Guidance for Radiation Accident Management

Regardless of where or how an ionizing radiation-related incident happens, three types of radiation-induced injury can occur—irradiation, external contamination with radioactive materials, and internal contamination with radioactive material, and incorporation of radioactive material.

Irradiation

Irradiation occurs when all or part of the body is exposed to penetrating radiation from an external source. This is the same process that occurs during an ordinary chest X-ray. Following irradiation, an individual is not radioactive, cannot spread radioactive contamination, and can be treated like any other patient.

External and internal contamination

The second and third types of radiation injury involve external or internal contamination with radioactive materials. Contamination means that radioactive materials are spread to an unintended location. An external surface of the body, such as the skin, can become contaminated and, if radioactive materials get inside the body through the respiratory system, the gastrointestinal system, or via wounds, the contaminant can become deposited internally. If a patient is internally contaminated, the body may incorporate the radioactive material. Incorporation refers to the uptake of radioactive materials by body cells, tissues, and target organs such as bone, liver, thyroid, or kidney. In general, radioactive materials are distributed throughout the body based upon their chemical properties. Incorporation cannot occur unless internal contamination has occurred.

Incorporation

The third type of radiation injury that can occur is incorporation of radioactive material. Incorporation refers to the uptake of radioactive materials by body cells, tissues, and target organs such as bone, liver, thyroid, or kidney. In general, radioactive materials are distributed throughout the body based upon their chemical properties. Incorporation cannot occur unless contamination has occurred. Refer to the section on assessment and treatment of the contaminated patient in hospital emergency care of the radiation accident patient.