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-

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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 .. . -.. ,..

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(

•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

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Killed OutrightSerious Injury

(hospitalization)Light Injury

(no hospitalization)

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Modorate damage

Ugh! damage

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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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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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10-19

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10-21

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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 •

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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

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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.

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10-37

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I

•

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10-3B

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