question: How does radiation exposure cause things like burns/poisoning/birth defects?
comment: Ionizing radiation tears the cellular structure apart. The skin blisters, turns red, then black. This is followed by a latency period. The immediate effects subside. The patient appears to be recovering. Healthy, even. But they aren't. This usually only lasts for a day or two. Then the cellular damage begins to manifest. The bone marrow dies, the immune system fails, the organs and soft tissue begin to decompose. The arteries and veins spill open like sieves, to the point where you can't even administer morphine for the pain, which is unimaginable. And then three days to three weeks, you are dead.
passages: Section::::History.:Notable incidents.
   During underground nuclear testing in Nevada, several workers developed burns and skin ulcers, in part attributed to exposure to tritium.
  
  Section::::Causes.:Nuclear accidents.
   High radiation doses can cause DNA damage. If left unrepaired, this damage can create serious and even lethal chromosomal aberrations. Ionizing radiation can produce reactive oxygen species, which are very damaging to DNA.
   Section::::Diagnosis.
  
  Diagnosis is typically made based on a history of significant radiation exposure and suitable clinical findings. An absolute lymphocyte count can give a rough estimate of radiation exposure. Time from exposure to vomiting can also give estimates of exposure levels if they are less than 10 Gray (1000 rad).
  
  Section::::Prevention.
  
  Section::::Prevention.:Time.
   BULLET::::- Rarer still would be personnel who experience radiation burns from highly penetrating gamma radiation. This would likely cause deep gamma penetration within the body, which would result in uniform whole body irradiation rather than only a surface burn. In cases of whole body gamma irradiation (c. 10 Gy) due to accidents involving medical product irradiators, some of the human subjects have developed injuries to their skin between the time of irradiation and death.
   Transport accidents can cause a release of radioactivity resulting in contamination or shielding to be damaged resulting in direct irradiation. In Cochabamba a defective gamma radiography set was transported in a passenger bus as cargo. The gamma source was outside the shielding, and it irradiated some bus passengers.
  
  In the United Kingdom, it was revealed in a court case that in March 2002 a radiotherapy source was transported from Leeds to Sellafield with defective shielding. The shielding had a gap on the underside. It is thought that no human has been seriously harmed by the escaping radiation.
  
  Section::::Accident categories.:Equipment failure.
   BULLET::::3. Neurovascular. This syndrome typically occurs at absorbed doses greater than , though it may occur at . It presents with neurological symptoms such as dizziness, headache, or decreased level of consciousness, occurring within minutes to a few hours, and with an absence of vomiting. It is invariably fatal.
  
  Early symptoms of ARS typically includes nausea and vomiting, headaches, fatigue, fever, and a short period of skin reddening. These symptoms may occur at radiation doses as low as . These symptoms are common to many illnesses, and may not, by themselves, indicate acute radiation sickness.
  
  Section::::Signs and symptoms.:Skin changes.
   The radiation generally occurs from a source outside the body, is applied over minutes with most of the body being exposed, and involves a total dose of greater than 0.7 Gy (70 rads). It is generally divided into three types: i) bone marrow syndrome (0.7 to 10 Gy); ii) gastrointestinal syndrome (10 to 50 Gy); and iii) neurovascular syndrome (50 Gy). Sources of such radiation may include nuclear reactors, cyclotrons, and certain devices used in cancer therapy. The cells that are most affected are generally those that are rapidly dividing. Diagnosis is based on a history of exposure and symptoms. Repeated complete blood counts (CBCs) can indicate the severity of exposure.
   Section::::Precursor cell integrity.
   Classically acute radiation syndrome is divided into three main presentations: hematopoietic, gastrointestinal, and neurological/vascular. These syndromes may or may not be preceded by a prodrome. The speed of onset of symptoms is related to radiation exposure, with greater doses resulting in a shorter delay in symptom onset. These presentations presume whole-body exposure and many of them are markers that are not valid if the entire body has not been exposed. Each syndrome requires that the tissue showing the syndrome itself be exposed. The gastrointestinal syndrome is not seen if the stomach and intestines are not exposed to radiation. Some areas affected are:
   More information on bone marrow shielding can be found in the Health Physics Radiation Safety Journal article Selective Shielding of Bone Marrow: An Approach to Protecting Humans from External Gamma Radiation, or in the Organisation for Economic Co-operation and Development (OECD) and the Nuclear Energy Agency (NEA)'s 2015 report: Occupational Radiation Protection in Severe Accident Management.
  
  Section::::Prevention.:Reduction of incorporation.
   Radiation burns are caused by exposure to high levels of radiation. Levels high enough to cause burn are generally lethal if received as a whole-body dose, whereas they may be treatable if received as a shallow or local dose.
  
  Section::::Causes.:Medical Imaging.
  
  Fluoroscopy may cause burns if performed repeatedly or for too long.
  
  Similarly, computed tomography and traditional projectional radiography have the potential to cause radiation burns if the exposure factors and exposure time are not appropriately controlled by the operator.
   Section::::Health effects.:In pregnancy.
  
  The risk for developing radiation-induced cancer at some point in life is greater when exposing a fetus than an adult, both because the cells are more vulnerable when they are growing, and because there is much longer lifespan after the dose to develop cancer.
  
