RADIATION

Ahmed Esmat Shoman

Professor in Dep. Of Community, Occupational and
Environmental Medicine
Two main types:
o Ionizing radiation
o Non ionizing radiation

A-Ionizing radiation
 This includes X rays, alpha, beta and gamma radiation
 Examples of occupational exposure to ionizing radiation:
o Medical radio-diagnosis and radiotherapy
o Sterilization of plastic or rubber instruments e.g. IV cannula
o Detection of defects of manufacture as cracks in gas cylinders
or iron bars
o Search for undersea or underground petrol layers
o Disinfecting seeds and killing germs before storing
o Research in atomic reactors and science institutes
 Health effects:
 Ionizing radiation induces free radicals which attacks the cell
constituents. This induces lipid peroxidation of the unsaturated
fatty acids of the endoplasmic reticulum and destruction of the
DNA of the nucleus.
 Acute effects:
 This occurs on sudden exposure to high doses as in atomic
explosions or on accidental exposure to radioactive bodies (as
happened in Meet Halfa).
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 Acute radiation syndrome may include
o Destruction of the mucous membranes leading to severe
watery diarrhea with mucous shreds
o Destruction of the bone marrow leading to severe anemia,
leucopenia and thrombocytopenia
o Cataract
o Abortion
o Death occurs due to superimposed infection and reduced
immunity. Survival from the effect of acute exposure may
be followed by delayed effects as cancer and congenital
anomalies.

 Delayed effects
This includes:
 Radio-dermatitis
 Cancer : skin cancer – leukemia
 Varying degrees of anemia
 Cataract
 Congenital anomalies
 Increased rate of abortion
 Sterility
 Shortening of the life span
 Early senility

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B-NON IONIZING RADIATION
1-Infrared:

 Occupational exposure:
Occurs on exposure to extremely hot red objects as in iron and
steel industry, ovens, melted metals, glass industry ……..etc
 Health effect:
o The main effect is on the lens where it induces posterior polar
cataract.
o The heating effect can induce heat disorders.

2-Ultraviolet:
 Occupational exposures:
o Electric welding of metals
o Photocopy machines
o Photo therapy of skin disorders
o Sterilization and disinfection in surgical wards
 Health effects:
o Conjunctivitis and corneal ulcers
o Skin erythema, burns but most importantly skin cancer
 Prevention:
ᴏ Follow the general rules of prevention of occupational diseases.
ᴏ The most important is use of protective goggles (special
eyeglasses) and protective aprons

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3-Microvave Exposure

 Occupational exposure
ᴏ Hospitals and hotels and in some homes.
ᴏ The risk of exposure increases in the presence of unsafe
utilization (usage of metal or reflecting materials) and bad
maintenance (ill-fitting doors) which causes leakage or
reflection of the microwave to the surrounding.
 Health effects:
Microwaves induce heating in the deep tissue. The damage can
occur without being noticed because the superficial tissue or skin
escapes the heating effect.

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 Ionizing Radiation
 Particles Ionizing Radiation
 Alpha particle:
o 2 proton + 2 neutron ((nucleous of Helium)
o High ionizing +Low penetrating power.
 Beta particles:
o Electrons
o Low ionizing + high penetrating power.
 Gamma rays:
o From transmission in the energy levels within the atomic
nucleolus
o Low ionizing + high penetrating power.
 Electromagnetic waves
ᴏ Xrays: from transmission of orbiting electrons
ᴏ Under effect of bombardment of heavy atomic weight or
by voltage applied between 2 electrodes

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  Factors modifying the biological effects of ionizing
radiation.
 Dose and radiation energy.
 Dose fractionation. If the dose is divided into small fractions
given at separate times, it causes less biological effects than a
single total dose as it gives a chance for Biological repair
process.
 Dose distribution: the most serious if the dose is directed to
bone marrow.
 Radiosensetivity:
ᴏ Children more susceptible than adult
ᴏ The most sensitive organs: hemopiotic, gut mucosa, skin,
Gonads, lens of the eye.
ᴏ The less sensitive is nervous system
 Doses
 Curie (Ci) The amount of radioactive material in which
3.7X1010 atomic disintegrations /second occurs
 Rontgen (r) The amount of radiation that produce one
electrostatic unit in on cm3 of dry air
 Rad (radiation adsorbed dose) energy absorption of 100 ergs/gm
 Rem= dose in radsX rbe(radiation biological effectiveness)
 Recent international System (SI)
ᴏ Radiation absorbed dose the gray (Gy)=100rad
ᴏ Radiation equivalent dose the Sievert (SV)=100 rem

