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sonnel to air blast may occur from sudden changesin environmental pressure acting directly on theexposed subject, from displacement of personnelinvolving decelerative tumbling or impact againsta rigid object, from blast-energized debris striking the individual, and from a variety of miscellaneous changes in the immediate environment.Individuals who are injured to such an extentthat they are unable to perform assigned tasksare designated casualties. Such a condition typically starts almost immediately following airblast trauma and it can be expected to last fromhours to several days, depending on the natureand severity of the injury. The biological effectswhich may result from exposure to a blast waveare divided into four categories: (I) direct overpressure effects, (2) effects from translationalforces and impact, (3) effects of blast energizeddebris, and (4) miscellaneous effects. These effects are discussed separately in the followingparagraphs.
10-1 Direct Overpressure Effects.
• Casualties that result from direct overpressure effects are those that result from man'sinability to withstand rapid changes in his environmental pressure. The body is relatively resistant to the crushing forces from air blast loading; however, large sudden pressure differencesresulting from blast wave overpressure may causeserious injury. Anatomic localization of such injury occurs predominantly in air-bearing organsystems such as the lungs, gastroenteric tract,ears and perinasal sinuses. At high overpressuresboth early (less than 30 minutes) and delayed(30 minutes to several days) lethality will occuras a result of disruption of lung tissue. Earlylethality is generally caused by interruption inthe blood supply to the heart or brain as a resultof air emboli entering the circulatory system
Chapter 10
PERSONNEL CASUALTIES1
• INTRODUCTION.
• The three principal phenomena associated with nuclear explosions that result in casualties to personnel are blast and shock, thermal-c";c';~'" and nuclear radiation. Blast injuriesmay be direct or indirect; the former are causedby the high air pressure (overpressure), Whilethe latter may be caused by missiles or by displacement of the body.• The frequency of burn injuries resulting
from a nuclear explosion is exceptionally high.Most of these are flash burns caused by directexposure to the thermal radiation, although personnel trapped by spreading fires may be subjected to flame burns. In addition, personnel inbuildings or tunnels close to ground zero maybe burned by hot gases and dust entering thestructure even though they are shielded ade~v from direct or scattered radiation._ The harmful effects of the nuclear radi
atIOns appear to be caused by ionization andexcitation (see paragraph 6-4, Chapter 6) produced in the cells composing living tissue. As aresult of ionization, some of the constituents,which are essential to the normal functioning ofl110 "Ol1S, are altered or destroyed. As describedin Section III, these changes may result in sickn~atmay terminate with death in some cases...The effects of these three phenomena on
personnel are described in the succeeding threesections. A briet disc!1ssion of the effects ofcombinations of the phl:'nomena is provided inSection IV.
SECfION I
.. AIR BLAST.
~ MECHANISMS AND CRITERIAFOR INJURY.
-'-Injury that results from exposure of per-
~0')M
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«I
C~
10-1
• •from the damaged lung. Delayed lethality occursas a result of suffocation caused by continuinghemorrhage within the lung or the developmentof pulm,mary edema. Delayed appearance ofcasualties also may occur at high overpressuresas a result of internal hemorrhage from rupturedorgans or as a result of infection due to perforation of the' intestine.... f''leriments conducted with animals ind~that dIrect overpressure effects dependupon the peak overpressure, duration and shapeof tho incident blast wave, and the orientation ofthe subject. Both the peak overpressure and tfieduration appear to be important for fast-risingblast waves that have durations less than 50 msec,whereas peak overpressure predominates for positive phase air-blast durations greater than 50msec. If the time to peak overpressure is greaterthan a few milliseconds, there is a lower probability of injury because the anatomic structureswill be subjected to pressure differences thatoccur less rapidly. This effect can take place in astructure where the pressure rises gradually dueto a long fill time or it may occur near a retlecting surface where the pressure rises in Hsteps" asa result of a separation in the arrival times of theincident and retlected waves. In general, personnel who are oriented with the feet or head toward the oncoming blast wave will be injuredIe» "lilll 1110>< who are oriented with the longaxis perpendicular to the blast wave. This isapparently caused by the action of the dynamicpressure to increase the'load on the thorax in thelatter case. A potentially more hazardous exposure condition occurs when personnel are situatedagainst a tlat surface, since normal-retlection of ablast wave results in pressures two or more timesthe magnitude of the incident wave.~ Current criteria for direct overpressuree~, based on extrapolations from animaldata, predict 50-percent casualties and one percent mortality for randomly oriented, pronepersonnel exposed to a long-duration fast-rising
blast wave of 41 psi and one percent casualtiesfor those exposed to 12 psi. Animal experimentsand human accident cases have shown that a50-percent incidence of eardrum rupture may beexpected to occur at 16 psi, whereas one percentmight be anticipated at 3.4 psi. Although in certain situations auditory acuity is imperative, eardrum rupture currently is not considered to bea disabling injury in terms of overall effectivenessto individuals in military units.
10-2 Translational Forces and Impact.
• Injuries caused by translational impactoccur as a result of whole body displacement ofpersonnel by blast winds. Anatomic localizationof such injuries is not as readily definable as thecase for direct overpressure effects. In instanceswhere head impact occurs, concussion, skull fractures, and intracranial hemorrhage may result inrapid loss of consciousness and, in many cases,early lethality. By contrast, impact in which the
. head is not involved results in a variety of traumatic injuries such as skeletal fractures, rupturedinternal organs, blood loss and, in more seriouscases, the development of shock. Recovery following such injuries may be more delayed thanrecovery from direct overpressure effects....·The translational and rotational velocitiesth~ attained by personnel during the accelerative phase of blast-induced displacement depend upon the geometry of exposure and theshape and magnitude of the dynamic-pressurewave. In general, a longer duration of the positivephase of the blast wave will result in a lowerpeak overpressure being required to produce agiven translational velocity. Therefore, largeryields will produce injuries at lower pressures(see Section I, Chapter 2). The severity of theinjuries caused by displacement depends to alarge extent on the nature of the decelerative .phase of the motion. If deceleration occurs byan "impact" with a rigid object, resulting in astopping distance of less than a few inches, the
10-2
J .. . -.. ,..
~~A~l6J&~iJ~~~
(
•probability of a serious mJury is much greaterthan if deceleration Occurs by "tumbling" overopen terrain, which will result in much longerstopping distances..- Because of the limited data available, cas~riteria for translational impact are far lesscertain than those for direct overpressure effects.In addition, there are marked differences in impact velocities that are associated with seriousinjury following head trauma compared withthose for noncranial impact. Human cadaverstudies indicate that 50 percent mortality may
. occur following head impact at velocities of18 ft/sec, whereas large animal studies and humanfree-fall experience suggest that 54 ft/sec is required for 50 percent mortality when head impact is minimized. Decelerative tumbling experiments involving a limited number of animalssuggest that significant mortality does not occurat translational velocities below 88 ft/sec._ Although tentative in nature, estimatesb~on human accidents and animal experiments predict that a peak translational velocityof 70 ft/sec will result in 50 percent casualtiesfor personnel when deceleration occurs by tum
bling over open terrain. If translation occurswhere 50 percent· of the personnel impact againststructures (buildings, vehicles, trees or other rigidobjects) the peak translational velocity for 50percent casualties is expected to be near 35 ft/sec.Similar figures for one percent casualties are13 ft/sec for decelerative tumbling and 8.5 ft/secfor translation near structures.
10-3 Blast-Energized Debris.
