• Radiation exposure. Should we begin to worry?


    A danger of radiation exposure thousands of miles away has been the hot topic of conversation and concern here in our Southern California communities. The Center for Disease Control and Prevention (CDC) has reported minimally higher levels of Iodine-131 in several state rivers, lakes, and rain water. They reassure us that “the very low levels of radioactive material currently being measured in surface water and rain water are far below those of public health concern.” The consequences of a nuclear reactor accident depend on several factors, such as population density, weather conditions and dietary habits. Additionally, the response to the accident by authority also plays an important role in reducing the adverse effects of such disasters. Estimates of acute and latent fatalities have been compared with other societal risks, such as cancer and they show much less overall risk. This is due to the fact that nuclear energy disasters are very uncommon, negating from its significant exposure risk.
    The symptoms of acute radiation illness is nausea, vomiting and diarrhea. There are two sources, internal and external radiation. Internal radiation exposure is when radionuclides particles are ingested or inhaled, and occurs with close proximity, such as plant workers and firefighters who are first at the scene and responding to disaster sites. External radiation consists of beta-, gamma-, and neutron-radiation released from plume of radionuclides. These forms of radiation exert dangerous injuries to skin and viscera by causing lesions in DNA and other molecules within the cells. If you’ve been to the dentist’s office, you may have noticed the apron shield worn by radiology technician, the purpose being protection of germ cells (ovaries in women, scrotum in men) against radiation. The adverse effects of DNA mutation on germ cells are seen NOT in the person affected, but their offspring. Exposures to radiation on all other cells, (non-germ cells) are categorized into random and nonrandom. Nonrandom are dose-dependent and affect individuals similarly. With higher levels of radiation, there will be higher risk for diseases such as hypothyroidism, cataracts, sterility, and growth retardation. The atomic bomb detonation survivors experienced increased frequency of cataracts, as were higher rates of hypothyroidism seen in Marshall Island residents exposed to radioactive fallout as a consequence of Bravo atmospheric atomic test.
    Random effects of radiation exposure are more elusive as data on dose and risk is more uncertain. Two of the most common long-term health consequences are thyroid abnormalities and cancer. When dispersed into the environment, radionuclides, Iodine-131 and Iodine-125, found in high concentrations in nuclear reactors, are absorbed and stored by humans in thyroid cells, causing mutations and cell death. Other cancers are leukemia, breast and lung, which can be seen as late as 10 to 30 years post exposure. Cesium-137 radioactivity has been implicated in non-thyroid cancers.
    Debridement and decontamination is very crucial in the early stages of accident, and iodine treatment with potassium iodine should begin immediately in persons affected. Supportive care for bone marrow failure, skin injuries and visceral injuries are to be addressed on a case by case basis, and treatment plans set for evaluation for late complications.
    All in all, it is safe to state, for our patients at Seaside Medical Practice and Santa Monica community at large, that we should not worry about radiation exposure as a result of the nuclear reactor spill in Japan.
    1. Champlin, R. et al. Radiation Accidents and Nuclear Energy: Medical Consequences and Therapy, Annals of Int Medicine, 11/1/1988
    2. CDC Website; http://www.bt.cdc.gov/radiation/isotopes/iodine131surfacewater.asp

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