 MEASUREMENT OF DOSE
When alpha or beta particles, or gamma radiation passes through
matter, they form ions. They accomplish this by knocking electrons
from the orbits of the molecules they pass through. We can monitor
the ionization effect by allowing the radiation to pass through dry air
and measuring the numbers of ions formed. This is most often done

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 by designing a chamber with an electrical charge capacitance,
allowing the radiation to pass through the chamber and monitoring the
amount of capacitance discharge caused by the formation of ions. The
device is a A. Geiger-Mueller Counter and has many variations.
 Roentgen
The ionizing ability is measured in roentgens, and a roentgen is the
number of ionizations necessary to form one electrostatic unit (e.s.u.)
in 1 cc of dry air. Since the roentgen is a large unit, dosages for cell
research use are normally divided into milliroentgens (mR).
Curie
Curies measure the amount of radioactive decay, roentgens measure
the amount of radiation transmitted through matter, over
distance. Neither unit is useful in determining biological effect, since
biological effect implies that the radiation is absorbed by the tissues
that are irradiated.
The rad
The rad (radiation absorbed dose) is a unit of absorbed dose and
equals 100 ergs absorbed in one gram of matter. The roentgen is the
amount of radiation exposure in air, while the rad represents the
amount of radiation exposure in tissue. The two are usually very close
in magnitude, however, since for most biological tissues, 1 roentgen
produces 0.96 rad.
Rem
Not all radioactive emissions have the same penetrating power,
however. If radiation safety (monitoring of dose) is considered, then
the rad is insufficient. A linear-energy- transfer dependent factor must
be defined for each type of emission. An alpha particle, for example,
would not travel very far through tissue, but it is 10 times more likely
to be absorbed than a gamma wave of the same energy dose. This
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factor is known as the Quality Factor (QF) or Relative Biological
Effectiveness (RBE). The RBE is limited to work in radiobiology, the
QF is used in other exposure monitor schemes. The use of the QF
results in a new parameter, the rem. The rem is a unit of dose
equivalent and is equal to the product of the QF x rad.

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 A-Acute Radiation Sickness
Exposure of the whole body to a large dose more than 100 rems of
penetrating radiation
Pathological Changes
1-Bone Marrow:
ᴏ Immediate dilatation of sinusoids and degenerative changes in
cells.
ᴏ Within 2 weeks: hyperemia in non cellular aplastic bone marrow
ᴏ Recovery takes place within the 4th week after exposure.
ᴏ In the 6th week: hyperplastic bone marrow.

2-Lymph nodes
ᴏ Depletion of lymphocytes begins early lymph nodes shrinkage
ᴏ Edema and hemorrage

3-Peripheral bl.
ᴏ Lymphocytopenia: begins within 2-3 hs, drop rapidly and
continue even during recovery
ᴏ Leucocytes: Initial leucocytosis (3hs-2 days), normal value for 2
weeks then leucopenia drops gradually, the lowest level in 21st
or 40thday.
ᴏ Platelets: normal for 2 weeks, thrombocytopenia begins in 14th
day then rapid and severe drop and the lowet level in 14th-21th
day.
ᴏ Erythrocytes: Normal for 4 weeksthe severe anemia.
ᴏ Morphology
 . Within few days: abnormal monocytes
 Abnormal lymphocytes.
 Giant granulocytes

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 5-GIT
ᴏ Mucosa :Mucosal ulceration, submucosal oedema and
hyperaemia
ᴏ Haemorrage
ᴏ There are nausea and vomiting due to central action of
irradiation.
6-Effect of atomic bomb explosions
ᴏ Heat
ᴏ Waves of pressure changes
ᴏ Ionizing radiation.
 TTT of acute radiation syndrome
1. Lines of TTT of acute radiation sickness
2. Maintain water and electrolyte balance+ anti emetic
3. Prophylaxis and TTT of infections (Isolation, antibiotic_ anti
septic technique)
4. TTT of profound anemia and Haemorrhage by bl transfusion ,
packed RBCs, platelets and even bone marrow transplantation.
5. Avoid drugs that supress the bone marrow
6. TTT of complications as burns, CV and renal failure