_ The effects of blast-energized debris inc~ injuries that result from the impact ofpenetrating or nonpenetrating missiles energizedby winds, blast overpressures, ground shock, and,in some cases, gravity. The wounding potentialof blast-energized debris depends upon the natureand velocity of the moving object and the portionof the body where impact occurs. The types of
injuries range from simple contusions and lacerations to more serious penetrations, fractures,crushing injuries, and critical damage to vitalorgans. The physical factors that determine thevelocity attained by debris and thereby determinethe severity of potential injury, are similar. tothose described for translation of personnel.When small light objects are displaced by a blastwave, they reach their maximum velocity quiterapidly, often after only a small portion of thewave has passed; therefore, the maximum velocityis not as dependent on duration as it is for largeheavy objects. There are too many variables toestablish definitive criteria for injury from debris.
_ In the specific instance of personnel info= tentative casualty criteria are availablebased on the probability of being struck by faIling trees. These criteria are related to the amountof forest damage. Fifty percent casualties arepredicted at ranges where the forest damage ismoderate to severe, and one percent casualtiesare anticipated where the damage is light (seeForest Damage Data, Chapter 15).
10-4 Miscellaneous Effects.
_ Miscellaneous blast injuries are those thatre~from non-line-of-sight thermal phenomena, ground shock, blast-induced fires and highconcentrations of dust,
• Non-line-of-sight thermal burns have beenobserved on animals located in open underground shelters in close proximity to nuclear explosions. Although this phenomenonis not well understood, it has been sugge;ledthat the burns resulted from contact withhot dust-laden air that was carried into thestructures by the blast wave.
• Ground shock may be a serious problem forpersonnel in blast-hardened undergroundstructures at close ranges. The magnitude ofthis hazard may be estimated from thehorizontal and vertical motions of the structure, which in turn may be estimated from
10-3
• the predicted ground motions discussed inChapter 2.
• Blast-induced fires are primarily a problemfor urban areas. The likelihood of such firesdepends on the amount of burning andcombustible materials in the vicinity of anexplosion.
• The evidence indicates that a high concentration of dust represents more of a discom-
_ fort than a serious hazard to personnel.
With the possible exception of groundshock, currently there is inadequate informationto predict the hazards associated with these miscellaneous effects reliably.
• CASUALTV PREDICTION •
10-5 Personnel in the Open .-
• For most burst conditions casualties fromwhole body translation of personnel in the openwill extend farther than those from direct overpressure hazards, excluding eardrum rupture. Thisis especially true for larger yield weapons because of the increased duration of the blast wave.The translation hazard will be less for personnellocated in relatively open terrain than for personnel located where they may be blown againstbuildings, vehicles, trees or other structures.Warned personnel can reduce the translationrisks by assuming a prone position, and in thecase of larger yields there will be sufficient timefor the fireball flash to serve as a warning. Itshould be noted, however, that for overheadbursts, the direct overpressure effects would beless severe for a standing'man lhan for a proneman because of the "step" loadinll of the thoraxin the former case.
_ Unless the target area is cluttered withm~als subject to fragmentation with displacement, blast-energized debris is not expected tobe an overriding hazard for personnel in the open.FC'r ,mall yield surface bursts, however, craterejecta may extend beyond the other blast effects,
10-4
although nuclear or thermal radiation may produce casualties at greater distance. In general,the probability of being struck by flying missilescan be reduced by lying down; however craterejecta, which is likely to be falling nearly vertically at the greater distances may strike moreprone personnel than those who are standing. Asin the case of blast-energized debris, the miscellaneous air blast effects are not generally expected to represent major hazards for personnelin the open._ If a precursor form of blast wave shouldd=p, personnel located in its proximity wouldprobably be subjected to greater translation anddebris hazards than would be expected otherwisebecause of the increased dynamic pressures. Burstconditions associated with precursor develop-
Mare discussed in Section I of Chapter 2.
Figures 10-1 and 10-2 show the groundIstances for 50 percent and one percent casual
ties, respectively, from the indicated air blast effects as a function of height of burst for randomly oriented, prone personnel exposed in the opento a one kt burst. These figures were derived onthe basis of the criteria and assumptions discussed earlier in this section, with the addedconditions that crater ejecta was not presentand no precursor formed. Since a man with aruptured eardrum mayor may not be considereda casualty depending on the tasks he is expectedto perform, this effect has been removed fromthe other direct overpressure effects, and separatecurves are provided. Two translation curves areshown in each figure and the one that is moreappropriate to the existing conditions should beused. The figures show the effects for one kt, butthey may be scaled to other yields by the scalingrules provided in Problem 10-1.
10-6 Personnel in a Forest •_ For personnel in a relatively dense forest,
th~zard of being struck by falling and translating trees generally will override that resultingfrom any other air-blast effect. In addition, for
.iIiII
•most burst conditions a forest will provide sig-nificant protection from thermal radiation andwill provide some shielding from nuclear radiation. Therefore, casualties resulting from forestblowdown generally will extend to greater rangesthan those from any other weapon effect (directoverpressure, translation, thermal radiation, nuckar radiation, etc.). Exceptions to this generalrule are casualties resulting from initial nuclearradiation associated with low yield weapons, andcasualties resulting from forest fires ignited bythe thermal radiation pulse.
• Casualty prediction curves for forestbl=own are given in Figures 10-1 and 10-2 asa function of height of burst and ground rangefor randomly oriented, prone personnel exposedto a one kt burst. These curves may be scaled toother yields by multiplying both the burst heightsand the ground ranges by the four-tenths powerof the yield. In general, a forest does not greatlyreduce or otherwise modify a blast wave. For thisreason the other curves in Figures 10-1 and 10-2,which were developed to predict air-blast casualties for personnel in the open, also may be usedfor personnel in a forest. A description of theparticulars concerning these curves has been givenin the above discussion for personnel in the open.
10-7 Personnel in Structures._1 n addition to providing shielding againstt~ and nuclear radiations, blast-resistantstructures such as bomb shelters, permanent gunemplacements and, to a certain extent, foxholesusually reduce the blast hazards unless personnelare located directly in the entryway of the structure. The design of these' structures may, however, permit the buildup of blast overpressuresto a value in excess of the overpressures outsidethe structure as a result of multiple reflections.Nevertheless, there is generally a lower probability of injury from direct overpressure effects inside a structure than at equivalent distances ontho "''''ide, particularly if personnel do not leanagainst the walls of the structure or sit or lie on
the floor. This results from alterations in thepattern of the overpressure wave upon enteringtyucture.
• Structural collapse and damage are themajor causes of casualties for personnel locatedin buildings subjected to air blast; forthis reason,the number of such casualties can be estimatedfrom the extent of the structural damage. Table10-1 shows estimates of casualties in two typesof buildings for three damage levels. Data fromChapter 11 may be used to predict the grounddistances at which specified structural damagewill occur for various yields. Collapse of a brickhouse is expected to result in approximately 25percent mortality, 20 percent serious injury and
lO percent light injury to the occupants. Reinforced concrete structures, though much moreresistant to blast forces, will produce almost100 percent mortality on collapse. Casualty percentages in Table 10-1 for brick homes are basedon data from British World War II experience.They may be assumed to be reasonably reliablefor cases where the population expects bombingand most personnel have selected the safest placesin the buildings. If there were no warning orpreparation, the number of casualties would beexpected to be considerably higher. To estimatecasualties in structures other than those listedin Table 10-1, the type of structural damage thatoccurs, and the characteristics of the resultantflying objects must be considered. Broken glassmay produce large numbers of casualties, particularly to an unwarned population, at overpressures where personnel would be rela tivelysafe from other effects. Overpressures as low asone or two psi may result in penetrating woundsto bare skin.
10-8 Personnel in Vehicles.
• Personnel in vehicles may be injured as are~of the response of the vehicle to blastforces. Padding, where applicable, and the use ofsafety belts, helmets and harnesses can reduce·
10-5
Table 10-1. Estimated Casualty Production in Buildingsfor Three Degrees of Structural Damage.
