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Inside The Mushroom Cloud

Part II
The Human Package


The accounts in this paper are not figments of imagination, though some guessing as to numbers involved has to play a part since the extent of any nuclear war is not yet known. The descriptions are based mainly on official publications of various governments, especially the U.S. government. Two of the more recent reports were: "The Effects of Nuclear War," U.S. Congress Office of Technology Assessment (1980) and 'The Effects of Nuclear Weapons," 1981, Gladstone & Dolan, published jointly by the U.S. Department of Defense and the U.S. Department of Energy.

The casualties will be discussed in a chronological sequence — that is, from the time of the explosion, the so-called barrage period, through the first days and weeks after the explosion, to the long-term effects.

THE BARRAGE PERIOD is associated with the following types of injuries:

1)  Flash burns. These arise not from the first pulse of ultraviolet radiation, but from the second pulse of infrared light which contains nearly 35% of the energy of a nuclear bomb. With a one-megaton bomb, this thermal radiation causes second degree burns on exposed skin of anyone in a range of 6-10 miles on a clear day. The heat is transmitted along the line of sight, so that any object between an individual and the heat source acts as a shield, and even a single layer of clothing helps protect against burns.

(Those who looked at the explosion would be blinded and Dr. Helen Caldicott says the eyes of many would be melted.)

2)  Blast effects. The flash burn effects on people up to three miles from the bomb are irrelevant as most people within this range — and many, of course, outside it — will be killed by blast injuries. There are three sources of these: primary, secondary and tertiary.

(The primary are ruptured lungs. Eardrums, of course, would be ruptured, but merely being deaf would not be a serious problem in the circumstances.

(Statistically, more people would be killed by the secondary blast effects: buildings of all sizes being smashed down causing hundreds of thousands of shocking compound fractures and cuts, as well as the millions of shards of flying glass.

(The smallest number of the total killed would be those persons sucked out of buildings by the overpressure and thrown against solid objects.)

3)  Flame burns will be suffered by many of those surviving the initial blast, particularly if a firestorm results. The development of a firestorm is unpredictable. Hiroshima had one, Nagasaki did not. It depends on various factors, including the combustibility of material and the effects of the blasts, which may even blow small fires out. However, it is highly likely that widespread fires would be present.

In Hamburg and in Dresden during the Second World War, huge firestorms arose after raids with conventional bombs. Temperatures of more than 800°C were recorded.

(Firestorms consume oxygen; most if not all of those in shelters are asphyxiated.)

It is reasonable to assume that a one-megaton bomb dropped on one major city would lead to thousands of severely burned casualties. In the entire U.S.A. last year, there were about 1,000 so-called burn beds.

(Severely burned patients need six months of intensive care: at least one nurse per two patients, fresh frozen plasma, intravenous fluids, antibiotics, grafts, operations every couple of days, hundreds of units of blood, and even then the patient often dies. The impossibility of the whole medical establishment of the North American continent dealing with a single nuclear attack on a single city is quite clear.)

4)  Acute radiation accounts for 5% of the bomb's energy. With a one-megaton bomb, the initial radiation of doses which would cause rapid inevitable death does not extend beyond the range where inevitable death will occur from blast and fire. In the surrounding areas the radiation will affect survivors in ways which will be discussed later. The range of effects depends on the height at which the explosion occurs and the shielding effects of buildings and hills.

5)  Early fallout radiation. This will be discussed later. The scenes in the first hours in Hiroshima are described in Mersey's book; simply titled Hiroshima:

"So, within a few short hours Hiroshima had been devastated. Of a population of 245,000, 78,000 were dead and a further 84,000 injured. No one could understand what had happened. Thousands of hurt and maimed people began to flee from the city. Hair and eyebrows were burned off; skin hung in sheets from faces and hands. Some were vomiting. Almost all had heads bowed, looked straight ahead, were silent, and showed no expression whatsoever."


THE SHELTER PERIOD — the period in which people will try to find shelter — can be divided into the first day, and the period up to the end of the first month.

1)  Flame burns are certainly going to continue to affect large numbers in this period.

2)  Suffocation and heat prostration will also kill many. In Dresden in 1943, it was found that all those in shelters died; the only survivors from the heat were those who had been in the open. In Hamburg, it was found that some days after the raid, as shelters were opened, enough heat remained that the influx of oxygen led to the entire shelter bursting into flames.

