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Biology and clinical features of radiation injury in adults

Nicholas Dainiak, MD, FACP
Section Editor
Laurence A Boxer, MD
Deputy Editor
Jennifer S Tirnauer, MD


The occurrence of industrial and medical radiation accidents and the threat of terrorist events involving radioactive material mandate the development and implementation of an appropriate medical response. Medical professionals who would logically be involved in such events include, among others, radiation safety officers, radiation oncologists, nuclear medicine physicians, emergency department physicians, hematologists, medical oncologists, infectious disease specialists, and gastroenterologists. All will be asked to play a significant role in evaluating and treating victims of an accidental or deliberate exposure to radiation. Due to their experience in managing patients with cytopenias and/or marrow aplasia, hematologists and medical oncologists will most likely be asked to take primary responsibility or a consultative role for the medical treatment of individuals exposed to a moderate or high dose of radiation.

However, all physicians, and especially medical triage personnel, must have an understanding of how radiation alters the function of cells, tissues, and organ systems, how radiation levels are quantified, and how victims receiving a significant radiation dose can be recognized and treated. In addition, all medical facilities should have a radiation emergency contingency plan with which their employees are familiar. Emergency personnel and hospital personnel must also be aware of local, state, and national resources that may be employed in the case of a radiological event [1].

General aspects of radiation biology and the clinical features of radiation injury in the adult will be discussed here. Clinical features of radiation exposure in children are presented separately. (See "Clinical features of radiation exposure in children".)

Triage and treatment of individuals involved in radiation accidents are also discussed separately. (See "Treatment of radiation injury in the adult" and "Management of radiation exposure in children following a nuclear disaster".)

Separate topic reviews address the risks of radiation injury from imaging procedures and decision making regarding these risks. (See "Radiation-related risks of imaging studies" and "Radiation dose and risk of malignancy from cardiovascular imaging".)


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