Percent of Personnel"
, .. _., - ~'V'J
Structural Damage
l.:.:.:L :.ll:-.lCS (high-explosive
Killed OutrightSerious Injury
(hospitalization)Light Injury
(no hospitalization)
d,ta from England):
Severe damage
Modorate damage
Ugh! damage
Reinforced-concrete buildings (nucleardata from Japan):
Severe damage
Moderate damage
Light damage
25
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10
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20
10
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5
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*These percentages do not include the casualties that may result from fires, asphyxiation, and other causesfrom failure to extricate trapped personnel. The numbers represent the estimated percentages of casualtiesex oected at the maximum range where a specified structural damage occurs. See Chapter 11 for the distancesat which these degrees of damage occur for various yields.
" source of casualties significantly, at leastwithin armored vehicles tha t are strong enought.n. rp<;j<;t r-nlhn<;;r> Sr:rious injury may result topersonnel in ordinary wheeled vehicles from Oy-
10-6
ing glass as well as from impact with the vehicle'sinterior. Comparative numbers of casualties arealmost impossible to assess because of the manyvariables involved.
Problem 10-1 Calculation of Casualties for Personnelin the Open or in a Forest
III,
(
• Figures 10-1 and 10-2 are families ofcurves that show 50 percent and I percent casual1ies, respectively, from the indicated air-blasteffects, as a function of height of burst and distance from ground zero. The curves apply torandomly oriented, prone personnel exposed intM"e a en to a 1 kt burst.
Scaling. For yields other than I kt, scaleas 0 ows:
I. For the direct overpressure and ear-drum rupture curves
where d I and h) are the distance from groundzero and height of burst respectively, for I kt;and d and h are the corresponding distance andheight of burst for a yield of W kt.
2. For the translation and forest blow-down curves
where d, and hI are the distance from groundzero and height of burst, respectively, for I kt;and d and h are the corresponding distance andheight of burst for a yield of W kt.
• ExamPle•Given: A 50 kt weapon burst at an altitude
of 860 feet over open terrain.Find: The distance from ground zero at
which translational effects would produce 50percent casualties among prone personnel.
Solution: The corresponding height of burstfor I kt is
h ~ -1:L ~ 860 ~ 180 ft.I WO.4 (50;OA
From Figure 10-1, at a height of burst of 180feet, the distance from ground zero at which50 percent casualties among personnel in theopen will occur for a I kt burst is 660 feet.
Answer: The corresponding distance for a50 kt weapon is
d ~ dl
X WO·4 ~ 660 x (50;OA ~ 3150 ft.
Reliability: The distances obtained fromFigures 10-1 and 10-2 are estimated to be reliable to within ±15 percent for the indicated effects; however, in view of the uncertainties discussed in paragraphs 10-5 and 10-6 (e.g., thepresence of debris, crater ejecta, etc.) no preciseestimate of the reliability can be made for aspecific situation.
Reiated Material: See paragraphs 10-1through 10-6.
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SECfION II
• THERMAL RADIATION._-SKIN BURNS.
.. When a nuclear weapon detonates, personnel will sustain skin burns at distances thatmay be larger than those distances at which injury occurs as a result of blast or nuclear radialoon. The,: b"rn3 may be produced directly bythe absorption of radiant energy by the skin, orindirectly by heat transference through clothingor by ignition of the clothing. Thermal radiationis composed of light iii the ultraviolet, visible andinfrared regions of the spectrum and travels in astraight line at the speed of light. It is emittedwithin periods of a few milliseconds to several
iii' f seconds. -If there is substantial material between
the individual and the nuclear burst, the thermalradiation will be absorbed and no burns will beproduced. Thus, persons in or behind buildings,vehicles, etc., will be shielded from the thermalpulse either partially or completely. In someinstances, burns may be avoided or reduced ifevasive action is taken during the delivery of thethermal pulse, since heating takes place only during direct exposure. These and other protectivemeasures will be discussed later.
... ':;"':':;:;;;-iCATION OF BURNS.
,. Burn severity is related to the degree ofelevation of skin temperature and the length oftime of this elevation. Pain, a familiar warningsensation, occurs when the temperature of certainnerve cells near the surface of the, skin is raisedto 43°C (109°F) or more. If the temperature isnot elevated to a high enough degree or for asufficient period of time, pain will cease and noinjury will occur. The amount of pain is not related to burn severity as is the classification offirst degree (I 0), second degree (2°) or third,1p~rpp n° l I,lIrns but it is a useful tool in warning an individual to evade the thermal pulse.
10-10
10-9 First Degree Burns.
• A skin burn is an injury to skin causedby temperature elevation following applicationof heat by absorption of direct thermal radiationor by transference through cloth. First degreeburns are characterized by immediate pain whichcontinues after exposure and by ensuing rednessof the exposed area. The first degree burn is areversible tissue injury; the classic example issunburn.
10-10 Second Degree Burns.
• Second degree burns are caused by temperatures that are higher and/or of longer duration than those necessary for first degree skinburns. The injury is characterized by pain andmay be accompanied by either no immediatevisible effect or by a variety of skin changes including blanching, redness, loss of elasticity,swelling and blisters. After 6 to 24 hours, ascab will form over the injured area. The scabmay be flexible, tan or brown, if the injury ismoderate, or it may be thick, stiff and dark, ifthe injury is more severe. Second degree burnwounds will heal within one to two weeks unlessthey are complicated by infection. Second degreeburns do not involve the full thickness of the skin,and the remaining uninjured cells may be able toregenerate normal skin without scar formation .
10-11 Third Degree Burns.
• Third degree burns are caused by temperatures of a higher magnitude and/or longerduration than second degree burns. The injuryis characterized by pain at the peripheral, lessinjured areas only, since the nerve endings in thecentrally burned areas are damaged to the extent that they are unable to transmit pain impulses. Immediately after exposure, the skin mayappear normal, scalded, or charred, and it maylose its elasticity. The healing of third degreeburns takes several weeks and always results inscar formation unless new skin is grafted over the
c'
•burned area, The scar results from the fact thatthe full thickness of the skin is injured, and theskin cells are unable to regenerate normal tissue.
10-12 Reduction-W.ffectivenessby Burns_
• The distribution of burns into threegroups obviously has certain limitations since it1" .... A~ :,""s~~9Ie to draw a sharp line of demarcation hetween first- and second-degree, or between second- and third-degree burns. Withineach class the burn may be mild, moderate, orsevere, so that upon preliminary examination itmay be difficult to distinguish between a severeburn of the second degree and a mild thirddegree burn. Subsequent pathology of the injury, however, will usually make a distinctionpossible. In the following discussion, referenceto a particular degree of burn should be takento imply a moderate burn of that type._The depth of the burn is not the onlyfa~n determining its effect on the individual.The extent of the area of the skin which has beeneffected is also important. Thus, a first-degreeburn over the entire body may be more seriousthan a third-degree burn at one spot. The largerthe area burned, the more likely is the appearanceof symptoms involving the whole body. Furtherme,re: there are certain critical, local regions,such as the hands, where almost any degree ofburn will incapacitate the individual.... Persons exposed to a low or intermediatey~nuclear weapon burst may sustain verysevere burns on tlieir faces and hands or otherexposed areas of the body as a result of the shortpulse of directly absorbed thermal radiation.These burns may cause severe superficial damagesimilar to a third degree burn, but the deeperlayers of the skin may be uninjured. This wouldresult in rapid healing similar to a mild seconddegree burn. Thermal radiation burns occurringunder clothing or from ignited clothing or othertinder will be similar to those ordinarily seen in
burn injuries of nonnuclear origin. Because of thelonger duration of the thermal pulse, the differences between flash burns on exposed skinfrom air burst high yield weapons and burns ofnonnuclear origin may be less apparent.
• BURN INJURY ENERGIES~ RANGES.
