National Academies Press: OpenBook

The Medical Implications of Nuclear War (1986)

Chapter: Glossary

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Suggested Citation:"Glossary." Institute of Medicine. 1986. The Medical Implications of Nuclear War. Washington, DC: The National Academies Press. doi: 10.17226/940.
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Suggested Citation:"Glossary." Institute of Medicine. 1986. The Medical Implications of Nuclear War. Washington, DC: The National Academies Press. doi: 10.17226/940.
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Glossary Absorption optical depth: unit used to describe the attenuation at the earth's surface of sunlight passing through atmospheric smoke. Albumin: most commonly used plasma protein for blood volume expansion. Aroma: failure of oxygen to gain access to, or be utilized by, the body tissues. Bamer nursing: isolation of radiation victims whose immune systems are suppressed to prevent them from contracting infectious diseases. BElR: National Research Council Committee on the Biological Effects of Ionizing Radiations. Beta particles: charged particles emitted from a nucleus during radioactive decay; a negatively charged beta particle is identical to an electron, and a positively charged particle is called a positron. Large amounts of beta radiation may cause skin burns, and beta emitters are harmful if they enter the body, but the particles are easily stopped by materials such as metal or plastic. Bioaccumulation: the accumulation of a substance in a living organism. Black rain: smoke from nuclear-initiated fires that is washed out of the atmosphere. Blast lung: lesion caused when a shock wave compresses the chest wall against the spinal column and then suddenly releases it. Death can occur immediately from the sudden propagation of air emboli into cerebral and cardiac circulation, or later, from pulmonary hemorrhage and pulmonary edema. Bone marrow: tissue occurring in the long bones and certain flat bones of vertebrates, the primary function of which is the generation of red and white blood cells. 589

s9o GLOSSARY Bone marrow transplants: bone marrow from matched donors may be used to restore immunologic competence in patients whose marrow function has been destroyed by ionizing radiation. Burn injuries: prst-degree burns affect only epidermis and can cause de- hydration and pain. Second-degree burns (partial thickness burns) result in blistering of the skin and will heal by slow regrowth of skin from the wound base. Third-degree burns substantially affect the dermis and will heal only with skin grafts. Flash burns resemble first- and second-degree burns, al- though with slightly less tissue swelling and fluid loss, and may occur on exposed surfaces as a result of direct thermal radiation. C3: the command, control, and communication functions of strategic weap- ons systems, including early warning monitoring systems. Carcinogen: an agent that causes development of a carcinoma or any other sort of malignancy. Casualty clearing station: a rudimentary hospital used within a few miles of the front line during World War I. Cesium-137: long-lived radioactive isotope (half-life 33 years) which be- haves like calcium and tends to accumulate in the cytoplasm of humans. Circadian cycles: a rhythmic process within an organism occurring inde- pendently of external synchronizing signals. In humans, this internal clock maintains a 24- to 25-hour cycle. Crater: pit, depression, or cavity formed in the earth's surface by a surface or underground explosion. Crisis relocation: planned evacuation of population centers in anticipation of nuclear war. CRP-2B: a scenario of massive nuclear war, designed by the Federal Emer- gency Management Agency, based on a hypothetical attack of 6,559 Mt of nuclear explosives targeted primarily at military installations and population centers within the United States. Cytostatic: an agent that suppresses cell growth and multiplication. Decay, radioactive: disintegration of the nucleus of an unstable nuclide by spontaneous emission of charged particles, photons, or both. Denial: a psychologic process by which what is consciously intolerable (facts, deeds, thoughts, feelings) is disowned by an unconscious mechanism of non-awareness; aspects of reality are regarded as non-existent or are trans- formed so that they are no longer unpleasant or painful. Dioxins: any of several heterocyclic hydrocarbons that occur as persistent toxic impurities in herbicides or as the waste product of some industrial chemical reactions, suspected of causing birth defects, liver damage, or death. Disaster syndrome: the tendency of victims to demonstrate apathetic, doc- ile, indecisive, unemotional, or mechanical behavior.

