100 EPFECTS ok JONTON G conditions a rend str stat stioal prognosis couid be made. However, t e 7 roblems invonwed with PAD ATION loose rates from which the total dose received by “oe Mar hallese was calculated were measured estimation of dose re ered by tye int Vict d Pee sya rina plane feet above the ground sur- present real praetiea hace. Because of the planar geometry of excostes nd the energy of the beam, for this iensired ose rate, the dose rate at the center ut the hody would be greater than for the same dose rate from oa high energy X-ray source, measared im ai at the proximal skin surface. Vhe effects of fallout gamma radiation would ‘rs oe expected to be greater, for the same dose ‘Uthendties. able that does estimate. Ir Dpreb vill be ivailable from dosimetry devices or fron: lose contout flies and the position of toe individual during ex posure. Some of the -Uffieudties cf relwing The ex heavily on dose estimates are obvious, act position of tie dnd vida and the degree of shielding will nor be known precisely The dosimetry devict records the dose or it dose rate which may not reflect aeenrately because if shielding, enere slependence of the device, ete, the deposition of” energy within the madividuals at the site of interest. iumels bone marrow ce gastromtestinal tract More important, 's cause of individua ciflerences no sensitisity individuals exposed t the same measured close may differ widely 3) their responses, Maus. estimates of dose enlcoalated from dose cates or derived from at iutegrating dosimeter or from ‘ensared ii vir. than would laboratory radiaWoo The h ghonitial incidence of nausea, vomiting rod durhen am the high-exposure Marshallese eroup. and the profound neutrophile and plate‘or cenit depression indieated a greater effect ‘han might have been expected from 175 rin the daboratory, in keeping with the above. As ndieated in Chapter PV. from this value for oye dose received, and from the degree of leuke- position of an iidiviaua, during exposure cnt ste depression if is possible to estimate the dose Hostaen a small incidence of mortality would fate of an individual we resulted without treatment. These convderanions would place the threshold for mor- not be accepted is the nest index of the probate oo as the tinal index te therapy, triage or prognosis Sinee the <s1, dromes of radiation ti jury Lave varying symp toms and are dove depencent the svmptomologs IS IN sense, a personal indicator of one’s fare Expermence with farmad radiation nyury a Hiroshima, Nagasak with veactar and emt oa assembly aceidents od the “allout acerdent te seribed herein strenziv siggest that che nes! method for est matieg the seroustiess af os posure af the ad siciad level is the symipre matic approach Vow thoany disease, an 1: curate appratsa) ef ae patient's condition ve sults only fron ou thoreugt evaluation of the history, physiedl) cue diborators osaniinat od (see Section 6 6.42 3 bel ow Influence ot Geometry of Exposure on the Effective Dose. 1.D. for Man The intluence oft the geamerry of exposdie os the effeerive dose ta se assed it baprer Toad the minimal letras ce se fear na on eater FA halits ar approximately 225 ro and the LD. at ipproxpmately 340 r for fallout gamma radia- cram. Tos also clear from the above consideriors, that oa figure for an LD. for man, ndependent of the condition of exposure is sser tia by meningless. Phe LD., traure of 350 ris below the value of er 6301 commonly quoted (7). A recent ‘eevalnation of the Japanese Nagasaki and Hhreshima bombing data has resulted in a figne sell above the #00 or 450 r value for the Innedtite radiation from the bomb. The error rtfosnenre, as well as that obtained from the \irrshaclese clatas is very great. TTowever, the rotonrd bematolugtenl effects seen in the Muarshalles would argue strongly for lowering, roat deast not pausing, the current [1)., esti- hates fore val defense and other plinning, this artooarhs under curew“instances where fallout vidnitions inay be expected to be the chief adialo rien hagzare.