3)  Lack of medical care. This is discussed in a paper by Prof. V.L. Matthews, head of the Department of Social and Preventive Medicine at the University of Saskatchewan, Saskatoon:

"Emergency equipment and drugs are handled through a complex, centralized distribution system. In Canada, practically all drugs and medical equipment are manufactured in other countries and channelled through two main distribution systems located in Montreal and Toronto . . . supplies of drugs and equipment might be cut off in an instant . . .

"Hospital and medical services are heavily concentrated in large urban centres which are primary targets in nuclear warfare. The number of nurses, physicians, physiotherapists and other health workers who would be annihilated by the first wave of destruction would be disproportionately high. . . . It is also evident it would remove . . . all of the superspecialty and most of the specialty services.

"H. Jack Geiger has described the potential clinical-care situation in an American city in the following terms: 'One carefully detailed study of an American city suggests that there would be 1,700 seriously injured survivors for every physician. . . . If conservatively we estimate only 1,000 seriously wounded patients per surviving physician and if we further assume that every physician sees each patient for only 10 minutes of diagnosis and treatment and if each physician worked 20 hours a day, it would be eight days before all the wounded would be seen once by a doctor. Most of the wounded would die without medical care of any sort; most would die without even the simple administration of drugs for relief of pain.

4)  Early fallout radiation. At the time of the explosion, very fine particles are carried into the stratosphere and the troposphere with the mushroom cloud. Larger particles, like dust and heavier, begin to descend within minutes and continue to fall for 48 hours, the rate of descent depending on particle size.

The radiation exuding silently and invisibly from all these particles, which are breathed in, get on the skin, and into almost everything, affects human tissue in two basic ways. First, it causes damage to cell membranes, which causes leakage of intracellular fluid. This affects the brain and lungs particularly. Secondly, it causes a loss of reproductive capacity in stem cells, especially in intestines, bone marrow, skin and reproductive tissue.

Irradiated survivors can be divided into three groups. In the first group, survival is improbable. Vomiting occurs promptly and continues, and is followed by prostration, diarrhea, anorexia and fever. These symptoms occur with a dosage of 600 rads. More than 5,000 rads is associated with convulsions and other CNS signs.

In the second group, there is early-onset vomiting, but it is of short duration. There is a period of apparent well being though some peripheral blood effects can be detected after the first week. After the latent period of 1-3 weeks during which there may be few symptoms other than fatigue, other effects start — hair loss, purpura, diarrhea and infection.

In the third group, there may be transient nausea on the first day. There may be no further symptoms, but haemopoietic changes may be seen, and depressed wound healing and immune deficiency may also be present.

It has been calculated that about 50% of those who receive 250 rads and about 90% of those who receive 400 rads will die.

(All of these effects would be taking place in an area where there was no electricity, no reasonable transportation system, no effective communication system, no ambulances and essentially no hospitals. There would also be no functioning water distribution system and any water left in reservoirs or the water pipes themselves would be highly contaminated. There also would be little housing and no distribution of electricity or fuel to the housing left. Central marketing and all distribution systems for food would also be effectively destroyed and what food that could be found would for the most part be contaminated.)

To quote again from Hersey's book:

"In general, survivors that day assisted only their relatives or immediate neighbours, for they could not comprehend or tolerate a wider circle of misery. From every second or third house came the voices of people buried or abandoned who invariably screamed. . . . Towards evening the streets became quieter. Now not many people walked in the streets, but a great number sat and lay on the pavement, vomited, waited for death, and died." "Others felt terribly thirsty and they drank from the river. At once they were nauseated and began vomiting, and they retched the whole day."

"Continuing fires whipped up by the wind forced cast crowds towards one of the rivers. Those near the bank were pushed in — and drowned."

The later part of the shelter period is associated with casualties due to flame burns, smoke inhalation, heat effects, and radiation. The latter begins to affect people at some distance from the explosion because fallout continues downwind.

Dehydration arises because of the hot conditions in fallout shelters, and also from vomiting and diarrhea secondary to gastrointestinal radiation, and gastrointestinal infection.

Malnutrition will occur. Most domestic animals will die in the affected areas, food storage areas will be destroyed, and there will be difficulty in transportation of food to needed areas.