GLOSSARY 591 Dose: general term denoting quantity of radiation or energy absorbed; ab- sorbed dose is the energy imparted to matter by ionizing radiation per unit mass of irradiated material at the point of interest (expressed in reds or grays); cumulative dose is total radiation resulting from repeated exposures; doubling dose is the amount of radiation needed to double the natural incidence of a genetic or somatic anomaly; genetically significant dose is the gonad dose from all sources of exposure that, if received by every member of the pop- ulation, would be expected to produce the same total genetic effect on the population as the sum of individual doses actually received; threshold dose is the minimum absorbed dose that will produce a detectable degree of any given effect. Electromagnetic pulse: a sharp pulse of electromagnetic energy generated by a nuclear explosion, capable of damaging unprotected electric and elec- tronic equipment at great distances. Ethnocentrism: a habitual disposition to judge foreign peoples or groups by the standards and practices of one's own culture or ethnic group. Fallout: particles of radioactively contaminated material which are dis- persed in the atmosphere following a nuclear explosion and which subse- quently settle to the earth's surface; localfallout refers to particles, generally larger than 1 micron, that reach the earth within 24 hours after a nuclear explosion; global fallout refers to fine particulate matter and gaseous com- pounds that ascend into the upper troposphere and stratosphere and may be widely distributed over a period of weeks or months (intermediate-fallout) to years (long-term fallout). False consensus bias: the belief that others share our attitudes. FEMA: Federal Emergency Management Agency. Fireball: luminous sphere of hot gases that is formed by a nuclear explosion. Firebreak: a cleared area of land intended to interrupt the spread of fire. Firestorm: a large area fire in which heated air and gases rise rapidly, drawing in cooler air from surrounding areas, thus generating surface tem- peratures of 1000°C, winds up to 90 mph, and convection patterns with a relatively static boundary. Fission: the splitting of heavy nucleus into two approximately equal parts, accompanied by the release of energy and neutrons. Fuel loading: amount and types of combustible materials in a structure or geographical area. Fusion: a nuclear reaction characterized by the joining together of light nuclei to form heavier nuclei. Gamma radiation: high-energy, short wavelength electromagnetic emis- sions from the nucleus, frequently accompanying alpha and beta emissions and always accompanying fission. Gamma rays are similar to X-rays, but are

592 GLOSSARY usually more energetic. They are very penetrating and are best shielded against by dense materials such as lead. Global climate model: three-dimensional computer simulation describing the actions of winds, temperature, moisture, and other factors throughout the global atmosphere. GLODEP2: an empirical model used to estimate the fate of intermediate . and long-term fallout particles in a normal atmosphere. GRANTOUR: three-dimensional transport model driven by meteorological data, used to estimate global fallout in a perturbed atmosphere. Gray (Gy): 100 reds. Ground zero: point on the earth's surface at which, above which, or below which an atomic detonation has actually occurred. Groupthink: a way of coping with stress that is characterized primarily by a shared illusion of invulnerability, an exaggerated belief in the competence of the group, and a shared illusion of unanimity within the group. Height of burst: height above the earth's surface at which a bomb is det- onated in air. The optimum height can be selected for a weapon of specified energy yield to produce effect over the maximum possible area. Hematopoietic syndrome: following exposure to 200-1000 reds, a victim may experience anorexia, apathy, nausea, and vomiting. Symptoms may subside after 36 hours, but lymph nodes, spleen, and bone marrow begin to atrophy, leading to abnormally low numbers of all formed elements in the blood. Hotline: direct circuit between government installations in the United States and the U.S.S.R., available for immediate use without patching or switching. Hotspot: region in a radioactively contaminated area in which the level of radiation is noticeably greater than in neighboring regions in the area. Hyperthermia: a disturbance of the body's heat-regulating mechanism, re- sulting from exposure to excessive heat, characterized by prostration and circulatory collapse, and which can result in high fever and collapse, and sometimes in convulsions, coma, and death. Hypervigilance: condition in which a decision maker, under crisis-induced stress, searches frantically for a way out of the dilemma, rapidly shifting between alternatives, and then impulsively seizing on a hastily contrived solution that seems to promise immediate relief. Hypocenter-. see Ground zero. Hypovolemia: low blood volume arising from dehydration or hemorrhage. Iatrogenic illness: abnormal state or condition inadvertently produced by medical intervention. ICRP: International Commission on Radiological Protection. immune response: in humans, it is divided into immoral (antibody) and cellular or cell-mediated components. The humoral portion is mediated by B

