers mean. Radiation exposure is measured in different ways. In the United States, the level of radiation sickness is described as the amount of radiation absorbed by the body.^{[4]
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- Different types of radiation are measured using different units, and to further complicate things, the country you are in may use yet a different unit.
- In the United States, absorbed radiation is measured in units called a gray, abbreviated as Gy, in rads, or in rem. Generally conversions are as follows: 1 Gy is equal to 100 rads, and 1 rad is equal to 1 rem.
- The rem equivalent for different types of radiation is not always expressed as just described. The information provided here includes basic conversion factors.
5
Recognize the method of exposure. Two types of exposure are possible; irradiation and contamination. Irradiation involves exposure to the radiation waves, emissions, or particles, while contamination involves direct contact with radioactive dust or liquid.^{[5]
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- Acute radiation sickness only occurs with irradiation. It is possible to have come into direct contact and also have experienced irradiation.
- Radiation contamination results in absorption of radioactive material through the skin and transportation to the bone marrow where it can result in health problems such as cancer.
6
Consider possible causes. Radiation sickness is possible but unlikely and actual incidents are rare. Radiation exposure caused by an accident at a work site that uses radiation could cause radiation sickness. Potentially, a natural disaster that alters the integrity of a structure that contains powerful radiation, such as a nuclear power plant, is possible.
- Natural disasters, like earthquakes or hurricanes, could potentially damage the integrity of a nuclear facility causing a localized release of potentially dangerous radiation; although this type of structural damage is unlikely.
- An act of war that involves the use of a nuclear weapon could cause widespread exposure leading to radiation sickness.
- A terrorist attack using dirty bombs could cause radiation sickness to people in the immediate vicinity.
- Space travel has risks related to radiation exposure.
- While possible, it is highly unlikely that exposure from equipment used for medical purposes could lead to the development of radiation sickness.
- Nuclear energy is all around us. Safeguards are in place to protect the public from accidental exposure.

Part 2

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Comparing Types of Radiation

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1
Identify the types of radiation. Radiation is around us everywhere; some in the form of waves and some as particles. Radiation can be unnoticed and cause no risk at all, while other forms are potent and dangerous if exposed. There are two types of radiation and four primary types of emissions from radiation.^{[6]
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- The two forms of radiation are ionizing and nonionizing.
- The four most common types of radioactive emissions include alpha particles, beta particles, gamma rays, and X rays.
2
Recognize the benefits of ionizing radiation. Ionizing radiation particles can carry a lot of energy. These particles cause changes when they comes in contact with other charged particles. This is not always a bad thing.^{[7]
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- Ionizing radiation is also used to safely create a chest x ray or a CT scan. Exposure to radiation for use as a diagnostic aid, such as x rays and CT scans, has no clear limit.
- According to guidelines published by the multidisciplinary field of study known as nondestructive testing, or NDT, 0.05 rem per year is recommended as a limit for exposure created by the use of medical equipment.
- There may be limits set by your doctor or determined by your illness if you are routinely exposed to radiation as a method of treatment for a disease, such as cancer.
3
Realize that nonionizing radiation is safe. Nonionizing radiation causes no harm and is used in items you come in contact with daily. Your microwave oven, a toaster with infrared heating, lawn fertilizer, your smoke detector in your home, and your cell phone are examples of nonionizing radiation.^{[8]
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- Common food items, such as wheat flour, white potatoes, pork, fruits and vegetables, poultry, and eggs, are irradiated with nonionizing radiation as a last step before appearing in your grocery store.^{[9]
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- Major well-respected agencies, such as the Centers for Disease Control and Prevention and the American Medical Association support the procedures used to irradiate foods to help control bacteria and parasites that may be dangerous if consumed.
- Your smoke detector protects you from fire by constantly emitting a low level of nonionizing radiation. The presence of smoke blocks the stream and tells your smoke detector to sound the alarm.
4
Recognize the types of radioactive emissions. If you were exposed to ionizing radiation, the types of emissions that were present influence the level of sickness you may, or may not, experience. The four common types of emissions include alpha particles, beta particles, gamma rays, and x rays.^{[10]
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- Alpha particles do not travel very far and have trouble passing through anything with substance. Alpha particles release all their energy in a small area.
- Alpha particles have trouble penetrating the skin, but if they penetrate the skin, then they can do a lot of damage, killing nearby tissues and cells.
- Beta particles can travel farther than alpha particles, but still have trouble penetrating through skin or layers of clothing.
- Beta particles are similar to alpha particles in that they can do more harm to the body if they are on the inside.
- Gamma rays travel at the speed of light and penetrate through materials and skin tissue much easier. Gamma rays are the most dangerous form of radiation.
- X rays also travel at the speed of light and can penetrate through skin. This is what makes them useful in diagnostic medicine and some industrial applications.

