WERBOCTA OF FALLOUPE RADIATION ON SIUC AKON a factor of 5, 10 or more, but with very litle penetration. Estimations of the dose of skin irradiation from ground source beta has been made by Sondhaus [1]. If no shielding occurred and exposure is considered continuous the dose at the level of the dorsum of the feet was calculated to be about 2,000 rep, at hip level 600 rep and at head level 300 rep. This source of radiation was apparently insufficient, alone, to produce any lesions, though it probably contributed significantly to the severity of the foot lesions observed. particulate nature and uneven distribution of o> yo. the fallout on the skin the developing lesions are likely to be spotty. A secondary wave of erythema maybe seen along with gross changes 448029 O—58——10 Cai —y om i With larger amounts of fallout, radi- ation from the ground source could be sufficient in itself to produce skin lesions. Acute effects of beta radiation on the skin. —In general beta radiation effects on the skin are similar to effects produced by more penetrating radiation such as gaminaor X-radintion, However, tho less penetrating beta radiation produces more superficial lesions with Tess damage to the dermis. Consequently they are ustinily Jess painful nud heal more rapidly, The time sequence of development of betn lesions from fallout. varies considerably with the dose to the skin. A primary erythema may or may not be observed beginning a fow hours after exposure. This was not seen in the Marshallese, perhaps due to the dark color of their skin. During the first day or so itching, burning, or Gingling of the affected skin may be experienced. As was pointed out these symptoms might in part be due to the chemical nature of the fallout. These early signs and symptoms are usually followed by an asymptomatie latent period before full-blown lesions develop. Tho length of the latent period may vary from « few days to several weeks which is usually related to the dose to the skin; the higher the dose the shorter the Intent period. In the Marshallese the more heavily exposed group developed skin lesions about a week before less heavily exposed groups. Due to the 139 in (he skin, These changes may be in the form of simple tanning, pigmentation, and mild desquamation with low doses. This reaction might bo classed as a first degree reaction. With higher doses vesiculation, complete epidermolysis and ulceration may occur. This severity of reaction might be classed as a second degree reaction, Spotty cpilation may occur along with lesions of the scalp. Regrowth of hair is likely with a second degree lesion. Healing is usually accomplished within a week or two with repigmentation of the skin in milder lesions. Deeper lesions may heal with some scarring and lack of repigmentation. Chronic radiationeffects,-—With larger doses of radiation chronic radiation dermatitis may develop. These lesions do not heal well and on healing may break down and ulcerate again. Badly searred skin with telangiectatic vessels may result. These severe reactions might be classed as third degree reactions, Repeated repair and breakdown may occur dueto instability and poor vascularity of the dermin, Tt is in skin of type that malignant change may Tater take place, Malignant changes in the skin has heen observed ino animals as a late effect of beta irradiation of the skin and presumably could also occur in the human skin. Though malignancy usually develops at the site of chronic radiation dermatitis, as a result of repented exposure to radiation tt hing been reported to oceur tn animals following a single exposure to betn radintion with little or no chronie change in the skin. Treatment of acute beta lesions ia mainly symptomutic. With mild lesions, daily cleansing, application of bland antipruitic ointments and lotions may be all that ig necessary. For more severe ulcerating lesions, cleaning with daily dressings, splinting and use of antibiotic ointments or antibiotics parenterally in case of secondary infections may be indicated. The use of Aloe Vera plant applications is claimed by some to enhance healing of radiation burns 21]. Lestons of chronic radiation dermatitis may be quite painful and the only effective therapy in such cases is early skin grafting [22].