GLOSSARY 593 lymphocytes which are precursors of antibody-secreting cells; the cellular portion is mediated by T-lymphocytes which protect against certain bacterial infections and many viral and fungal infections, and which provide resistance to malignant tumors. Lymphocytes can be further differentiated as effector T-lymphocytes, which respond to target antigens, e.g., reject foreign tumors and eliminate virus-infected cells; helper T-lymphocytes, which stimulate the differentiation of B-lymphocytes into mature antibody-secreting plasma cells and activate effecter T-lymphocytes; and suppressor T-lymphocytes, which suppress the initiation of specific immune responses. intercontinental ballistic missile (ICBM): weapon flying a ballistic trajec- tory after guided powered flight, usually over ranges in excess of 4000 miles (6500 km). Ionizing radiation: any electromagnetic or particulate radiation capable of displacing electrons from atoms or molecules, thereby producing ions, e.g., alpha, beta, gamma, X-rays, neutrons, and ultraviolet light. High doses may produce severe skin or tissue damage. Isotopes: forms of an element having identical chemical properties but dif- fenng in atomic masses (due to different numbers of neutrons in their re- spective nuclei) and in their radioactive properties. Kazarma: Soviet military barracks. Kerma: a measure of the intensity of a radiation field, in reds. Kiloton (lit): an explosive power equal to 1000 tons of TNT. Lapse rate: rate at which atmospheric temperature changes with altitude. Latency period: the stage of a disease in which there are no clinical signs or symptoms. LDso: dose of a substance that will kill 50 percent of individuals in a population within a specified period (usually 60 days). Leukemia: any of several acute or chronic malignancies of the blood-form- ing organs characterized by uncontrolled leukocyte proliferation. - Light-water reactors: reactors using ordinary water as coolant, including boiling water reactors and pressurized water reactors, the most common types used in the United States. Lymphocytes: see Immune response. Maximum permissible concentration: highest quantity per unit volume of radioactive material in air, water, and foodstuffs that is not considered an undue risk to human health. Megaton (Mt): energy released by the explosion of 1 million metric tons of TNT. Methaqualone: a sedative and hypnotic drug that is habit-forming and sub ject to abuse; also known as Quaalude. (MIRV) Multiple, independently Targetable, Reentry Vehicles: method of

