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Eight of the most severe cases of acute radiation disease (ARS) known to have occurred in humans (as the result of criticality accidents) had survival times less than 120 h (herein defined as "early death"). These accidents were analyzed and are discussed with respect to the specific accident scenarios and the resulting accident-specific, mixed neutron-gamma radiation clinical dose distributions. This analysis concludes that the cardiovascular system appears to be the most critical organ system failure for causing "early death" following approximate total body, mixed gamma-neutron radiation doses greater than 40-50 Gy. The clinical data also suggest that there was definite chest dose dependence in the resulting survival times for these eight workers, who unfortunately suffered profound radiation injury and unusual clinical effects from such high dose radiation exposures. In addition, "toxemic syndrome" is correlated with the irradiation of large volumes of soft tissues. Doses to the hands or legs greater than 80-100 Gy or radiation lung injury also play significant but secondary roles in causing "early death" in accidents delivering chest doses greater than 50 Gy.

The characteristics of occupational diseases from radiation exposure at the first nuclear plant (Prod. Assoc. 'Mayak') in the period of its formation is presented here in brief. Chronic radiation disease (ChRD) made up the predominant part of the spectrum of radiation injuries caused by external whole body exposure to gamma-radiation (more than 80%). Acute radiation disease, local radiation injuries (burns, dermatitis), plutonium pneumosclerosis, and one case of a radiation cataract were diagnosed as well.

Data are presented on the frequency of multi-aberrant cells in lymphocytes gained during the period from 1967 to 1992 in some groups of the USSR inhabitants, who contacted with different environment mutagenesis. It is shown that the results of the study of 1500 men give a possibility to account some groups of multi-aberrant cells not to be artifacts and to be induced by some of the mutagens studied.

A follow-up of 115 patients with acute radiation disease resulting from external gamma-beta-radiation confirmed a high value of the previously proposed principles of predicting a degree of severity on the basis of the clinical manifestations of a primary reaction of disease and some syndromes using methods of hematological and cytogenetic analysis. Early isolation of patients with ARD of II-IV degree, selective intestinal decontamination, administration of antibiotics of a broad spectrum of action, antimycotic and antiviral drugs, and gamma-globulin can practically eliminate the risk of development of fatal infectious complications in medullary and transient types of radiation disease. The efficient use of thrombomass transfusion completely prevents development of the thrombocytopenic hemorrhagic syndrome. Experience in bone marrow transplantation requires a review of therapeutic indications.