Effect of medical care on acute radiation syndrome

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 Treatment is supportive with the use of antibiotics, blood products, and stem
cell transplan

B-Chronic Effect of Ionizing Radiation

 Health effects:
1- Increase incidence of malignancy
ᴏ (Skin malignancy, lung cancer, osteosarcoma, thyroid
carcinoma, myeloid leukemia)
ᴏ There is a dose response relationship. The accumulated dose
from chronic exposure is less carcinogenic than if the same dose
given within a short time.
2- Reduction of life span
3-Congenital anomalies: microcephaly, hip dislocation, mental
retardation.
4-Death of zygote
5- Stunting of growth
6-Local Radiation Injury Skin
ᴏ Skin (Acute radiation dermatitis): erythema, scaling, hair loss,
burn
ᴏ Chronic Effect: Painful lesion and dermatitis specially around
nail bed (Skiagrapher’s dermatitis), atrophy of the skin, warts
later on destruction of sweat gland and hair follicles, ulcer that
progress to involve the tendons with deformity.
ᴏ Skin cancer

7-Eye
ᴏ Keratoconjunctivitis
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 ᴏ Posterior polar cataract

8-Gonads
ᴏ Increase incidence of mutation
ᴏ Reduced number of sperms.
ᴏ Irregularity of menstruation
ᴏ Fibrous atrophy of gonads

9-Bone Marrow
ᴏ Inhibition of all haemopoietic elements.
ᴏ Chronic myeloid leukemia.

10-Bone
ᴏ Radiation osteitis
ᴏ Sarcoma

11-Thyroid
ᴏ Reduced thyroid activities.
ᴏ Malignancy

12-Lung
ᴏ Fibrosis
ᴏ Cancer

13-GIT
ᴏ Salivary and gastric secretions decrease.
ᴏ Hepatitis
ᴏ Mucous M. Edema and necrosis
ᴏ Nausea, vomiting, hematemesis, diarrhea, abdominal pain and
distension

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 14-Kidney
ᴏ Nephritis

15-CVS
Pericarditis and effusion
Constrictive pericarditis
Myocarditis
Damage to arterioles and capillaries
16-CNS
Highly resistant and if affected through damage of blood vessels

 Prevention Aspect
1-Environmental Monitoring
 Frequent monitoring of environmental exposure at the work
places
 Medical Measures:
ᴏ Pre employment examination should include blood picture
ᴏ Periodic Medical examination should include
 Complete blood picture every 6 months
 Assessing radioactive material by examining stool,
urine and expired air
 early detection of skin or other system affection
ᴏ Chemical protection :Sulpher containing
compound
ᴏ Using personal protective devices as leaded aprons

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 ᴏ Periodic monitoring of personal exposure through personal
dosimeters (Personal monitoring device)
1- Film badge: Darkness of the film depends on the dose
received.
2-Quartz fiber electrometer: Scale of 0-500 millirads, immediate
recording but do not get the sum.
3-Thermoluminscent device which give light emission
proportional to the amount of radiation received
ᴏ Occupational exposure to radiation should not exceed 5 Rem
(Roentgen Equivalent Man) or 50 milliSevert per year.
However, workers should not exceed half this amount (2.5
rem) in a 3 months period or for the whole period of
pregnancy in case of females.
ᴏ Exposure of the general population should not exceed 2.5
rem/year.
 Medical point of view
Those who are not allowed to be exposed:
ᴏ Pregnant
ᴏ Children below 18y.
ᴏ Susceptible(with low leucocytic count, bl diseases or with
parenchymatous or skin diseases.)
2-Engineering Prevention
 Substitution
 Isolation (lead and concrete)
 Remote control
 Hygienic point of view.
 Use of special protective clothes as Lead apron
3-Disposal of radioactive wastes
 Short half-life (in special container)

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  Contaminated waste in desert

