Ionizing radiation and its effects are discussed in detail elsewhere (see Radiation Exposure and Contamination). Mass casualties due to ionizing radiation can result from the detonation of a nuclear (fission) or a thermonuclear (fusion) device, from the contamination of conventional explosives with radioactive material (such a weapon is called a radiation dispersal device, or a dirty bomb), or from placement (eg, under a subway seat) of a concealed point source of radiation.
Radiation exposure may involve
Contamination (external or internal)
Irradiation
Both
Contamination is contact with radioactive material, typically as a dust or liquid. Irradiation is exposure to ionizing radiation but not radioactive material.
In cases of the deliberate use of radiation as a weapon, it must be determined whether patients have been exposed (irradiated), contaminated, or both. If contamination has occurred, determination of whether it is external, internal, or both is needed. Use of the ASBESTOS acronym (see table ASBESTOS*: Secondary Assessment of Mass Casualties Due to Chemical or Radiological Weapons) is helpful in making these determinations. Another useful clinical resource is the online and downloadable module, Radiation Emergency Medical Management (REMM).
(See also Overview of Incidents Involving Mass-Casualty Weapons.)
The views expressed in this article are those of the author and do not reflect the official policy of the Department of Army, Department of Defense, or the US Government.