• The critical radiant exposure for a skinburn changes as the thermal radiation pulse duration and spectrum change; therefore, the criticaldistance cannot be determined simply from thecalculated radiant exposure. The effective spectrum shifts with yield and altitude; the thermalradiation pulse is shorter for smaller yields orhigher burst altitudes (see Chapter 3).
10-13 Personnel Parameters.
• The probability and severity of an individual being burned will depend upon many factors including: pigmentation, absorptive properties, thickness, conductivity and initial temperature of the skin; distance from the detonationand the amount of shielding; clothing, orientation with respect to the burst, and voluntaryevasive action._ Severity of the burn cannot be determ~by temperature elevation and pulse duration alone. The energy absorbed by the skin in anormal population may vary by as much as 50percent because of the variance in skin pigmentation. It is known that depths in skin of 0.00 I to0.002 centimeter are the sites of the initial damage that results in a burn from thermal radiationpulses and that skin temperatures of 70°C (l5SoF)for a fraction of a second or temperatures of4SoC (I I SoF) for minutes can result in burns.Skin temperatures for first degree and thirddegree burns are roughly 25 percent lower andhigher, respectively, than those for second degreeburns._ For pulses of 0.5 second duration and10"the amount of energy absorbed is an im-
10-11
•portant factor. Figure 10-3 shows the effect ofabsorptive differences of human skin as calcubted from measurements of the spectral absorptance and the spectral distribution of the peakpower of nuclear weapons bursts in the loweratmosphere. As shown in Figure 10-3, very darkskinned people will receive burns from approximately two-thirds the energy required to produce the same degree of burns on very lightskinned people.
10-14 Burn ~osures for UnprotectedSkin.
• Figure 10-4 shows ranges of radiant exposures for the probabilities of burn occurrence.The solid lines represent 50 percent probabilityfor an average population taking no evasive actionto receive the indicated type of burns. The dottedlines divide the burn probability distributionsinto ranges for the three burn levels with averageburn probabilities of 18 percent and 82 percentassioned within these exposure ranges.
_ For example, from Figure 10-4, it canb~licted that, if a normal population is exposed to the thermal pulse at distances producingbetween 4.5 and 6.0 calories per square centimeter from a 1 megaton weapon, 18 percent ofthe population will receive second degree burnsand 82 percent will receive first degree burns.
• A radius from ground zero that producesareas of equal burn probability may be obtainedby employing the radiant exposures for skin burnprobability from Figure 10-5 and the weaponyield-distance relationship Jar radiant exposuresfrom Chapter 3.
10-15 Burns Under Clothing.
• Skin burns under clothing are pr~ducedseveral ways: by direct transmittance throughthe cloth if the cloth is thin and merely acts asan attenuating screen; by heating the cloth andcausing steam or volatile products to impinge onthe skin; by conduction from the hot fabric to
10-12
the skin; or the fabric may ignite, and consequent volatiles and flames will cause burns wheret.·mPinge on the skin.
Heat transfer mechanisms cause burnsbenea h clothing as a result of heat transfer forsome time after the thermal pulse ends. Theseburns generally involve deeper tissues than thosethat result from the direct thermal pulse on bareskin. Burns caused by ignited clothing also resultfrom longer heat application, and thus will bemore like burns occurring in nonnuclear weaponsituations.
10-16 Body Areas Involved. .
• The pattern of body area involved inthermal radiation burns from nuclear weaponswill differ from the areas injured from conventional means. For weapons of 100 kt Or less,where effective evasive action cannot be taken,burns would occur primarily on the directly exposed parts of the body unless the clothing ignites. First and second degree burns of the uncovered skin, and burns through thin clothingoccur at lower radiant exposures than thosewhich ignite clothing. Because of these factors,first and second degree burns for this low yieldrange would involve limited body area and wouldoccur only on one side of the body. For closerdistances where the direct thermal pulse produces burns and clothing ignition takes place,persons wearing thin clothing would have thirddegree burns over that area of the body facingthe burst. This phenomenon is typically seen inpersons whose clothing catches fire by conventional means.
• For the yield range 100 kt and less, persons wearing heavy clothing (in the third degreebare skin burn and clothing ignition zone) willhave third degree burns on one exposed bodysurface and third degree burns on other areasresulting from the burning clothes prior to itsremoval, or full body third degree burns if theclothing cannot be removed.
15
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13 M • Medium SkinD .. Dark Skin
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10-17 Incapacitation from Burns.
..Burns to certain anatomical sites of thebody, even if only first degree, will frequentlycause ineffectiveness because of their critical 10cation. Any burn surrounding the eyes that causesoccluded vision because of the resultant swellingof the eyelids, will be incapacitating. Burns ofthe elbows, knees, hands and feet produce im1,10oili,y or limitation of motion as the result ofswelling, pain or scab formation, and will causeineffectiveness in most cases. Burns of the faceand upper extremity areas are most likely to occurbecause these areas will more frequently be unprotected. Second or third degree burns in excessof 20 percent of the surface area of the bodyshould be considered a major burn and will re-
.•.special medical care in a hospital.. Shock is a term denoting a generalized
, ate of severe circulatory inadequacy. It will result in ineffectiveness and if untreated may causedeath. Third degree burns of 25 percent of thebody and second degree burns of 30 percent ofthe body will generally produce shock within 30minutes to 12 hours and require prompt medicaltreatment. Such medical treatment is complicatedand causes a heavy drain on medical personneland supply resources.
10-18 Modification of Inju~_1imely evasion can be effective in reduci~ns with weapons yields of 100 kt andgreater. The length of time between the burstand the point at which critical radiant exposureoccurs increases with increasing yields, permittingpersonnel to react prior to receiving severe burns.With yields of less than aboM 100 kt, or for highaltitude bursts of larger yields, the thermal pulseis too short for personnel to react and take cover.Since pain occurs at low radiant exposures andat lower temperatures than those that cause firstdegree burns, it is the initial sensation that occurs,and involuntary action due to pain can be expected instinctively. More effective action can
be expected with proper training. Figure 10-5illustrates the effect of evasion on the production of burns.
_ Personnel in the shadow of buildings,veBs, or other objects at the time of detonation will be shielded from the pulse and will notbe burned.
• EFFECTS OF THERMAL RADIATIONON THE EYES.
• Exposure of the eye to a bright flash ofa =ear detonation produces two possible effects; flashblindness and/or retinal burns.
10-19 Flashblindness. .
• Flashblindness (dazzle) is a temporaryimpaIrment of vision caused by the saturationof the light sensitive elements (rods and cones)in the retina of the eye. It is an entirely reversiblephenomena which will normally blank out theentire visual field of view with a bright afterimage. FIashblindness normally will be brief, andrecovery is complete._ During the period of flashblindness (seve~conds to minutes) useful vision is lost.This loss of vision may preclude effective performance of activities requiring constant, precisevisual function. The severity and time requiredfor recovery of vision are determined by theintensity and duration of the flash, the viewingangle from the burst, the pupil size, brightnessnecessary to perform a task and the background,and the visual complexity of the task. Flashblindness will be more severe at night since thepupil is larger and the object being viewed andthe background are usually dimly illuminated.
_ Flashblindness may be produced by scatte~light and does not necessarily require eyefocusing on the fireball.
10-20 Retinal Burns.
_ A retinal burn is a permanent eye injuryth~ccurs whenever the retinal tissue is heated.
