Acute And Chronic Radiation Sickness - Symptoms, Treatment, Degrees

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Radiation sickness

The content of the article:

1. Causes
2. Forms
3. Stages
4. Radiation sickness symptoms
5. Diagnostics
6. Treatment of radiation sickness
7. Potential consequences and complications
8. Forecast
9. Prevention

Radiation sickness is a disease that is caused by exposure to the body of radioactive radiation in doses exceeding the maximum permissible.

Ionizing radiation is a type of energy that, when interacting with substances, leads to their ionization, i.e., the formation of electrically charged particles. Ionization of substances in the cells of living organisms leads to chemical reactions that can lead to cell death.

Each person is constantly exposed to low doses of ionizing radiation from natural and artificial sources. A total annual dose of 1–3 mGy is considered safe for health.

Source: regnum.ru

Causes

Irradiation of the body can occur as a result of massive exposure to significant doses of penetrating radiation during man-made disasters, nuclear weapons tests, if safety precautions are not followed in the course of professional work related to radiation, as well as during radiotherapy.

Systematic irradiation of the body with γ-waves, neutrons or X-rays is possible for medical personnel in the departments of radiation therapy and diagnostics, for employees of industrial enterprises in contact with sources of radioactive radiation.

The ingress of radioactive compounds into the body is possible through the digestive tract (with water or food), the respiratory system, damaged skin or mucous membranes, as a result of injection, injury.

Forms

According to the time of injury and the total dose of absorbed radiation, radiation sickness is:

• acute - develops with a single intense exposure to radioactive radiation. The total dose of absorbed radiation exceeds 1 J / kg (100 rad);
• chronic - is formed during long-term irradiation in relatively low (0.02 Gy / min and less) doses.

Depending on the absorbed dose, acute radiation sickness is subdivided into several clinical forms:

• radiation injury - the absorbed dose is less than 1 Gy;
• bone marrow form - 1–6 Gy, typical form;
• transitional form - 6–10 Gy;
• intestinal form –10–20 Gy, proceeds with severe enteritis, fever, bleeding from the gastrointestinal tract;
• toxemic (vascular) - 20–80 Gy, characterized by hemodynamic disturbances;
• cerebral form - over 80 Gy, accompanied by cerebral edema.

The bone marrow form has 4 degrees of severity, depending on the absorbed dose of radiation:

• mild radiation sickness (1–2 Gy);
• moderately heavy (2–4 Gy);
• heavy (4–6 Gy);
• extremely severe (more than 6 Gy).

Depending on the route of entry of radioactive substances, the following options for the development of chronic radiation sickness are possible:

• chronic radiation sickness, provoked by general radiation (in the case of exposure to general external radiation or radioactive isotopes with their uniform distribution in the body);
• chronic radiation sickness caused by the ingress of radioactive isotopes into the body with selective deposition or local exposure.

Stages

The course of a typical (bone marrow) form of acute radiation sickness goes through 4 phases.

1. The phase of primary general reactivity - develops immediately after radiation exposure. Duration from several hours to several days.
2. The latent phase is an apparent clinical well-being. Duration from 3-4 days to 4-5 weeks.
3. The phase of advanced symptoms. In case of recovery, it lasts 2-3 weeks.
4. Recovery. Duration from 6 months to 3 years.

Chronic radiation sickness caused by general irradiation goes through three stages in its development:

1. Formation stage. Lasts 1-3 years. A clinical syndrome develops.
2. Recovery. Begins 1-3 years after the termination or decrease in the intensity of radiation exposure.
3. Stage of consequences (complications). The outcome of chronic radiation sickness can be recovery, stabilization of changes or their worsening.

Chronic radiation sickness, provoked by local irradiation, has the following stages of development:

1. Preclinical.
2. The stage of clinical manifestations (hypoplastic anemia, accelerated aging, pneumosclerosis, leukemia, skin neoplasms).
3. Exodus.

Radiation sickness symptoms

The symptoms of radiation sickness are determined by the dose of radiation, the power and type of radiation, and the characteristics of the organism.

Signs of a primary reaction are a complex of symptoms of radiation sickness that appear in the first minutes and hours after exposure to ionizing radiation:

• weakness;
• nausea, vomiting is possible;
• agitation or, on the contrary, apathy and lethargy;
• increased heart rate, tachycardia;
• headache, dizziness;
• increased blood pressure, which is then replaced by hypotension;
• increased body temperature;
• dry mouth, thirst;
• hyperemia of the skin;
• decreased muscle tone;
• hyperhidrosis;
• diarrhea;
• pain in the rectal area;
• paresis of the stomach and intestines;
• lower abdominal pain;
• pain in the region of the heart;
• hand tremor;
• loss of consciousness.

