Health effects: immediate and direct

What are the direct effects of a nuclear explosion on the human body? Here are some basics.

Burns

Burn injuries are the major cause of death on the first day. The fireball of the explosion creates direct ‘flash burns’ and more penetrating ‘flame burns’. Keloids – mounds of raised and twisted flesh – were found in 50-60% of those burned by direct exposure within 1.2 miles of the hypocentres in Hiroshima and Nagasaki. People also die in the building fires that result from a blast. Looking at the fireball, even from a distance of 20 km, can cause retinal burning and blindness.

Burn injuries are a massive burden on health services. One patient with severe burns may need hospital care for six weeks or more, including:

• operations: 8-10 times

• blood erythrocytes: 6 litres

• blood plasma: 5 litres

• intravenous salt and sugar solutions: 80 litres

• amino and lipid acids: 30- 40 litres

• antibiotics

• dressings

The treatment of burns present the greatest challenge to health workers. It can take an average of 52 minutes for three people to dress a single burned hand. To treat 34,000 serious burn cases would require 170,000 health workers and 8,000 tons of supplies!

Mechanical (traumatic) injuries

The blast causes crush injuries, ruptured organs, lacerations, compound fractures and haemorrhage from flying and collapsing missiles. Eardrums will be ruptured, causing temporary and permanent deafness. The most common injury is laceration by small glass fragments from windows. Treatment is complicated by the lowering of white blood cell counts (leukopenia) due to ionizing radiation, causing what are normally minor lacerations and abrasions to result in severe infections.

Radiation injuries

Radiation exposure poses a particular problem. There is no way of knowing whether a person has received a 100 rem exposure and might survive with adequate care, or has received a 1000 rem exposure and will die regardless of what treatment is offered. As a result triage is not possible and all patients must be treated. Acute radiation exposure causes central nervous system dysfunction, gastrointestinal damage, uncontrolled internal bleeding, and bleeding from gums or within the skin. Because radiation exposure damages or destroys the immune system, resistance to infections is compromised and minor infections may become fatal.

The symptoms of acute radiation sickness are nausea, vomiting, weight loss (anorexia), hair loss (epilation), bleeding gums, haemorrhaging into skin or internal organs (purpura), sores in the throat (oropharyngeal ulceration), infection and diarrhoea. The earliest manifestations are mostly gastrointestinal symptoms. They may be followed by a period of relative well-being whose length depends on the exposure. At three to seven days there follows a feverish period of several weeks characterized by severe diarrhoea, and ending in death or a long recovery period. Severely exposed patients die within two weeks. Less exposed patients may begin the feverish phase with epilation about two weeks after exposure.

For more information and further reading, see the ‘See Also’ section below.