10-15
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•excessively by the focused image of the fireballwithin the eye. The underlying pigmented cellsabsorb much of the light and raise the temperature in that area. A temperature elevation of12-20oC (22-36°F) in the eye produces a thermalinjury which involves both the pigmented layerand the adjacent rods and cones, so the visualcapacity is permanently lost in the burned area.The natural tendency of personnel to look directly at the fireball tends to increase the incidence of retinal burns._ Retinal burns can be produced at great~es from nuclear detonations, because theprobability of eye burns does not decrease as thesquare of the distance from the detonation as istrue of many other nuclear weapons effects.Theoretically, the optical process of image formation within the eye negates the inverse squarelaw and keeps the intensity per unit area on theretina a constant, regardless of the distance. However, meteorological conditions and the fact thatthe human eye is not a perfect lens, all contributetoward reducing the retinal burn hazard as thedistance is increased between the observer andthe detonation._ Explosion yields greater than one megat~nd at heights of burst greater than about130 kilofeet may produce retinal burns as rarout as the horizon on clear nights. Bursts above'1~li kilofeet probably will not produce anyretinal burns in personnel on the ground unlessthe weapon yield is greater than 10 Mt.
(U) A retinal burn normally will not be noticed by the indivi~ual concerned if it is off thecentral axis of vision; however, very small burnedareas may be noticeable 1f they are centrallylocated. Personnel generally will be able to compensate for a small retinal burn by learning toscan around the burned area.
10-21 Modification of Thermal Effectson the Eye.
• The thermal pulse from a nuclear weaponis emItted at such a rapid rate that any device de-
signed to protect the eye must close extremelyfast «100 !,sec) to afford a sure degree of protection for all situations. During the daytime,when the pupil is smaller and objects are illuminated brightly, the 2 percent transmission goldgoggle/visor will reduce flashblindness recoverytimes to acceptable levels. At present, this goggleis unsatisfactory for use at night, and there is noprotective device that is adequate for night use._ The blink reflexes of the eye are suffic~ fast (-0.2 second) to provide some protection against weapons greater than 100 kt detonated below about 130 kilofee.t. The blink timeis too slow to provide any appreciable protectionfor smaller weapon yields or higher burst alti-
•
u s.When personnel have adequate warning
an impending nuclear burst l evasive action including closing or shielding the eyes will preventflashblindness and retinal burns.
10-22 Safe Separation Distance Curves.
• Figures 10-6 through 10-10 present flashblindness and retinal burn curves for a number ofburst heights as a function of weapon yields andsafe separation distance, e.g., that distance wherepersonnel will not receive incapacitating eye injuries. The retinal burn curves show distancesthat current data show to be safe. The Curves forflashblindness were specifically designed for pilots of strategic bombers, where a pilot can effectively read his instruments and complete his mission after a temporary 10 second complete lossof vision. These curves are also applicable to anytask where the same criteria of dim task lighting,visual demands,and the 10 second visual loss
• can be applied. Data are not available for specificdistances at which flashblindness will not occur.
_ It should be noted that the flashblindnessan"e retinal burn safe separation distances donot bear the same relationship to one another asthe yield changes. ln circumstances that requiredetermination of complete eye safety (realizing
10-17
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o 40 80 120 160 200 240I I I I t I I I I I I I I I I I I , I I 1 I I I I 1
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Figure 10-6.•Safe Separation Distances, for an Observer on the Ground, from Burstsat 10 kft and 50 kft During the Day •
11)...18
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Figure 10-7.• Safe Separation Distance, for an Observer at 50 kft, from Burstsat 10 kft and 50 kft During the Day.
10-19
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SAFE SEPARATION DISTANCE (nm)
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10-20
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10-21
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Figure 10-10.• Safe Separation Distance, for an Observer on the Ground, from Low YieldWeapons Exploded at 1,000 ft Height of Burst •
10-22
(
•the 10 second loss of vision criterion in the flash-hlindness curves), the retinal burn or flashblindness curve that shows the effect that occurs at thegreatest distance from the burst should be used.For example, using Figure 10-8 and a 50 kilofeetheight of burst, to determine the distance from anuclear detonation where there will be no incapacitating eye effects, the flashblindness curve isthe limiting factor up to about 3 megatons, thenthe retinal burn curve becomes the limiting factor.
• In instances where only permanent eyedamage is of interest, and the temporary loss ofvision from flashblindness is not of concern, only
Me retinal burn curves should be used.The retinal burn curves show distances at
whle a nuclear burst will not produce retinalburns provided the eye can blink within 250 milliseconds. A faster blink time would not changethe distances appreciably. The curves are basedon a very clear day (60 mile visual range). For acloudy day with a 5 mile visual range, the safeseparation distances would be reduced by about50 percent.
SECfION III
• NUCLEAR RADIATION.
• The injurious effects of nuclear radiations (gamma rays, neu trons, beta particles andalpha particles) on the human target represent aphenomenon that is completely absent from conventional explosives. Since there has not beensufficient experience with humans in the exposure ranges of military interest, the materialpresented below is based largely on animal experimentation that 'has b~en extrapolated to thearea of human response. Even if sufficient humandata were available, they would be expected toshow similar responses and the same wide rangeof biological variability within species as is seenin animals. Data are presented in terms of absorbed dose at or near the body surface in orderto relate to source and transport factors given inChapter 5. Current radiobiological research re-
suIts are frequently reported as midline tissuedose in rad, a dose significantly lower than dosesmeasured by radiac instruments and absorbedwithin those volumes near the surface of the bodythat faces toward the source. For nuclear weaponradiation', the midline tissue doses would beapproximately 70 percent of the body surfacedoses presented in the following paragraphs.
_INITIAL RADIATION.
• Neutrons and gamma rays in various proportIOns are responsible for biological injuryfrom initial radiation. For military purposes, anduntil further animal experimentation providesevidence to the contrary, it must be assumed thatdamage to tissue is directly proportional to theabsorbed dose regardless of whether it is delivered by neutrons or gamma rays. For effects ofmilitary in terest, it is assumed that injury froma neutron rad is equal to that from a gamma rad,and that one rad absorbed dose results from exposure to one roentgen.
10-23 Radiation Sickness.
• Individuals exposed to whale body ionizing railiation may show certain signs and symptoms of illness. The time interval to onset ofthese symptoms, their severity, and their duration generally depend on the amount of radiationabsorbed, although there will be significant variations among individuals. Within any given doserange, the effects that are manifested can be divided conveniently into three time phases: initial latent, and final.•. During the initial phase, individuals maye.nce nausea, vomiting, headache, dizzinessand a generalized feeling of illness. The onsettime decreases and the severity of these symptoms increases with increasing doses. During thelatent phase, exposed individuals will experiencefew, if any, symptoms and most likely wiJI beable to perform operational duties. The finalphase is characterized by frank illness tha t re-
10-23
"I '1' . f 'hglmes 10splta lZatlOn a ter exposure to the hlg erdoses. In addition to the recurrence of the symplams noted during the initial phase, skin hemorrhages. diarrhea and Joss of hair may appear, and,at high doses, seizures and prostration may occur.The final phase is consummated by recovery ordeath. At doses above 1000 rad, death may beexpected in all cases. Maximum recovery of survivors exposed to lower doses may require asmuch as three to six months time. With the foregoing in mind, Table 10-2 is presented as thebest available summary of the effects of variouswhole-body dose ranges of ionizing radiation inhuman beings.
10-24 Incapacitation.
_ Direct effects of high doses of external~on administered over a short time period
may result in loss of ability to perform purposeful actions. At doses greater than 2,000 rads, anacute collapse may occur in a short time. Thecollapse may persist from several minutes to afew hours. A period of relatively normal performance capability will then occur; however,after some time permanent incapacitation anddeath will result. This early incapacitation, followed by a temporary period of recovery, is defined as early transient incapacitation (ETI). Following this transient incapacitation, exposed personnel may be reasonably well oriented, lucid,and able to perform tasks requiring coordinationof visual and auditory sensory input. The duration of early transient incapacitation is believedto be dose dependent, i.e., the greater the dose,the longer the transient incapacitation phase.The duration of the temporary period of effec-
Table 10-2 • Response to Single Whole-Body Exposures.