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Treating Radiation Sickness

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1
Seek emergency medical attention. Call 911 and remove yourself from the area immediately. Do not wait for symptoms to develop. If you know you have been exposed to ionized radiation, seek treatment the fastest possible way. Mild to moderate forms of radiation sickness can be treated. More severe forms are usually fatal.^{[11]
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- If you think you have been exposed to a dose of radiation, remove all clothing and materials you were wearing at the time and place them in a plastic bag.
- Wash your body with soap and water as soon as possible. Do not scrub the skin. That may cause irritation or break the skin which can lead to systemic absorption of any remaining radiation from the surface of the skin.
2
Determine the level of exposure. Understanding the type of ionized radiation at the site where your exposure occurred and how much your body absorbed are key factors in reaching a diagnosis of the level of severity.^{[12]
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- The goals for treatment for radiation sickness include avoiding any further contamination, treat the most immediate life-threatening problems, reduce symptoms, and manage pain.
- Those who experience mild to moderate exposure and receive treatment often have a full recovery. For a person who survives the radiation exposure, the blood cells will begin to replenish themselves after four to five weeks.
- Severe and very severe exposure results in death ranging from two days to two weeks following exposure.
- In most cases, the cause of death from radiation sickness is due to internal bleeding and infections.
3
Receive prescription medications. Often, radiation sickness symptoms can be effectively managed in a hospital setting. The approach to treatment involves maintaining hydration, controlling the progressive development of symptoms, preventing infection, and allowing the body to recover.
- Antibiotics are prescribed to treat infections that more commonly occur in people with radiation sickness.
- Since the bone marrow is sensitive to radiation, you be given certain medications that promote the growth of blood cells.
- Treatments may include the use of blood products, colony stimulating factors, bone marrow transplant, and stem cell transplant as indicated. In some cases, blood and/or platelet transfusions may help to repair the damaged bone marrow.
- Those receiving treatment are usually kept separate from others to help prevent infection. Visitation is sometimes limited to reduce the change of contamination with infectious agents.
- Medications are available to help manage internal organ damage, depending on the specific types of radiation particles or emissions involved.
4
Expect supportive care. Symptom management is part of the treatment, but for people that have received high doses, greater than 10 Gy, the treatment goals will be to make the person as comfortable as possible.^{[13]
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- Examples of supportive care include aggressive pain management and medications provided for ongoing symptoms such as nausea and vomiting.
- Pastoral care and psychological counseling may be available.
5
Monitor your health. People exposed to a radiation event that develop radiation sickness have a greater than normal chance of developing health problems, including cancer, years later.^{[14]
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- A single, rapid, large dose of radiation to the entire body can be fatal. Exposure to the same dose spread over a period of weeks or months can be treated with a good survival rate.
- Animal studies show that severe irradiation can result in birth defects caused by irradiated reproductive cells. While it is possible that radiation sickness can cause problems with developing ova, sperm, and genetic alterations, these effects in humans have not been demonstrated.
6
Track your exposure in your workplace. Standards set by OSHA provide guidelines to companies and facilities that use equipment involving ionizing radiation. There are many types of radiation beyond what is discussed here, as well as many safe applications in our world that we depend on every day.
- Workers that are exposed to radiation as a part of their jobs are often required to wear badges that keep track of a cumulative dose.
- Workers are not allowed to remain in a situation of risk once they have reached the company or government limitations, unless there is a declared state of emergency.
- Standards for radiation exposure in the workplace in the United States set limits at 5 rem per year. In situations of emergency, those levels are raised to 25 rem per year, which is still considered within the range of safe exposure.^{[15]
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- As your body recovers from radiation exposure, it is possible to return to that same work environment. There are no guidelines and little evidence to suggest that there may be future health risks associated with such repeated exposures.

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Can you get cold sores from radiation?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Yes, you can get cold sores from radiation. Sun exposure is a form of radiation, and this can lead to cold sore flare-ups.

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Are airport security x-rays safe?

Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.

Chris M. Matsko, MD

Family Medicine Physician

Expert Answer

Yes, generally the amount of radiation that you receive from an airport security x-ray, or a doctor's x-ray, is safe.

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