EFFECTS OF IONIZING RADIATION
16
le ei 8
of Grewen TE Qilnemar). 5 jeseent of Geoap
12) (Amenecans). and none of Ciroup IV
(Utirik>. Three peaple in Gireup PE and one
in Giresp Hi comphsined of itching and burning
of the eves and lacrimation. There initial skin
and eye symptoms were mort likely due to irradiation since all individuals who experienced
disease seen, discweed below, were similar in
all espemure groupe and in nesexpomed indtvicduals.
2.3
the initin| symptoms later developed unques-
tioned radiation induced skin lesions (epilation
and
conjunctivitis).
(See
Chapter
TIT.)
Furthermore the initial symptomatology in
thene people was similar to that reported in in-
stances of accidental laboratory overexposure
to radiation, described in Chapter HII. It is
possible, however, that chemical irritation by
the fallout material, which was predominantly
highly alkaline calctum oxide, may have ac-
centuated the initial symptonis.
About two-thirds of Group [ were nauseated
during the tirst 2 days and one-tenth vomited
and had diarrhea. One individual in Grroup
1] was nauseated. In Groups PPP and £V there
were no gastrointestinal (G2) svmptoms. The
information concerning symptoms was obtained
by questioning through an interpreter by several individuals. Despite the repeated interrogations and the inevitable suggestions of the
interrogators, the stories remained consistent.
AIL GD symptoms subsided by the third day
without therapy and there was no recurrence.
The presence, severity, and duration of nansea, Vomiting, and diurrhesa are known to bear
a direct relationship to degree of exposure and
probability of the recovery (1. 2.6). and it is
of note that the incidence of these =viiptoms
was correlated with the dose received and that
there were no pastromtestinal symptoms in
Ciroup EV. the largest group, which received
only lr. GE symptomatology may have been
tlie to direct injury of the GE tract as observed
in aunimals after whole body irradiation (7, 8)
orotnay have been non-specitic as is observed
following therapeutic radiation,
Various other clinical conditions, which were
encountered during the course of observation
of the exposed groups were not the results of
radiation exposure,
‘Vhe meidence und type of
Clinical Observation and Therapy
With Respect to Hematological
Findings
2.31 Clinical Observations and Leukocyre Couns
Berwren Tue 38rd and 43rd post-exposure
days, 10 percent of the individuals in Group I
had an absolute granulocyte level of 1000 per
ctthic millimeter or below. The lowest count ob-
served during ¢his period was 700 granulocytes /
mim.* During this interval the advisability of
giving prophylactic antibiotic therapy to
granulocytopenic individuals was carefully con-
sidered.
However,
prophylactic antibtotic
therapy was not instituted for the following
reasons:
(1) All individuals were under continuous
medical observation so that infection would be
discovered in its earliest stagew.
(2) Premature administration of antibiotics
might have obscured medical indications for
treatment, and might also have lead to the development of drug resistant organisms in individuals with a Jowered resistance to infection,
(3) There was no accurate knowledge of the
number of granulocytes required by man to prevent infection with this type of granulocytopenia.
The observed situation was not strictly comparable to agranulocytosis with an aplastic
arrow as seen following known lethal doses of
radiation. In the latter instance. granulocytes
fall rapidly with practically none in cireulation and no evidence of granulocyte regeneration when infection occurs (6). In the present group of individuals exposed to radiation,
mest counts reached approximately one-fourth
the normal value, but the fatl to that level was
gradual and the presence of immature granuloeytes in the peripheral blood during the pe-