JOO-200 Rad 200-400 Rad 400-600 Rad 600-1000 Rad 1000-2500 Rad
3-6 hrs 1-6 hrs 1/2 to 6 hrs 1/4 to 4 hrs 5-30 min
<I day 1-2 days 1-2 days <2 days <I day
<I day 1-2 days 1-2 days Q days q day
~2 weeks 2-4 weeks 1-2 weeks 5-10 days 0-7 days'
Latent Phase
1. Onset after irradiation
2. Duration of phase
2. Duration of phase
Initial Phase
I. Onset of symptoms afterirradiation
Final Phase
I. Onset of symptoms afterirradiation
2. Duration of phase
3. Time from irradiationto death
4. Deaths (% of thoseexposed)
10-14 ~ays
4 weeks
No deaths
2-4 weeks
2-8 weeks
4-12 weeks
0-30%
7-14 days
1-8 weeks
2-10 weeks
30-90%
5-10 days
1-4 weeks
1-6 weeks
90-100%
4-8 days
2-10 days
4-14 days
100%
• At the higher doses within this range there may be no latent period.
10-24
•tiveness is inversely related to the dose. At dosesin excess of 15,000 rads, most individuals willexperience permanent complete incapacitationwithin a few minutes post-irradiation, followedbl' death within 2 to 24 hours.
_ Figures 10-11 through 10-15 list estim='personnel effectiveness at various timesfollowing acute radiation doses of 1,400 rads andgreater. It should be noted that incapacitation,or performance, decrement, and not death, isthe endpoint of interest in these figures.
10-25 Modification of Injury.
'-I'hen only a portion of the body is ex~ radiation, the effects are significantlyless than those described in the preceding twosections. The reduction of the effects depends onthe magnitude of exposure and the particularportion of the body that is exposed. Thus, partialshielding afforded by natural or man-made structures can be expected to decrease the severity ofradiation injury. .• Considerable effort has been expendedin searching for compounds that will reduce theextent and seriousness of radiation injury whenthey are administered prior to exposure. At present, there is no satisfactory compound availablefor issue, although research continues in this area.
_Treatment of radiation injury is support;" i" nature. The treatment is based primarilyon symptomology rather than measured or estimated dose received by the individual.
10-26 Military Assumptions.
~ In order to' apply the material above too"han single exposures, it may be assumedthat multiple exposures within any 24-hour period are arithmetically additive. This assumptionis necessary because the information concerningthe results of multiple exposures is limited.~ Although there is reason to believe thatr~y from radiation exposure(s) is neverreally complete (i.e., some residual injury not
necessarily affecting effectiveness remains), itmay be assumed for military planning purposes
. that recovery is complete in approximately 30days following a single sublethal exposure. Table10-2 lists more specific information regardingdurations of ineffectiveness under varying exposure conditions.
__RESIDUAL RADIATION.
__ The importance of residual radiation asa source of injury to personnel depends uponthe necessity for military operations in or nearareas of local fallout. Time of arrival, weathering,and decay of the deposited fallout all result in aconstantly changing rate of external protractedexposure to personnel in contrast to the almostinstantaneous exposure to initial radiation. Anadded hazard results from the presence of small,finely divided, radioactive particulate sourcesthat can contribute to injury by both externaland internal irradiation.
10-27 External HazardS.
• Gamma rays present the major militarilysigmllcant external hazard from residual radiation. Effects on personnel will range from thosedescribed previously for initial radiation exposures (in new, high dose-rate, fallout fields) tolesser effects for the same total exposure in lowdose-rate fields."Beta burns can occur if fallout particlesremam on the skin for periods of hours or more.They will occur most frequently when the falloutparticles are deposited on moist skin areas, bodycrevices, in the hair, or when the particles areheld in contact by clothing. While minor skinsymptoms may occur during the first 48 hoursfollowing exposure, the appearance of burns willbe delayed two weeks or more after exposure.Severity of the burns is a function of the radioactivity of the fallout particles and the timeperiod during which they adhere to the body.Personnel ineffectiveness will depend on theseverity of the burn and its location on the body.
10-25
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10-28 Internal Hazards •
• Radioactive materials entering the bodyby inhalation, eating, or through wounds orbreaks in the skin may be deposited in the bodywhere alpha particles, beta particles or gammarays continue to born bard adjacent tissues. Oncefixed within the body, removal is almost impossible, except through natural processes. Ef:, ,:, .:0: :.;:~cnal emitters usually become apparentafter a period of years, so, while of not immediateconcern insofar as personnel effectiveness is concerned, this deposition may eventually be ofgreatconcern to the individual._ Inhalation as a route of entry can bee~ed as the result of resuspension of radioactive materials from dust-producing activities,such as the operations of helicopter and fastmoving vehicles. Handling of contaminatedequipment, supplies, and clothing may result inthe hands becoming contaminated. The contamination then may enter the body while eating.Ingestion of contaminated foodstuffs and watersupplies is another source of internal emitters.
10-29 Modification of InjUry.
• External residual radiation can be red: by shielding. i.e., interposition of densematerial between personnel and the source ofradiation. as described previously for initial radiation. protection is afforded to varying degrees byarmored vehicles, foxholes, buildings and underground shelters. However, in a residual radiationenvironment, it is probable that radioactive materials will be brought into the protected areas asa result of their adherence to clothing, skin,hair, and equipment. Thus~ to reduce exposure,it is necessary to decontaminate both the individual and his equipment. Additionally, as muchtime as is militarily feasible should be spent inprotected environments while the residual radiation is decaying to lower levels. Decontaminationof the outer surfaces of structures also will reduce the total dose to personnel.
• If the outer packaging of foodstuffs isundamaged, they may be consumed withouthazard, provided care is taken to insure that thefood is not contaminated during removal of theprotective covering. Cans should be washcd before opening. Normal water filtration procedureswill remove a majority of the fallout radioactivematerials.
.•Treatment of individuals showing radiatIOn SIckness symptoms from exposure to residual radiation is similar to the treatment of sickness caused by initial radiation. Burns caused byprolonged contact of beta emitters with the skincan be reduced in severity, or prevented. by earlyremoval of the fallout material. Burns which dooccur respond to conventional methods of treat-
:wfor similar burns resulting from othcr cau'es.Medical management of conditions aris
ing a later times as a result of fixed internalemitters depends on the organ(s) in which thematerial is fixed, the number of demonstratedlesions, and the threat of this damage to life.