  Possible deterministic effects include of radiation exposure in pregnancy include miscarriage, structural birth defects, Growth restriction and intellectual disability. The determinstistic effects have been studied at for example survivors of the atomic bombings of Hiroshima and Nagasaki and cases where radiation therapy has been necessary during pregnancy:
   Section::::Cause.:Acquired.:Radiation.
  
  Exposure to radiation poses a high risk of infertility, depending on the frequency, power, and exposure duration. Radiotherapy is reported to cause infertility, and 5G wave 2 is rumored to cause infertility.
  
  the amount of radiation absorbed by the ovaries will determine if she becomes infertile. High doses can destroy some or all of the eggs in the ovaries and might cause infertility or early menopause. 
  
  Section::::Cause.:Acquired.:Chemotherapy.
   BULLET::::1. Hematopoietic. This syndrome is marked by a drop in the number of blood cells, called aplastic anemia. This may result in infections due to a low amount of white blood cells, bleeding due to a lack of platelets, and anemia due to too few red blood cells in the circulation. These changes can be detected by blood tests after receiving a whole-body acute dose as low as , though they might never be felt by the patient if the dose is below . Conventional trauma and burns resulting from a bomb blast are complicated by the poor wound healing caused by hematopoietic syndrome, increasing mortality.
   In most of the acute exposure scenarios that lead to radiation sickness, the bulk of the radiation is external whole-body gamma, in which case the absorbed, equivalent and effective doses are all equal. There are exceptions, such as the Therac-25 accidents and the 1958 Cecil Kelley criticality accident, where the absorbed doses in Gy or rad are the only useful quantities, because of the targeted nature of the exposure to the body.
   BULLET::::- 0.3 - 0.8 bar (5-12 psi) - 50% dead, 40% injured, 10% safe
  
  BULLET::::- 0.14 - 0.3 bar (2-5 psi) - 5% dead, 45% injured, 50% safe
  
  Section::::Types of radioactive exposure after a nuclear attack.
  
  In a nuclear explosion the human body can be irradiated by at least three processes. The first, and most major, cause of burns is due to thermal radiation and not caused by ionizing radiation.
  
  BULLET::::- Thermal burns from infrared heat radiation, these would be the most common burn type experienced by personnel.
   Section::::Prevention.:Distance.
  
  Increasing distance from the radiation source reduces the dose according to the inverse-square law for a point source. Distance can sometimes be effectively increased by means as simple as handling a source with forceps rather than fingers. This could reduce erythema to the fingers, but the extra few centimeters distance from the body will give little protection from acute radiation syndrome.
  
  Section::::Prevention.:Shielding.
   Two important points observed during this study was:
  
  BULLET::::1. The severity and frequency of the congenital abnormalities seen increased with dose of radiation which depended on the closeness to the source or explosion.
  
  BULLET::::2. It was determined that there were critical periods of pregnancy when these exposures had the maximum effect on the fetal development.
  
  Section::::History.:Congenital rubella syndrome (CRS).
   BULLET::::2. Gastrointestinal. This syndrome often follows absorbed doses of . The signs and symptoms of this form of radiation injury include nausea, vomiting, loss of appetite, and abdominal pain. Vomiting in this time-frame is a marker for whole body exposures that are in the fatal range above . Without exotic treatment such as bone marrow transplant, death with this dose is common. The death is generally more due to infection than gastrointestinal dysfunction.
   A study of radiation-induced skin injuries has been performed by the Food and Drug Administration (FDA) based on results from 1994, followed by an advisory to minimize further fluoroscopy-induced injuries. The problem of radiation injuries due to fluoroscopy has been further investigated in review articles in 2000, 2001, 2009 and 2010.
  
  Section::::Causes.:Radioactive fallout.
  
  Beta burns are frequently the result of exposure to radioactive fallout after nuclear explosions or nuclear accidents. Shortly after the explosion, the fission products have very high beta activity, with about two beta emissions per each gamma photon.
   Section::::Signs and symptoms.:Cancer.
   Radiation of 100 mGy to the head at infancy resulted in the beginning appearance of statistically significant cognitive-deficits in one Swedish/radiation-therapy follow-up study. Radiation of 1300-1500mGy to the head at childhood was similarly found to be roughly the threshold dose for the beginning increase in statistically significant rates of schizophrenia. 
   The human body contains many types of cells and a human can be killed by the loss of a single type of cells in a vital organ. For many short term radiation deaths (3 days to 30 days), the loss of two important types of cells that are constantly being regenerated causes death. The loss of cells forming blood cells (bone marrow) and the cells in the digestive system (microvilli, which form part of the wall of the intestines) is fatal.
  
  Section::::Management.
   In accordance with ICRP recommendations, most regulators permit nuclear energy workers to receive up to 20 times more radiation dose than is permitted for the general public. Higher doses are usually permitted when responding to an emergency. The majority of workers are routinely kept well within regulatory limits, while a few essential technicians will routinely approach their maximum each year. Accidental overexposures beyond regulatory limits happen globally several times a year. Astronauts on long missions are at higher risk of cancer, see cancer and spaceflight.
  