Editing Acute radiation syndrome (section)

==History==
Acute effects of ionizing radiation were first observed when [[Wilhelm Röntgen]] intentionally subjected his fingers to X-rays in 1895. He published his observations concerning the burns that developed that eventually healed, and misattributed them to ozone. Röntgen believed the [[free radical]] produced in air by X-rays from the ozone was the cause, but other free radicals produced within the body are now understood to be more important. David Walsh first established the symptoms of radiation sickness in 1897.<ref>{{cite journal |last1=Walsh |first1=D |title=Deep Tissue Traumatism from Roentgen Ray Exposure. |journal=[[The BMJ|British Medical Journal]] |date=31 July 1897 |volume=2 |issue=1909 |pages=272–3 |doi=10.1136/bmj.2.1909.272 |pmid=20757183|pmc=2407341 }}</ref>

Ingestion of radioactive materials caused many [[radiation-induced cancer]]s in the 1930s, but no one was exposed to high enough doses at high enough rates to bring on ARS.

The [[atomic bombings of Hiroshima and Nagasaki]] resulted in high acute doses of radiation to a large number of Japanese people, allowing for greater insight into its symptoms and dangers. Red Cross Hospital Surgeon [[Terufumi Sasaki]] led intensive research into the syndrome in the weeks and months following the Hiroshima and Nagasaki bombings. Sasaki and his team were able to monitor the effects of radiation in patients of varying proximities to the blast itself, leading to the establishment of three recorded stages of the syndrome. Within 25–30&nbsp;days of the explosion, Sasaki noticed a sharp drop in white blood cell count and established this drop, along with symptoms of fever, as prognostic standards for ARS.<ref>{{cite book |last=Carmichael |first=Ann G. |title=Medicine: A Treasury of Art and Literature |year=1991 |publisher=Harkavy Publishing Service|location=New York|isbn=978-0-88363-991-7 |page=376}}</ref>  Actress [[Midori Naka]], who was present during the atomic bombing of Hiroshima, was the first incident of radiation poisoning to be extensively studied. Her death on 24&nbsp;August 1945 was the first death ever to be officially certified as a result of ARS (or "Atomic bomb disease").

There are two major databases that track radiation accidents: The American [[ORISE]] REAC/TS and the European [[IRSN]] ACCIRAD. REAC/TS shows 417&nbsp;accidents occurring between 1944 and 2000, causing about 3000 cases of ARS, of which 127 were fatal.<ref>{{cite journal |last=Turai |first=István |author2=Veress, Katalin |title=Radiation Accidents: Occurrence, Types, Consequences, Medical Management, and the Lessons to be Learned |journal=Central European Journal of Occupational and Environmental Medicine |year=2001 |volume=7 |issue=1 |pages=3–14 |url=http://www.omfi.hu/cejoem/Volume7/Vol7No1/CE01_1-01.html |access-date=1 June 2012 |url-status=dead |archive-url=https://web.archive.org/web/20130515051324/http://www.omfi.hu/cejoem/Volume7/Vol7No1/CE01_1-01.html |archive-date=2013-05-15 |df=dmy-all}}</ref> ACCIRAD lists 580 accidents with 180 ARS fatalities for an almost identical period.<ref>{{cite journal |author1=Chambrette, V. |author2=Hardy, S. |author3=Nenot, J.C. |title=Les accidents d'irradiation: Mise en place d'une base de données "ACCIRAD" à I'IPSN |journal=Radioprotection |year=2001 |volume=36 |issue=4 |pages=477–510 |doi=10.1051/radiopro:2001105|url=http://www.radioprotection.org/articles/radiopro/pdf/2001/04/Chambrette.pdf |access-date=13 June 2012 |url-status=live |archive-url=https://web.archive.org/web/20160304224446/http://www.radioprotection.org/articles/radiopro/pdf/2001/04/Chambrette.pdf |archive-date=4 March 2016|doi-access=free }}</ref> The two deliberate bombings are not included in either database, nor are any possible radiation-induced cancers from low doses. The detailed accounting is difficult because of confounding factors. ARS may be accompanied by conventional injuries such as steam burns, or may occur in someone with a pre-existing condition undergoing radiotherapy. There may be multiple causes for death, and the contribution from radiation may be unclear. Some documents may incorrectly refer to radiation-induced cancers as radiation poisoning, or may count all overexposed individuals as survivors without mentioning if they had any symptoms of ARS.