SECTION IV
..COMBINED INJURY •
.-Th~us far in this chapter little has beensaid about the possibility of personnel receivingmultiple types of injury; however, such injuriesprobably would be a common occurrence in theadvent of a nuclear war. Multiple injuries mightbe received nearly simUltaneously (e.g., from exposure to a single detonation without falloutradiation) or separated in time by minutes todays (e.g., from exposure to a single detonationfollowed by fallout radiation, or exposure tomultiple detonations). These injuries may consist of any combination of radiation, blast andthermal injuries from nuclear weapons as well aswounds from conventional weapons. Furthermore, such injuries may be influenced by otherconditions that might be expected during or aftera nuclear attack, such as malnutrition, poor
10-31
•. f' d' h .Sal1ltatlOn. atlgue, an vanous ot er enVlfon-mental factors. Since there are insufficient quantitative data to indicate the manner in whichcasualty production might be influenced by theselatter factors, only combinations of pairs of thefollowing three categories will be discussed inthis section: (l) ionizing radiation injuries, (2)thermal injuries, and (3) mechanical injuries (e.g.,injuries that result from blast effects).• Most of our current'knowledge concerning combined injuries is derived from studies ofJapanese bomb victims in Hiroshima and Nagasakiand from laboratory and field test experimentsinvolving a variety of animals. In Hiroshima andNagasaki, 50 percent of the injured 20-day survivors within about 2,200 yards of ground zeroreceived combined injuries whereas an incidenceof 25 percent was observed in those located between 2,200 and 5,500 yards. The contributionof such injuries to overall mortality and morbidityhas never been determined adequately, but twogeneral impressions have emerged: the combination of mechanical and thermal injury was responsible for the majority of deaths that occurredwithin the first 48 hours: delayed mortality washigher and complications were more numerousamong burned people who had received radiationthan what would be anticipated in a burned population where no radiation exposure had occurred.ft ,h",,'cl be recognized that the stated incidencesof com bined injuries apply only to the conditionsexisting in the two Japanese cities at the time ofattack and that the number and types of combined injuries are sensitive to yield, burst height,and conditions of exposure. Yields smaller than10 kilotons probably would result in a significantnumber of casualties with co~binations ofprompt-radiation, thermal, and mechanical injuries. On the other hand, larger yields would beexpected to result in a marked increase in thenumber of people with burns associated withmechanical injuries, and prompt-radiation injurics would be relatively insignificant in the
10-32
surviving population. A weapon detonated at aburst height where fallout is minimized wouldresult in a large number of thermal and mechanical injuries, and, depending upon yield,might also produce a significant number ofprompt-radiation injuries. A weapon detonatednear (above or below) the surface would maximize the number of injuries due to fallout andwould produce a large number of casualtieswhere such injuries would be combined withmechanical and thermal trauma. Personnel outside and unshielded would have a greater likelihood of sustaining prompt and/or fallout radiation in combination with thermal burns thanwould be the case for personnel inside of anyform of structure. In the latter case, thermalburns would be minimized, whereas combinations of mechanical and radiation injury might_ate.,. Combined injuries may result in synergislIc effects, additive effects, or antienergisticeffects. That is, the resultant response, whethermeasured as percent combat ineffectiveness (CI)or mortality, may be greater than, equal to, orless than what would be predicted based on theassumption that the various injuries act independently of one another in producing casualties.Quantitative data from laboratory experimentssuggests that, in situations where a combinedeffect has been observed, the interaction of thevarious forms of trauma has resulted in enhanceddelayed mortality, with little apparent effect onearly mortality.
10-30 Radiation and Thermal Injuries.
• Depending upon the radiation dose andthe severity of burn, mortality has been foundto increase by as much as a factor of six abovethat which might be expected from the twoinjuries administered singly. Thus, burns whichserve as a portal of entry for infection may beconsiderably more hazardous to a person whoseresistance to infection has been lowered by ioniz-
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•ing rfdiation. However. enhanced mortality hasnot been observed when low radiation doses havebeen administered in combination with minimalburn injuries. Very little information is availableon fallout radiation in combination with thermalor any other form of injury.
10-31 Mechanical and RadiationInjUries.
• Mechanical and radiation injuries can beexpected to be frequent, particularly if falloutis present. Studies indicate that a delay in woundhealing is observed with doses in excess of 300rads, and that wounds in irradiated subjects areconsiderably more serious if treatment is delayedfor more than 24 hours. In addition, missile andimpact· injuries that result in disruption of theskin and damage to the soft tissues would provide a portal of entry for infection, and thus maybe extremely hazardous to irradiated people. Injuries that are associated with significant bloodloss would be more serious in personnel whohave received a radiation dose large enough tointerfere with normal blood clotting mechanisms.
10-32 Thermal and MechanicalInjuri.es.
• Burns and mechanical injuries in combination are often encountered in victims ofconventional explosions and increased delayedcomplications, shorter times-to-death and enhanced mortality are frequent occurrences. However, little quantitative data are available on thisform of combined injury.
_ CASUALTV CRITERIA.
• No reliable criteria for combat ineffeclives are known for personnel receiving combinedinjuries. The available data do indicate, however,that individuals receiving combined injuries thatoccur nearly simultaneously are unlikely to become casualties within a few hours, provided theindividual injuries would not produce casualties
if administered separately. Consequently, it isnot unreasonable to make early casualty predictions for a single nuclear detonation on the basis
of the most far-reaching effect. In regard totroop-casualty predictions, combined effects canbe considered as a bonus, helping to aSSure theattainment of predicted Cllevels, especially sincethere is a reasonable amount of uncertainty inthe predictions for individual effects. If exposure exceeds any "minimal" risk level, that effectcould contribute to combined injury and couldresult in increased casualties at later times. Thisbecomes an important factor in terms of troopsafety.
"
ERSONNEl IN THE OPEN.
Figure 10-16 indicates expected burnleve s, prompt ionizing-radiation doses, and peaktranslational velocities as functions of yield andground distance for randomly-oriented, pronepersonnel exposed in the open. The curves werederived, assuming a visual range of 16 miles and aburst height such that the fireball would justtouch the surface. This is the minimum heightof burst which would result in negligible early,or local, fallout. The curves, which are presentedfor illustrative purposes only, form the limits ofa band for each effect. These limits correspondto 50 percent early casualties and "minimal"early risk. The ionizing-radiation dose requiredto produce 50 percent CI within one hour, e.g.,approximately 5,000 rads, is so large that it willresult in 100 percent mortality within severaldays. For this reason, a 500-rad curve, whichwould correspond to approximately 50 percentmortality within 60 days, is included in Figure10-16. Direct overpressure effects are not included in the figure since, except for eardrumrupture, which is not normally considered toproduce CI, translational effects extend to greater
..
an es for all of the yields considered.In the case of troop-casualty predictions,
promp -radiation predominates for yields less
10-33
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•than 2 kt whereas thermal radiation is the mostfar-reaching hazard for yields greater than 2 kt.In situations where thermal exposure is neglectedas a casualty-producing factor, ionizing radiationis the major effect in producing a 50 percent CIlevel for yields below 100 kt, while for largeryields. blast effects (translation) predominate..• With regard to troop safety, ionizing radiatlOll IS the major hazard below I kt, while thermal radiation predominates for larger yields. Ifthe troops can be shielded adequately from thethermal pulse, ionizing radiation is the majorhazard for yields up to 100 kt, above'which blasteffects are the most far-reaching hazard.
• PERSONNEL IN STRUCTURES.
• In order to predict casualty levels fortroops in situations other than open terrain, forexample, inside armoured vehicles or field fortifications, the amount of nuclear radiation, thermal radiation, and blast shielding, as well .as thedegree of blast hardness of the surrounding materials must be taken into account for each geometry of exposure. As was the case for personnel in the open, casualty predictions must bemade on the basis of the most far-reaching singleeffect rather than on the basis of combined effects. In general, for troops in structures, them"inr effect producing early casualties is likelyto be ionizing radiation for small yields and blasteffects for larger yields, with the cross-over pointdepending on the degree of hardness of the structure. While the hazards from thermal and ionizing radiation levels ?re reduced in a structure, thehazards from air blast may be magnified as a result of structural collapse; whole-body impact,and falling debris. This is particularly true forrelatively soft structures at greater distances.
IIln the case of personnel in field fortific s, severf damage to the structure (Section
VI ~. Chapter!g,) should be taken as representative"f 'in ~ercent early CI from blast. Shielding fac-
1/,tors (Section W, Chapter 9) must be consideredwhen estimating nuclear radiation responses ofpersonnel in such structures.
• TREATMENT. .
.• The triage a?d treatment of combinedII1Junes present special problems, partIcularly ifsignificant radiation exposure has occurred. Certain modifications in accepted medical and surgical practices must be considered since radiationexposure, depending upon dose, is known to increase susceptibility to infection, to decrease theefficiency of wound and fracture healing, to increase the likelihood of hemorrhage, to decreasetolerance to anesthetic agents, and to decreasethll'mune response.
