RADIATION POISONING

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RADIATION

POISONING

Presented by S.Nandhini

• Radiation is a form of energy whose sources are synthetic and

naturally occurring.

• Small quantities of radioactive materials occur naturally in the

environment (atmosphere, water, and food) and are referred to as

internal exposure.

• External exposure results from sunlight radiation and from

synthetic and naturally occurring radioactive materials.

• Radiation poisoning is also known as radiation sickness

• Radiation sickness is illness and symptoms resulting from

excessive exposure to ionizing radiation.2LMT

• Radiation is often categorized as either ionizing or non-

ionizing depending on the energy of the radiated particles

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• IONIZING RADIATION -Gamma rays, X-rays and the higher

energy range of ultraviolet light constitute the ionizing part of

the electromagnetic spectrum.

• NON IONIZING RADIATION -The lower-energy, longer-

wavelength part of the spectrum including visible light, infrared

light, microwaves and radio waves is non-ionizing; its main

effect when interacting with tissue is heating.

• This type of radiation only damages cells if the intensity is high

enough to cause excessive heating. Ultraviolet radiation has

some features of both ionizing and non-ionizing radiation.

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IONIZING RADIATION

• Ionizing radiation induces somatic changes in cells and tissues

by displacing electrons from their atomic nuclei, resulting in

the intracellular ionization of molecules.

• Depending on the dose and length of exposure, the effects can

be immediate, chronic, or delayed. The most important targets

are the DNA-molecules, where direct or indirect actions of

radiation could result in lesions, such as base damage, single-

strand breaks and double-strand breaks.

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• Double-strand breaks are considered the most serious DNA-

lesions, since they can result in the cleavage of chromatin and

might not be successfully repaired by the cell. The occurrence

of DNA-lesions and, especially, of double-strand breaks will

increase with increasing radiation exposure and will lead to a

higher risk of cell death

• Thus, reversible or irreversible DNA changes are induced,

initiating a series of events that culminate in the production of a

mutagenic response, a carcinogenic response, the inhibition of

cell replication, or cell death.

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SOURCE OF IONIZING RADIATION Medical Sources

• The largest source of medical exposure, when averaged over all

individuals, is from diagnostic x-rays, including both chest or limb x-

rays and dental x-rays.

• Nuclear medicine also includes in treatment of disease. Some

examples are cobalt irradiation for the treatment of cancers, or the

injection of radioactive iodine which concentrates in the thyroid for

treatment of Graves’ disease.

• High-energy diagnostic or therapeutic X-rays, used in the treatment of

cancer. LMT 8

Occupational exposure involves variable amounts of

radioactivity from nuclear reactors, linear accelerators, and

sealed cesium, americium, and cobalt sources used in

therapeutic instruments and detectors.

Natural Sources of Radiation

• Peoples are exposed to X rays and Gamma rays from cosmic

rays from our solar system and radioactive elements normally

present in the soil

• Radium and radon gas are naturally occurring hazardous

isotopes embedded in the Earth’s crust

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Symptoms of Radiation Poisoning

SKIN CHANGES: Cutaneous radiation syndrome (CRS) refers to

the skin symptoms of radiation exposure. Within a few hours after

irradiation, a transient and inconsistent redness(associated with

itching) can occur. Then, a latent phase may occur and last from a few

days up to several weeks, when intense reddening, blistering, and

ulceration of the irradiated site are visible.

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Nausea and vomiting Hair loss

Fatigue Spontaneous bleeding

Moderate radiation sicknessWith an acute absorbed dose of 2 to 3.5 Gy

Nausea and vomiting within 12 to 24 hours ,Fever Hair loss ,Infections Vomiting blood ,Bloody stool Poor wound healing . It can be fatal to those most sensitive to radiation exposure.

Severe radiation sickness An absorbed dose of 3.5 to 5.5 Gy

Nausea and vomiting less than one hour after exposure to radiation Diarrhea ,High fever Severe radiation sickness is fatal about half the time.