===Notable cases===  <!--A name is required here, while an article on or about the individual is preferred-->
The following table includes only those known for their attempted survival with ARS. These cases exclude chronic radiation syndrome such as [[Albert Stevens]], in which radiation is exposed to a given subject over a long duration. The table also necessarily excludes cases where the individual was exposed to so much radiation that death occurred before medical assistance or dose estimations could be made, such as an attempted cobalt-60 thief who reportedly died 30 minutes after exposure.<ref>{{cite web |title=Criminal Dies Stealing Radioactive Material |url=https://www.nti.org/analysis/articles/criminal-dies-stealing-radioactive-material/|url-status=dead|archive-url=https://web.archive.org/web/20211006132919/https://www.nti.org/analysis/articles/criminal-dies-stealing-radioactive-material/|archive-date=2021-10-06 |website=Nuclear Threat Initiative |orig-date=1999|access-date=October 30, 2023}}</ref> The result column represents the time of exposure to the time of death attributed to the short and long term effects attributed to initial exposure. As ARS is measured by a whole-body [[absorbed dose]], the exposure column only includes units of gray (Gy).

{| class="wikitable sortable"
|-
! Date
! Name
! Exposure [[Gray (unit)|Gy]]
! Incident/accident
! Result
|-
| August 21, 1945
| [[Harry Daghlian]]
| align="center" data-sort-value="3.1" | 3.1 Gy<ref name=hempelman>{{cite conference|last1=Hempelman|first1=Louis Henry|last2=Lushbaugh|first2=Clarence C.|last3=Voelz|first3=George L.|title=What Has Happened to the Survivors of the Early Los Alamos Nuclear Accidents?|conference=Conference for Radiation Accident Preparedness|date=October 19, 1979|url=http://www.orau.org/ptp/pdf/accidentsurvivorslanl.pdf|access-date=January 5, 2013|publisher=[[Los Alamos Scientific Laboratory]]|location=Oak Ridge|id=LA-UR-79-2802|url-status=live|archive-url=https://web.archive.org/web/20140912141857/http://www.orau.org/ptp/pdf/accidentsurvivorslanl.pdf|archive-date=September 12, 2014}} Patient numbers in this document have been identified as: 1 – Daghlian, 2 – Hemmerly, 3 – Slotin, 4 – Graves, 5 – Kline, 6 – Young, 7 – Cleary, 8 – Cieleski, 9 – Schreiber, 10 – Perlman</ref>
| [[Demon core#First incident|Harry Daghlian criticality accident]]
| data-sort-value="25" | Death in 25 days
|-
| rowspan="2" | May 21, 1946
| [[Louis Slotin]]
| align="center" data-sort-value="11" | 11 Gy<ref>{{cite report|last=Lawrence|first=James N. P.|title=Internal Memorandum on Los Alamos Criticality Accidents, 1945–1946, Personnel Exposures|date=6 October 1978|publisher=Los Alamos Scientific Laboratory|id=H-l-78}}</ref>
| rowspan="2" | [[Demon core#Second incident|Slotin criticality accident]]
| data-sort-value="9" | Death in 9 days
|-
| [[Alvin C. Graves]]
| align="center" data-sort-value="1.9" | 1.9 Gy<ref name="hempelman"/>
| data-sort-value="6935" | Death in 19 years<!--~6935 days-->
|-
| December 30, 1958
| [[Cecil Kelley criticality accident|Cecil Kelley]]