It is imperative that primary closure ofwoun s be accomplished at the earliest possibletime and that patients be treated with a broadspectrum antibiotic throughout the period ofmaximum bone marrow depression. Secondaryclosure of small soft-tissue wounds should beaccomplished by the second or third day. Reparative surgery of an extensive nature should not beperformed later than four to five days after injury since skin and soft-tissue healing should haveoccurred before the effects of ionizing radiation
occur. If reparative surgery is not performedwithin this limited period of time, it must bepostponed until the bone marrow has recovered(one to two months post-exposure). Wounds ofinjuries that require longer than three weeks for
. healing, such as severe burns and most fractures,should not be definitively treated until radiationrecovery is evident. Although reconstructive surgery in the absence of radiation exposure mightbe performed within the second month or earlierafter conventional trauma, it must be postponedfor at least three months in instances where radiation exposure is a significant contributory factor. In all instances, extra precaution must betaken to avoid infection and blood loss.
10-35
• BIBLIOGRAPHY •
Allen, R, G" et aI" Tile Calculation of Retinal Bum and Flashblindness Safe Separation Distances, U,S, Air Force School of Aerospace Medicine, Brooks Air Force Base, Texas,September 1968, SAM-TR-68-106
Anderson, R. S., F, W. Stemler, and E. B. Rogers, Air Blast Studies with Animals, ChemicalResearch and Development Laboratories, Army Chemical Center, Maryland, April 1961,DASA 1193 .
Behrens, C. F., Atomic Medicine, Williams & Wilkins, Baltimore, 1959. Biological and Enl'ironmental Effects of Nuclear War, Hearings before the Special Subcommittee on Radiation of the Joint Committee on Atomic Energy, Congress of the United States, June1959. U.S. Government Printing Office, Washington. D. .
Blatz. H.. Radiation Hygiene Handbook, McGraw-:Hill Book Co., Inc., New York, 1959
Bowen, I. G., A. F. Strehler, and M. B. Wetherbe, Distribution ofMissiles from Nuclear Explosions, Lovelace Foundation for Medical Education and Research. Albuquerque, NewMexico. December 1956, WT-116
Bowen. I. G., et aI" Biophysical Mechanisms and Scaling Procedures Applicable in AssessingResponses ofthe Thorax Energized by Air-Blast Overpressures or Non-Penetrating Missiles,Lovelace Foundation for Medical Education and Research, Albuquerque, New Mexico,November 1966, DASA 1857
Bowen. I. G.. F. R. Fletcher, and D. R. Richmond, Estimate ofMan's Tolerance to the DirectEffects ofAir Blast, Lovelace Foundation for Medical Education and Research, Albuquerque, New Mexico, October 1968, DASA 211
~c"ccc. ~,1.. The Acute Radiation Syndrome: Y-12 Accident, Oak Ridge Institute of NuclearStudies, April 1959, ORINS-25
Bryant, F. J., et aI" U.K. Atomic Energy Authority Report AERE HP/R 2353 (}957);Strontium in Diet, Brit. Medical Journal,j, 1371 (} 958
Claus, W. D. (Ed.), Radiation Biology and Medicine, Addison-Wesley Publishing Co. Inc.,Reading, Mass.,19:5~
Conard, R. A., et al"Medical Survey of Rongelap People Five and Six Years After Exposure toFallout, Brookhaven National Laboratory, September 1960, BNL-609
Fletcher. E. R., et aI" Determination of Aerodynamic-Drag Parameters of Small IrregularObjects by Means ofDrop Tests. Lovelace Foundation for Medical Education and Research,Albuquerque, New Mexico, October 1961, CEX-59.14
10-36
i
• •Fletcher, E. R., and I. G. Bowen, Blast Induced Translational Effects, Lovelace Foundationfor Medical Education and Research, Albuquerque, New Mexico, November 1966, DASA185
Gerstner, H. B., Acute Radiation Syndrome in Man, U.S. Armed Forces Medical Journal, 9.313 (1958)
Hayes, D. F., A Summary ofAccidents and Incidents InvolVing Radiation in Atomic EnergyActivities, TID-5360, August 1956; Supplement No. I, August1957~September 1959. U.S. Atomic Energy Commission, Washington, D.C...-.-
Hirsch, F. G., Effects of Overpressure on the Ear - A Review, Lovelace Foundation forMedical Education and Research, Albuquerque, New Mexico, November 1966, DASA1858
Kulp, J. L., A. R. Schulert and E. J. Hodges, Strontium-90 in Man IV, Science, 132,448(1960)
(
Lappin, P. W., and C. F. Adams, Analysis of the First Thermal Pulse and Associated EyeEffects, Aerospace Medical Research Laboratories. Wright Patterson Air Force Base, Ohio,December 1968, AM RL-TR-67-214
Loutit, J. F., and R. S. Russell, (Eds.), The Entry of Fission Products into Food Chains,Progress in Nuclear Energy, Series VI, Vol. 3, Pergamon Press, Inc., New York, 1961
Miller, R. W., Delayed Radiation Effects in Atomic Bomb SurVivors, Science, 166, 569(1969)
National Academy of Sciences-National Research Council, The Biological Effects ofAtomicRadiation, 1956; Pathological Effects of Atomic Radiation, Publication No. 452, 1961;Long-Term Effects of Ionizing Radiations from External Sources. Publication No. 849,1961 ; Effects of Ionizing Radiation on the Human Hematopoietic System, PublicationNo. 875, 1961; Effects 0 Inhaled Radioactive Particles, Publication No. 848, 1961,Washington, D.C.
National Council on Radiation Protection and Measurements, Basic Radiation ProtectionCriteria, NCRP Report No. 39, 1971, Washington, D.C,
Oughterson, A. W., and S. Warren, Medical Effects ofthe Atomic Bomb in Japan, National Nuclear Energy Series VlII, McGraw-Hill Book Co., Inc., New York, 1956
Proceedings of the International Conferences on the Peaceful Uses of Atomic Energy, Geneva,Biological Effects of Radiation, Volume II, 1956; Vol. 22, 1958; United Nations, NewYork
10-37
•
,
•Richmond, D, R" L G, Bowen, and C. S, White, Tertiary Blast Effects: The Effects of Impact0'; Mice, etc, Aerospace Medicine, 32,789 (1961
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Richmond, D, R" et aI., The Relationship Between Selected Blast Wave Parameters and theRespo/lse of Mammals Exposed to Air Blast, Lovelace Foundation for Medical Educationand Research, Albuquerque, New Mexico, November 1966, DASA 1860
~ymposmm on Radioactive Fallout in Foods, Agriculturaland Food Chemistry, 9, 90 (1961)
I
•
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Wald, N" and G, E. Toma, Jr., Radiation Accidents through December 1958, Oak RidgeNational Laboratory, March 1961, ORNL-2748, PartB
White, C. S" et aI., Comparatil'e Nuclear Effects of Biomedical Interest, Civil Effects Study,January 1961, CEX-58,8
White, C. S" and D, R, Richmond, Blast Biology, Lovelace Foundation for Medical Education and Research, September 1959,TID-5.76~
White, C. S" L G, Bowen, and D, R, Richmond, A Comparative Analysis of Some of theImmediate E/ll'iromn£/ltal Effects at Hiroshima and Nagasaki, Health Physics, PergamonPress, 10,89 (1964)
White, C. S" Tentative Biological Criteria for Assessing Potential Hazards from NuclearExplosions, Lovelace Foundation for Medical Education and Research, Albuquerque, NewMexico, December 1963, DASA146~
White, C. S" The Scope of Blast and Shock Biology and Problem Areas in Relating Physicaland Biological Parameters, Lovelace Foundation for Medical Education and Research,Albuquerque, New Mexico, November 1966, DASA 1856
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White, C. S" et aI., The Biodynamics ofAir Blast, Lovelace Foundation for Medical Educa[',H' ""J Research, Albuquerque, New Mexico, July 1971, DNA 2738T
10-3B
•&,
Recommended