Radioactive cloud

 Sources of Exposure
 In case of radioactive cloud, the human gets exposure by
inhalation and radioactive contamination of skin and clothes.
 Then there is contamination of food and formation of
radioactive dust
 Radioactive contamination of water.
 The source may be liable to orphan

 Famous Characteristics of Radioactive Cloud

 The majority of radioactive isotopes have short half life,
sometimes it takes hs and even ys

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  The more time have passed , there will be less radiation as the
radio active materials decay
 The main radiation are X and gamma rays, alpha particles
radiation occur in nuclear fission

 The risk factors

1- The source of intake: inhaled air, water or food
2- The isotopes are sol. or insoluble.
3-The type of radiation
4- Left the body or not
5- The organ affected and this depends on isotopes chemistry for ex.
iodine affect the thyroid gland.

The License should focus on emergency planning

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The Competent state authorities and licensees should identify and
implement measures for emergency planning and emergency
preparedness in case of accident with likelihood radiation
consequences. These measures should be based on the analysis of
possible scenarios for the origin and development of various accidents
and assess the radiation risk to the population.

Maintenance of the emergency preparation for response in case

of accidents
1. Establish and maintain emergency teams at national level;
2. Maintain a system for notification and early warning to the
population;
3. Assure funds for radiation protection and radiation monitoring,
including forecasting of the radiation situation and the
consequences of the accident;
4. Assure funds to carry out urgent and emergency action and
recovery work;
5. Update periodically the emergency plans by the relevant
institutions, local authorities and licensees;
6. Educate the individuals designated to perform actions according
the emergency plans and conduct exercises and training for the
implementation of the emergency plans;
7. Inform the public on important issues related to radiation
protection and implementation of protection measures in case of
accidents.

Access of Communication
1. Keep the public informed and inform the authority, including
what action to do

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 2. There should be an access with the authority to explain any
unclear knowledge.
3. If you learn of the accident while you are inside keep inside
4. If you received the news while you are outside , go to a place
where you can get information
Information
1. Pass the received information about the accident to your friends
and family, if you think they do not know about the event.
Explain to your children what had happened and what to do in
occurred situations, taking into account their age. Perform the
received initial instructions.
2. Turn on your TV receivers and / or radio to obtain further
information on the official channels.
The Critical Time
The time of passage of the radioactive cloud is the most hazardous
moment, at this moment keep inside houses, if you do not find
shelters' refugee, the house can provide protection
The Clothes
1. Thick clothes or poly ethylene film are sufficient to protect from
alpha particles.
2. Use gloves and rubber boots
3. Women use trousers
4. If part of body and hair are not covered, it should be cleaned by
water and soap.
5. Use respirator or use hand kerchief to cover mouth and nose

Protective Drugs

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 1. Iodine prophylaxis is very important, take Na or k iodide if the
drug is not available, take few drops of iodine solution dissolved
in water or milk.
2. Children older than 2 ys and adult take K iodide 0.125g
3. children younger than 2ys take 0.04 g once a day after meal ,
drink it with tea or water.

General Instructions
1. Timely notification of the population and submission of
appropriate instructions;
2. Sheltering in appropriate places;
3. Restriction and controlling the access in places with increased
radiation risk to the population;

The Shelter
To weaken gamma radiation twice, a protective layer of 12 cm thick
concrete, 3 cm thick iron and 1cm thick lead.
Seal
1. Seal according to the available resources and means the
premises for sheltering in case of emergency. This will limit the
penetration of radioactive substances into the building through
the air, which is achieved by closing and tightening doors and
windows in homes and public buildings, stopping ventilation in
them, placing the filtering tissue ion the windows during airing,
cleaning of the premises only with wet tissues (sweeping and
beating should be avoided).

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 2. To protect the respiratory track from falling of radioactive
substances in the human body can be used standard protection
equipment (respirator, facial masks against dust, gasmask) and
the available materials (gauze bandages, cheesecloth,
handkerchiefs and other filtering materials that are wet for better
holding of the dust particles contained in the air).
3. Temporary sheltering as a security precaution can last several
days depending on the development of accident and the
consequences

After The Time of Cloud

1. Radiometric and dosimetric measurements for assessing the
situation and taking the decision by the competent authorities;
2. Decontamination of buildings and areas contaminated with
radioactive substances;
3. Implementation of specific requirements to the radiation
hygiene of the population;
4. Limitation the consumption of radioactively contaminated
foodstuffs, including water and milk;
5. Implementation of additional measures for radiation protection
of the population based on measurements, forecasts for the
development of the accident and estimates of the likelihood
consequences of it.