Very severe radiation sicknessAbsorbed dose greater than 5.5 to 8 Gy

Nausea and vomiting less than 30 minutes after exposure to radiation Dizziness ,Disorientation hypotension Very severe radiation sickness is often fatal

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UV RADIATION• Prolonged human exposure to solar UV radiation

may result in acute and chronic health effects

on the skin, eye and immune system.

• UV rays (e.g., from sun exposure) is mediated principally by the

generation of reactive oxygen species and the interruption of

melanin production.

• Sunburn (erythema) is the best-known acute effect of excessive UV

radiation exposure.

• Another long-term effect is an inflammatory reaction of the eye. In

the most serious cases, skin cancer and cataracts can occur.LMT 13

EFFECT OF UV RAYS

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Ultraviolet (UV) photons harm the DNA molecules of living organisms in different ways. In one common damage event, adjacent bases bond with each other, instead of across the “ladder.” This makes a bulge, and the distorted DNA molecule does not function properly.

• SOURCE: Sunlight is the main source of UV rays. Tanning lamps and beds are also sources of UV rays.

• Fluorescent lamps ,Mercury vapour lamp ,Halogen lamps

• There are 3 main types of UV rays:

• UVA rays age skin cells and can damage their DNA. Most tanning

beds give off large amounts of UVA, which has been found to

increase skin cancer risk.

• UVB rays have slightly more energy than UVA rays. They can

cause sunburns and most skin cancers.

• UVC rays have more energy than the other types of UV rays, but

they don’t get through sunlight. They are not normally a cause of

skin cancer.LMT 15

Reactions To Excessive Sunlight Clinical Effects

General Dermatologic Dermatoheliosis – aging of the skin due to chronic exposure to sunlightElastosis – yellow discoloration of skin with accompanying small nodulesWrinkling, hyperpigmentation, atrophy and dermatitis

Actinic keratoses Precancerous keratotic lesions, appear after many years of exposure toUV rays

Squamous/basal cellcarcinoma

Occurs more commonly in light-skinned individuals exposed to extensiveUV rays during adolescence

Malignant melanomas prolonged exposure to UV light

Photosensitivereactions

Erythema and erythema multiform lesions; urticaria, dermatitis, bullae;thickened, scaling patches

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• First-degree burns are generally red, sensitive, and moist. The

absence of blisters and blanching of the skin with application of

light pressure are characteristic features.

• Second-degree burns are classified as superficial intermediate, or

deep, with partial skin loss. The presence of erythematous blisters

with exudate is typical of second-degree burns

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• Third-degree burns involve deep dermal, whole skin loss. The

skin appears black, charred, and leathery. Subdermal vessels do

not blanch with applied pressure and the areas exposed are

generally anesthetic or insensitive to pain stimuli.

• fourth-degree burns involve deep tissue and structure loss.

Hypertrophic scars and chronic granulations develop unless skin

grafting treatment is instituted.

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UV effects on eye• The eyes are particularly sensitive to UV radiation. Even a short

exposure of a few seconds can result in a painful, but temporary

condition known as photokeratitis and conjunctivitis.

• which becomes swollen and produces a watery discharge. It

causes discomfort rather than pain and does not usually affect

vision

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PREVENTION• Wear a sunscreen that has an SPF of at least 30 and says "broad-

spectrum" on the label, which means that it protects against the sun's

UVA and UVB rays..

• Limit sun exposure between 10 a.m. to 2 p.m.

• Wear sunglasses, a hat, and protective clothing.

• Avoid unnecessary exposure to radiation.

• Persons working in radiation hazard areas should wear badges to

measure their exposure level.