- 594 GLOSSARY delivering several warheads having individual yields of 100 to 500 kt on a single rocket. Multiple myeloma: a primary bone malignancy characterized by diffuse osteoporosis, anemia, hyperglobulinemia, and other clinical features. Mutagen: an agent that raises the frequency of mutation above the spon- taneous rate. Mutation: abrupt change in the genotype of an organism; genetic material may undergo qualitative or quantitative alteration, or rearrangement. Mutual assured destruction (MAD): strategic policy to deter nuclear attack by assuring the destruction of any attacker in retaliation. Neurosis: a category of emotional maladjustments characterized by some impairment of thinking and judgment, with anxiety as the chief symptom. Neutron: an uncharged elementary particle with a mass slightly greater than that of the proton. The neutron is a constituent of the nuclei of every atom heavier than hydrogen. NOx: Oxides of nitrogen. Nuclear fuel cycle facilities: nuclear power reactors, facilities for mining, milling, isotopic enrichment, fabrication of fuel elements, reprocessing of fissionable material remaining in spent fuel, re-enrichment of fuel material, refabrication into new fuel elements, and waste disposal. Nuclear weapons: bomb, warhead, or projectile using active nuclear ma- ~terial to cause a chain reaction on detonation. Strategic nuclear weapons have long ranges and large yields; tactical nuclear weapons generally have a rel- atively short range (less than 100 km) and relatively small yields; theater nuclear weapons are medium range and medium yield. Nuclear winter: global climatic perturbations triggered by the lofting of smoke and soot into the upper atmosphere from fires ignited by nuclear weapons. Organ factor: proportion of a radioactive dose to the body surface that reaches the bone marrow. Osteosarcoma: a malignant tumor derived from bone or containing bone tissue. Overpressure: the transient pressure, in excess of normal atmospheric pres- sure, produced by the shock wave from an explosion. Ozone depletion: reduction of the layer of ozone in the atmosphere that filters ultraviolet radiation, roughly between 10 and 50 km above the earth's surface. Permissive action link (PALJ: a coded lock to prevent the unauthorized release of nuclear weapons. Personnel reliability programs: processes for screening individuals with access to and technical knowledge of nuclear weapons. Photochemical smog: atmospheric pollutants resulting from chemical re

GLOSSARY 595 actions involving hydrocarbons and nitrogen oxides in the presence of sun- light. Polychlorinated biphenyls (PCBs): highly carcinogenic compounds pro- duced by replacing hydrogen atoms in biphenyl with chlorine, used primarily as an insulating fluid in electrical equipment and to lend durability to hydraulic fluids and plastics. It has been found to accumulate in fish and to cause animal cancers. Polyvinyl chlorides (PVCs): synthetic material in the family of vinyl resins, used for food packaging and in molded products such as pipes, fibers, up- holstery, and bristles. Combustion products are very toxic, especially in com- bination with other agents. Precipitation scavenging: removal of smoke from the atmosphere by rain- fall. Probit analysis: statistical measurement of probability based on deviations from the mean of a normal frequency distribution. Prodromal syndrome: the early acute effects of exposure to radiation. See Radiation sickness. Progeny testing: evaluation of the genotype of an animal in terms of its offspring, for the purpose of controlled breeding. Psychosis: an impairment of mental functioning to the extent that it interferes grossly with an individual's ability to meet the ordinary demands of life; generally characterized by severe affective disturbance, withdrawal from real- ity, formation of delusions or hallucinations, and regression presenting the appearance of personality disintegration. PUPA photochemotherapy: ultraviolet radiation therapy for patients with . . psonasls. Rad (Roentgen Absorbed Dose): absorbed dose of any nuclear radiation which is accompanied by the liberation of 100 ergs of energy per gram of absorbing material. Radiation sickness: the complex of symptoms characterizing the disease known as radiation injury, resulting from excessive exposure of the whole body (or large part) to ionizing radiation. Earliest symptoms are nausea, fatigue, vomiting, and diarrhea, which may be followed by loss of hair, hemorrhage, inflammation of the mouth and throat, and loss of energy. In severe cases, where the radiation exposure has been relatively large, death may occur within 2 to 4 weeks. Those who survive 6 weeks after the receipt of a single large dose of radiation generally may be expected to recover. Radionuclides: an unstable isotope of an element that decays or disintegrates spontaneously, emitting ionizing radiation. Reactor core: central portion of a nuclear reactor containing the radioactive fuel elements. Reactor vessel: a strong-walled container housing the core of most types of