Over time, the state of the body improves, a period of imaginary recovery begins. Signs of the primary reaction gradually disappear, however, during the examination, signs of changes in the hematopoietic tissue, in the endocrine and nervous systems are revealed. By the end of the phase, reflexes subside, motor and coordination disorders, skin lesions appear, and hair loss begins.

During the period of severe clinical symptoms, there is a sharp deterioration in all body systems. In this period, the following syndromes are distinguished:

• general intoxication;
• pancytopenic (hematopoietic disorders);
• hemorrhagic;
• asthenization;
• infectious;
• intestinal disorders;
• sensitization.

The listed syndromes are characterized by the following manifestations:

• hemorrhage and bleeding;
• increased body temperature;
• general weakening and depletion of the body (asthenia);
• tachycardia, hypotension;
• trophic disorders, ulcerative processes, skin necrosis;
• frequent urination;
• lesions of the gastrointestinal tract (nausea, vomiting, loose stools mixed with blood);
• confusion, meningeal symptoms;
• suppression of immunity, leading to the development of infectious complications (pneumonia, necrotizing tonsillitis, abscesses, wound suppuration).

In the chronic form of radiation sickness, the primary reaction is delayed (it develops as the radiation dose accumulates), the phase of pronounced clinical symptoms and the recovery phase are extended over time.

Diagnostics

Diagnostics of radiation sickness includes examination by a therapist, collection of anamnesis and the following types of laboratory and instrumental studies:

• general, clinical, biochemical blood test;
• bacteriological examination of scrapings from foci of infection with determination of the sensitivity of microflora to antibiotics;
• dosimetric analyzes of blood, feces and urine;
• microscopy of scrapings of ulcers of the skin and mucous membranes;
• chromosomal analysis of hematopoietic cells;
• blood culture for sterility;
• coagulogram;
• bone marrow examination;
• Ultrasound of the abdominal cavity, lymph nodes;
• radiography;
• myelography;
• electroencephalography;
• endoscopy (FGDS, colonoscopy, etc.);
• CT scan.

Treatment of radiation sickness

The volume and intensity of radiation sickness therapy are determined by the severity of its course.

Patients with grade I acute radiation sickness require symptomatic treatment, patients with grade IV acute radiation sickness - in pathogenetic therapy in a specialized hospital. In chronic radiation sickness, measures are taken to stop the effects of ionizing radiation and remove radioactive substances from the body.

Areas of treatment for radiation sickness:

• Isolation of the patient and the creation of aseptic conditions (aseptic blocks, the use of sterile medical clothing by personnel at the entrance to the ward, sterilization of food);
• urgent help with infection, stopping vomiting;
• intensive therapy for relief of shock or collaptoid states, disseminated intravascular coagulation syndrome, cerebral edema;
• correction of hemodynamic disorders;
• detoxification and replacement therapy (infusion therapy using saline solutions, in some cases - forced diuresis, plasmapheresis);
• restoration of hematopoiesis and correction of granulocytopenia;
• blood transfusion therapy;
• elimination of intestinal dysfunction;
• antiviral and antibacterial therapy using several groups of antibiotics;
• transition to parenteral nutrition with the development of necrotizing enteropathy;
• local therapy of radiation damage to the skin, areas of necrosis (use of drugs that have anesthetic properties and promote tissue regeneration);
• taking sedatives and antihistamines, analgesics and multivitamins;
• prevention of pathological conditions, rehabilitation of foci of chronic infection.

If symptomatic therapy is ineffective, they resort to bone marrow transplantation. The optimal period for transplantation of bone marrow cells to an irradiated recipient is 24 hours after radiation exposure.

Upon completion of inpatient treatment, patients undergo rehabilitation, during the recovery period, the use of immunomodulators, anabolic steroids is indicated, it is recommended to adhere to a diet with a high content of proteins, vitamins and minerals.

Potential consequences and complications

Complications of radiation sickness can be:

• the development of hemolytic syndrome;
• malignant neoplasms of different localization;
• hemoblastosis;
• arterial hypertension;
• diseases of an ophthalmic nature, damage to the lens, cataracts;
• genetic abnormalities in offspring due to the vulnerability of germ cells to radiation.

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Forecast

The prognosis depends on the time of the damaging effect, the degree of radiation sickness and the intensity of the radiation dose received.

Survival for 12 weeks after exposure is an important prognostic indicator. The condition of patients who survived this critical period usually improves in the future, although complications, including late ones, cannot be ruled out.

Prevention

Preventive measures when performing all types of work with radioactive elements:

• strict adherence to norms and standards when working with radioactive sources;
• limiting the time spent in the fields of intense radiation;
• dosimetric control with serviceable devices for measuring the radiation level;
• film adaptation;
• use of personal protective equipment (gas masks, respirators, bandages, special suits);
• reception of radioprotectors;
• taking vitamins P, B6, C;
• drinking a lot of water;
• regular medical examinations.

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!