• Protective shields should always be placed over the parts of the body

not being treated or studied during x-ray imaging /radiation therapy.LMT 21

Non-ionizing  radiation

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• Types of non –ionising radiation:

Optical Radiation

- Ultraviolet,

- Infrared and

- Visible (including lasers)

Radiofrequency Radiation

- Microwaves

- Radiofrequency

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IR Sources and effects

• SOURCES: most are thermal sources (plasma torches, halogen lamps)

• Target Organs: skin and eyes• Can damage – cornea, iris, retina and lens of

the eye• Skin: heats/burn surface of the skin and tissues

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Microwave Sources

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Radar

Microwave oven

Traffic controller

Biological Effects [Microwaves]• Primarily thermal effects• cataracts• CNS, biochemical changes • Secondary problems (pace-makers, etc.)• The latter are also capable of disrupting the normal

function of electronic medical devices such as subcutaneously implanted cardiac pacemakers and monitors.

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DIAGNOSIS

• The most useful and rapid method for clinical assessment of the

degree of radiation exposure, especially ionizing radiation, is

determination of the patient’s total blood lymphocyte count.

Serial determinations are performed every 6 h for atleast 48 h. A 50%

fall in total lymphocytes every 24 h for 2 days is indicative of a

potentially lethal injury.

• A device called a dosimeter can measure the absorbed dose of

radiation but only if it was exposed to the same radiation event as the

affected person.

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DOSIMETER.

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MANAGEMENT

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GOALS

• The treatment goals for radiation sickness are

to prevent further radioactive contamination;

treat life-threatening injuries, such as from

burns and trauma; reduce symptoms; and

manage pain.

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• Decontamination• Decontamination prevents further distribution of radioactive

materials and lowers the risk of internal contamination from

inhalation, ingestion or open wounds

• Removing clothing and shoes eliminates

about 90 percent of external contamination.

• Gently washing with water and soap removes additional

radiation particles from the skin.

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• Treatment for internal contamination

• Some treatments may reduce damage to internal organs caused

by radioactive particles. These treatments include the following:

• Potassium iodide.

• Prussian blue

• Diethylenetriamine penta acetic acid.

• Filgrastim LMT 32

Potassium iodide (Thyroshield, Iosat).

•  This is a non radioactive form of iodine. is most

effective if taken within a day of exposure

• can help block radioactive iodine from being absorbed by the thyroid

gland

• Adults dose- 130 mg (OD130 mg OR BD 65 mg )

• Side effects -stomach upset, allergic reactions and

inflammation of the salivary glands

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• Prussian blue (Radiogardase). 

• This type of dye binds to particles of radioactive elements known as cesium

and thallium.

• This treatment speeds up the elimination of the radioactive particles and

reduces the amount of radiation cells may absorb.

• It reduces the biological half-life of cesium from 110 days to 30 days.

• It reduces the biological half-life of

thallium from 8 days to 3 days

• Dose – 500 mg capsule.

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• Diethylenetriamine pentaacetic acid (DTPA).

• Ca-DTPA and Zn - DTPA

• DTPA binds to particles of the radioactive elements

plutonium, and curium.

• The radioactive particles pass out of the body

in urine, thereby reducing the amount

of radiation absorbed.

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• Treatment for damaged bone marrow

• A protein called granulocyte colony-stimulating factor, which promotes

the growth of white blood cells, may counter the effect of radiation

sickness on bone marrow.

• Treatment with this protein-based medication, which includes filgrastim

(Neupogen), and pegfilgrastim (Neulasta), may increase white blood

cell production and help prevent subsequent infections.

• 10 mcg/kg SC as a single daily injection for patients exposed to

myelosuppressive doses of radiation

• Administer as soon as possible after suspected or confirmed exposure to

radiation doses >2 gray (Gy)

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Filgrastim: Must follow the labelling instruction before administaration

Do not shake. Shaking will cause damage the filgrastim. Before using the drug take it from refrigerator & keep it room

temp for 30 min. Choose new site for injection every time. Discard the unused part of drug up to 2 weeks, by subcutaneous injection

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