Combined Injury: Radiation in Combination with Trauma, Infectious Disease, or Chemical Exposures
Abstract
Biomedical consequences of radiation exposure are exacerbated by concurrent trauma and/or disease. After a nuclear detonation burns and/or wounds in combination with radiation are highly likely. At Hiroshima and Nagasaki, 60% to 70% of radiation victims sustained traumatic injury. In the 1986 Chernobyl reactor incident, 10% of the 237 accident victims received both significant radiation doses and burns. Animal studies in several species demonstrate that traumatic injuries increase mortality associated with acute radiation syndrome. For example, Brooks et al. [Brooks 1952], found that combining 1 Gy radiation (12% mortality alone) with a modest sized thermal burn (non-lethal alone) elicited 75% mortality in a canine model. Similarly, in rats a burn associated with 50% mortality inflicted in conjunction with sublethal radiation (2.5 Gy) increased mortality to 95% [Alpen 1954]. Burns and wounds shift the radiation dose response curve to the left. In a study of gamma-irradiated mice, the LD50 with radiation alone decreased from 9.63 Gy with radiation alone to 8.20 Gy with a non-lethal, 15% body surface burn and to 7.61 Gy with a non-lethal, 15% body surface wound. Although the mechanisms of this interaction are undetermined, increased susceptibility to infection is known to contribute to the synergism. Infectious disease is a likely confounder following a nuclear event that can disrupt public health infrastructure. In combination with radiation, morbidity and mortality from infection will increase significantly. An infectious agent can be naturally occurring in the environment or it can be intentionally dispersed as a biological warfare agent. Because radiation impairs the immune response and compromises the normal barriers to infection (i.e., the epithelial cell layers of the intestinal tract and lung), an individual becomes more susceptible to pathogens.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2005
- Accession Number
- ADA438764
Entities
People
- G. David Ledney
- T. C. Pellmar
Organizations
- Armed Forces Radiobiology Research Institute