The Pathophysiology of Combined Radiation Injuries: A Review and Analysis of the Literature on Non-Human Research

Abstract

Publ reporting burden for thiscollection of Infom tion is estmlted to average 1 hour p repiolns Including the time for reviewing instructions, serchinig existing data sOurces gathering and maintaining the "dt neded. Approved for public release; distribution is unlimited. ABSTRACT (Maximum 200 words)One hundred and seventy one references applicable to determining the effect of tactical nuclear weapons on military personnel have been reviewed, and the signifi-ant conclusions are reported. The study reviews the scientific literature and focuses on animal experiments published from 1933 to the present time, including a number of German studies and some Soviet research not previously reviewed in English language publications. Recurring themes of the review are the synergistic increase in mortality when injury (burn, wound, bleeding, fracture, etc.) follows irradiation and the reduction in mortality when injury precedes irradiation and/or when antibiotics are administered.

An Overview of the Technical Basis of HENRE 2.0 Models

“…Due to uncertainty in radiation effects on the vascular epithelium at high doses of radiation, a statistical model is used to predict lethality from radiation dose greater than about 4 Gy. The combined injury probit model was adapted from experimental animal data on combined injury (Alpen 1954, Baum 1991, which were extrapolated based on comparable equivalent human doses for each of the exposures used in the animal studies (Stricklin 2013c). The extrapolations were made using known dose-response curves for each species and each insult, radiation and burn.…”

“…Historical data from Hiroshima show that 65-70% of injured persons are expected to have combined injuries (Geiger 1964, Goans 2009. Experimental data has shown that radiation, combined with other injuries, shortens the onset of symptoms, exacerbates symptoms, causes synergistic increases in mortality, and impairs wound healing (Messerschmidt 1965, Baum 1991. To improve our understanding of human response to combined injury, updated models of radiation combined injury are needed.…”