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 6. Maintain cleanliness in yours homes, wash hands thoroughly,
especially before eating. Bathers daily, clean shoes upon
entering at your home, more often wash clothing that wear out;
7. Do not consume foodstuffs, including water and milk, which has
been declared a temporary ban. Wash thoroughly the foodstuffs
before consumption and before culinary preparation, especially
leaf vegetables and fruits. Store food in suitable packaging, in
sealed vessels (containers) and premises, refrigerators;
8. Fulfill strictly the recommendations of the competent state
authorities for the consumption of foodstuffs until the final
liquidation of the consequences of an accident.
Evacuation
1. Evacuation as a protection measure for the population is a short-
term change of residence for up to 7 days depending on the
development of accident and the consequences thereof. The
selection of a suitable place where the population affected by the
accident can be evacuated depends on the specific radiation and
meteorological conditions during the event. Routes and transport
means for evacuation, the places for accommodation of the
individuals and the order for evacuation should be defined by
the competent state authorities. The security of the private house
the evacuated population should be provided by the competent
state authorities.
2. Do not perform unorganized evacuation without instructions
from the competent state authorities.
At time of evacuation
1. After announcing the decision of the competent state authorities
for implementation of evacuation you should do the following:
2. Take with you the identification documents and other important
documents at your own opinion, available money, valuables,
clothing and object of common use, available medicines, food
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 for one-two days, drinking water, cell phone (if you have one).
Wrap all them in polyethylene bags, backpacks, bags or
suitcases;
3. Turn off all electric household appliances (stoves, ovens,
boilers, air conditioners, lamps, etc.), disconnect power from the
power-fuses, turn off all water taps, turn off gas appliances and
installations, extinguished t stoves and fireplaces, close doors
and windows, take hand luggage and lock the doors of your
home;
4. Do not take your large volume and heavy objects;
5. Move promptly to the announced evacuation meeting point
(using private transport or walking) from where you will be
transported by destination according to the instructions of the
competent state authorities.
6. For evacuation of sick, disabled, children and adults for which
you need help, ask for assistance from the competent state
authorities at local level (Regional Directorate Civil Protection,
on duty staff in mayoralties and hospitals in the respective
localities).
Temporary relocation
Temporary relocation as a protection measure for the population is a
long-term change of residence for up to 30 days depending on the
development of the accident and the consequences thereof.
Temporary relocation is organized by the competent state authorities
only in the case that other protection measures (sheltering, iodine
prophylaxis, evacuation) are not sufficient to ensure radiation
protection of the affected by the accident population in the relevant
place.

Organizations involved in radiation accidents and emergencies

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  International Atomic Energy Agency (IAEA)
 WHO
 The Food and Agricultural Organization (FAO),
 The Nuclear Energy Agency (NEA) of the Organization on
Economic Cooperation and Development (OECD),
 The United Nations Office for the Coordination of Humanitarian
Affairs (UN OCHA),
 The World Meteorological Organization (WMO).

Duties
1. WHO is a full party to the Conventions on Early Notification of
a Nuclear Accident
2. Facilitate exchange of information and the prompt provision of
assistance in the event of radiation accidents, with the aim of
minimizing the health consequences.
3. WHO works closely with IAEA to prepare for and respond to
nuclear accidents and radiological emergencies, principally to
provide, coordinate and consult medical assistance to victims of
such events where severe radiation exposure has occurred.
Advice can also be provided to national authorities on how to
prepare and respond to such radiation accidents, or what kind of
public health actions may be needed.
4. Emergency medical support for radiation exposed individuals is
provided through WHO's Radiation Emergency Medical
Preparedness and Assistance Network (REMPAN). This is
activated following notification about a radiation accident with
casualties (but even in case of a single victim with severe
overexposure) from the IAEA or directly to WHO.

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