Communicable diseases will arise. An article by Abrams and von Kaenel in the New England Journal of Medicine pointed to several factors which will lead to an increased risk and severity of infection:

  • Radiation leading to depressed immune systems and gastrointestinal damage
  • Burns can become easily infected because of the blood and immune effects
  • Malnutrition, which will inevitably be widespread, has been shown to predispose to infection
  • Exposure and hardship due to inadequate shelter, lack of heating fuel, and intensive labor, will lower resistance further
  • Lowered natural resistance due to suppressed immune mechanisms can cause spread of diseases, including some exotic varieties.

Factors which specifically might cause spread of disease include:

  • The crowded, hot, unsanitary conditions in shelters
  • The sanitation problems with disruption of water supplies, food preparation, sewage and waste disposal
  • The proliferation of insects and bacteria, which are extremely resistant to radiation. Cockroaches are not appreciably damaged by radiation of 40,000 rads. Only 10% of an E. coli population is killed by 20,000 rads of radiation
  • The decreased immunity of animals may lead to the spread of infections such as brucella, leptospirosis and rabies.


IN THE SURVIVAL PERIOD casualties will be seen from several mechanisms which have been discussed previously, but medium-term effects from the fallout radiation need further discussion. These include sterility in males, which may last several months to years; effects seen on the foetuses of women irradiated while pregnant, i.e. increased incidence of microcephaly, mental retardation (50% of those in the Japanese experience were from mothers exposed to 200-300 rads); and increased stillbirth and abortion rates. For instance, in Nagasaki there were 177 pregnant survivors and 45 had abnormal terminations of pregnancy — 19/19 in those within 3 km of the centre, 15/20 in those within 3-20 km, and 11/138 in those more than 20 km away.


THE RECOVERY PERIOD. These are just words. It should not be assumed there would be a recovery period. The elimination of all life on the planet not only is technically feasible. The means exist to accomplish the elimination. These means would be used in the event of an all-out nuclear war. Most military planners agree that should a nuclear war break out, it will be almost impossible to limit it. The term "recovery period" assumes such limitation.

For the last 35 years, an on-going study has been conducted on the survivors of the American atom bomb strikes on Hiroshima and Nagasaki. The studies have been conducted by American and Japanese scientists. Some of their findings:

1)  Cancer. Definite increases in incidence have been seen with leukemias, especially in those under 10 or over 50 at the time of the bombings, and with some solid tumors, including thyroid, breast, lung and stomach.

2)  Genetic damage. Ionising radiation induces genes mutation and chromosome breaks more or less in proportion to the dose, but increased incidence of genetic defects in children of survivors of the Japanese bombs was not demonstrated, though delay in studies being carried out initially may have led to inaccuracies in analysis. What effects might occur in future nuclear explosions is difficult to say because of uncertainty about the weapons to be used.

Likewise, in the first generation offspring there has been no increase in mortality, leukemia or alterations of growth and development.

3)  Cataracts. There was an increase in the incidence of cataracts in the Japanese survivors. These started to occur about five years after the explosion.

4)  Effects on ozone layer. This potential problem was raised by the National Academy of Sciences in 1975 and is discussed by Prof. Donald G. Bates of the Department of Humanities and Social Studies in Medicine, McGill University, Montreal:

"Planners now talk of a nuclear war in terms of the number of megatons involved — and a commonplace (but modest) figure is the 10,000-megaton war, the explosive equivalent of 10-billion tons of TNT. The U.S. National Academy of Sciences suggests such a war would be enough to modify the climate, probably toward cold. For two years or more there would be a 50 per cent reduction in ozone in the atmosphere; there would be significant contamination of food crops for years to come (and) worldwide famine. There would be an increase in the cancer rate of 2-10 per cent. . . . It would be dangerous to go out in the sun.

5)  Delayed fallout. Quite apart from the long-term damage arising from early fallout, there has always been concern about the possible harmful effects of delayed fallout, which may take years to descend. Only a few isotopes are important because they are produced in large amounts, have long half lives and emit substantial amounts of radiation.


Inside The Mushroom Cloud Part I: The "Physics Package"
Inside The Mushroom Cloud: Introduction

Published in Sources Summer 1983 

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