596 GLOSSARY power reactors; it usually also contains the moderator, neutron reflector, thermal shield, and control rods. Reinforced Mach front: a single vertical shock wave formed when the primary shock wave of a nuclear detonation reaches the earth's surface and coincides with a second wave generated by reflection. The overpressure is roughly twice that of either the primary or secondary shock. Ringer's lac~e: a balanced electrolyte solution used as a blood volume expander. SCOPE/ENUWAR: Scientific Committee on Problems of the Environment of the International Council of Scientific Unions program on the Environ- mental Effects of Nuclear War; a project involving about 100 physical and atmospheric scientists and 200 agricultural and ecological scientists from more than 30 countries around the world in a unique undertaking to assess the global consequences of nuclear war. Shock wave: the wave of air pressure produced by an explosion. Sepsis: severe, toxic, febrile state resulting from infection with pyogenic microorganisms . SLBM: submarine-launched ballistic missile. SSBN: nuclear-powered ballistic missile-firing submarine. SDI (Strategic Defense lenitive): a program of advanced technological research initiated by Presidential directive in March 1983 for the purpose of "eliminating the threat of nuclear ballistic missiles"; also known by the sobriquet "Star Wars." Stratosphere: atmospheric shell extending about 55 km above the tropo- pause, i.e., atmospheric layer between the troposphere and the mesosphere, in which temperature changes very little with altitude. S~ontium-90: long-lived radioactive isotope (half-life 28 years) which tends to accumulate in the bones of humans. Superpres: see Firestorms. Surface bursts: nuclear explosions that contact land surfaces drawing up large amounts (about 100,000 tons per megaton of yield) of dust, soil, and debris with the fireball. Synergism or synergy: the joint action of agents so that their combined effect is greater than the sum of their individual effects. Teragrams: 1 teragram (Tg) = 10~2 grams. Teratogenic effects: formation of a fetal monstrosity or congenital anomaly, often leading to spontaneous abortion. Fetuses irradiated during the third and fourth months of development are particularly prone to brain damage. Thermal fluence: amount of heat transferred across a surface of unit area in a unit of time. Thermal pulse: brief but intense release of heat emanating from a nuclear fireball, roughly equivalent to one-third of the total yield of a 1-Mt weapon.

GLOSSARY 597 Thermal time: measure of the number of hours during the growing season that air temperatures exceed a specified base level by various amounts, cal- culated by multiplying the amount of time that the air temperature exceeds the base level times the increment of temperature above that level. Threshold level value: average concentration of toxic gas to which a normal person can be exposed without injury for 8 hours per day, 5 days per week, for an unlimited period. Total Iymphoid irradiation (TLI): therapy in which a patient's immune reactions are suppressed by delivering ionizing radiation in multiple doses to lymphoid tissue over a period of weeks. Triage: the process of sorting casualties for the purpose of allocating re- sources and determining the priorities of medical response. Tropopause: altitude at which the ambient air temperature begins increasing with altitude; it is viewed as the dividing line between the lower atmosphere and the stratosphere. Troposphere: region of the atmosphere from the earth's surface to the tro- popause, that is, the lowest 10 to 20 km, in which storms and rainfall occur, and in which temperature falls with increasing altitude. Ultraviolet-B radiation (W-B): emissions in the wavelength range 280- 320 nm, which is biologically damaging to plants and animals. UNSCEAR: United Nations Scientific Committee on the Effects of Atomic Radiation. Wield shears: local variations of wind vector or any of its components in a given direction. World food reserves: measured by total cereal stores at any given time. In recent years they have amounted to about 2 months' supply. X-rays: electromagnetic radiation, identical to gamma rays, but produced in processes outside the atomic nucleus.

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Written by world-renowned scientists, this volume portrays the possible direct and indirect devastation of human health from a nuclear attack. The most comprehensive work yet produced on this subject, The Medical Implications of Nuclear War includes an overview of the potential environmental and physical effects of nuclear bombardment, describes the problems of choosing who among the injured would get the scarce medical care available, addresses the nuclear arms race from a psychosocial perspective, and reviews the medical needs—in contrast to the medical resources likely to be available—after a nuclear attack. "It should serve as the definitive statement on the consequences of nuclear war." —Arms Control Today

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