| align="center" data-sort-value="36" | 36 Gy<ref>{{cite book|title= Professional guide to diseases|edition= 9th|editor-last= Harold|editor-first= Catherine|place= Philadelphia|publisher= Lippincott Williams & Wilkins|isbn= 978-0-7817-7899-2|oclc= 475981026|url= https://archive.org/details/isbn_9780781778992|year= 2009}}</ref>
| [[Cecil Kelley criticality accident]]
| data-sort-value="1.6" | Death in 38 hours<!--~1.6 days-->
|-
| July 24, 1964
| Robert Peabody
| align="center" data-sort-value="100" | ~100 Gy<ref>{{cite book|first1=Thomas P.| last1=McLaughlin| first2=Shean P.| last2=Monahan| first3=Norman L.| last3=Pruvost| first4=Vladimir V.| last4=Frolov| first5=Boris G.| last5=Ryazanov| first6=Victor I.| last6=Sviridov|title=A Review of Criticality Accidents: 2000 Revision|year=2000|publisher=Los Alamos National Laboratory|location=Los Alamos, NM|pages=33–34|url=http://www.csirc.net/docs/reports/la-13638.pdf|url-status=usurped|archive-url=https://web.archive.org/web/20090911070650/http://www.csirc.net/docs/reports/la-13638.pdf|archive-date=2009-09-11|access-date=October 30, 2023}}</ref><ref>{{cite book|author=[United States Nuclear Regulatory Commission], Division of Compliance, Region I|title=UNC Recovery Sytems [sic]: Compliance Investigation Report|date=September 16, 1964|volume=3 - Supplemental Report with Exhibits|url=https://www.nrc.gov/docs/ML0601/ML060130267.pdf|url-status=live|archive-url=https://web.archive.org/web/20220107151039/https://www.nrc.gov/docs/ML0601/ML060130267.pdf|archive-date=2022-01-07|access-date=October 30, 2023}}</ref>
| [[Wood River Junction, Rhode Island#Criticality accident|Robert Peabody criticality accident]]
| data-sort-value="2" | Death in 49 hours<!--~2.04 days-->
|-
| April 26, 1986
| [[Aleksandr Akimov]]
| align="center" data-sort-value="15" | 15 Gy<ref>{{cite book|url=https://books.google.com/books?id=7gQ0DwAAQBAJ&q=Akimov&pg=PT419|title=Chernobyl: the history of a nuclear catastrophe|author=Serhii Plokhii|publisher=Basic Books|year=2018|author-link=Serhii Plokhii|isbn=978-1541617087}}</ref>
| [[Chernobyl disaster]]
| data-sort-value="14" | Death in 14 days
|-
| rowspan="2" | September 30, 1999
| Hisashi Ouchi
| align="center" data-sort-value="11" | 17 Gy<ref name="Lamar 937">{{Cite journal |last=Lamar |first=Joe |date=1999-10-09 |title=Japan's worst nuclear accident leaves two fighting for life |journal=BMJ: British Medical Journal |volume=319 |issue=7215 |pages=937 |doi=10.1136/bmj.319.7215.937a |issn=0959-8138 |pmc=1116790 |pmid=10514143}}</ref>
| rowspan="2" | [[Tokaimura nuclear accidents|Tokaimura nuclear accident]]
| data-sort-value="9" | Death in 83 days
|-
| Masato Shinohara
| align="center" data-sort-value="1.9" | 10 Gy<ref name="Lamar 937"/>
| data-sort-value="6935" | Death in 210 days
|-
| December 2, 2001
| Patient "1-DN"
| align="center" data-sort-value="3.6" | 3.6 Gy<ref>{{Cite book |url=https://www-pub.iaea.org/MTCD/Publications/PDF/Pub1660web-81061875.pdf |title=The radiological accident in Lia, Georgia. |date=2014 |publisher=[[International Atomic Energy Agency]] |isbn=978-92-0-103614-8 |location=Vienna |oclc=900016880}}</ref> <!--3.6 is an average of the 4 numbers mentioned per [[WP:CALC]].-->
| [[Lia radiological accident]]
| data-sort-value="893" | Death in 893 days
|}