IONIZING RADIATION (IR) 

INFORMATION FOR HEALTH CARE PROVIDERS 

WHAT IS IONIZING RADIATION? 

Ionizing radiation (IR) is high-energy radiation. Exposure to 

high doses of IR may cause adverse health effects. Sources of 

IR exposure during military service include: 

•	 Proximity to radioactive material, such as, calibration and 

measurement sources, nuclear weapons, and depleted 

uranium as fumes from fires or as shrapnel from an 

explosion 

•	 Medical treatment using high dose radiation 

VETERANS POTENTIALLY AFFECTED 

Veterans who served in one or more of the following situations 

or circumstances may have been exposed to radiation. 

•	 Radiation-risk activity (includes "Atomic Veterans") 

Exposure to above-ground nuclear weapons testing and/ 

or fallout radiation during the American occupation of 

Hiroshima and Nagasaki 

•	 Fukushima nuclear accident 

Exposure to very low doses of radiation following the 

nuclear accident in Japan from March 12 to May 11, 2011 

•	 Military occupational exposure 

Worked specific various military occupations, such as 

nuclear weapons technician or x-ray technologist, including 

routine and usually safe exposure to radiation 

•	 Depleted uranium 

Proximity to an explosion where shrapnel or fumes 

containing depleted uranium, used in tank armor and some 

bullets, is embedded in the body or inhaled 

•	 LORAN radiation 

Exposure to X-ray radiation from high voltage vacuum tubes 

used at LORAN (Long Range Navigation) stations from 1942 

to 2010 by the U.S. Coast Guard 

•	 McMurdo Station, Antarctica nuclear power plant 

Exposure to radiation due to a nuclear plant leak at the U.S. 

Navy’s McMurdo Station in Antarctica from 1964 to 1973 

•	 Nasopharyngeal (nose and throat) radium 

irradiation treatments 

Radiation treatment received by certain pilots, submariners, 

divers, and others during service from 1940 to the mid-1960s 

to prevent ear damage from pressure changes 

•	 Radiation therapy 

Exposure to radiation during the treatment of disease, 

most commonly cancer 

WHAT DISEASES AND ILLNESSES ARE LINKED TO 

IR EXPOSURE? 

For most military exposures, radiation doses are well below 

levels associated with adverse medical conditions. Occurrence 

of disease is dependent on the amount of radiation exposure 

and the time elapsed between exposure and the development 

of disease. 

VA recognizes that the following diseases may be caused by 

exposure to IR, but are not considered presumptive diseases: 

•	 All cancers 

•	 Non-malignant thyroid nodular disease 

•	 Posterior subcapsular cataracts 

•	 Non-malignant tumors of the brain and central nervous system 

Some Veterans affected by IR are referred to as “Atomic 

Veterans.” These Veterans participated in one or more 

“radiation risk activity”, such as, above-ground nuclear tests 

during their military service between 1945 and 1962; or were 

part of the U.S. military occupation forces in and around 

Hiroshima or Nagasaki, Japan, before 1946. 

For Veterans exposed as part of a “radiation risk activity,” 

VA refers to certain cancers linked to IR exposure as 

presumptive diseases. Veterans involved in “radiation 

risk activity” do not have to prove an association between 

their illness and military service. 

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MAY 2015 | W W W. P U B L I C H E A LT H .V A . G O V 

U.S. Department of Veterans Affairs 

Veterans Health Administration 

Office of Public Health 
IONIZING RADIATION (IR) 

Continued from front 

Presumptive diseases related to IR include: 

•	 Cancers of the bile ducts, bone, brain, breast, colon, 

esophagus, gall bladder, liver (primary site, but not if 

cirrhosis or hepatitis B is indicated), lung (including 

bronchiolo-alveolar cancer), pancreas, pharynx, ovary, 

salivary gland, small intestine, stomach, thyroid, urinary 

tract (kidney/renal, pelvis, urinary bladder, and urethra) 

•	 Leukemia (except chronic lymphocytic leukemia) 

•	 Lymphomas (except Hodgkin’s disease) 

•	 Multiple myeloma (cancer of plasma cells) 

WHAT YOU CAN DO 

To help conduct the examination, engage Veterans by asking 

questions such as: 

1.	 When and where were you exposed to radiation? 

2.	 How were you exposed? Possible responses might 

include proximity to sources, inhalation, ingestion, 

or transdermal exposure. 

3.	 What precautions did you take at the time? 

Possible actions might include avoidance, 

personal protective equipment, and/or treatment. 

4.	 Was your exposure measured by wearing a dosimeter 

or some other form of measurement (in vivo or in 

vitro bioassay)? 

5.	 Why are you concerned about this exposure? 

SUGGESTIONS ON HOW PROVIDERS EXPLAIN 

IR-RELATED HEALTH CONDITIONS IN PLAIN LANGUAGE 

When explaining IR-related health conditions to your 

patients use terms and descriptions that are plain language. 

Radiation exposure causes specific, well documented, 

diagnosable disease. Specialists are available in VHA to assist 

you (nuclear medicine, radiation oncology, radiology, and 

radiation safety). The effects of radiation exposure are 

directly related to dose; therefore, it is important to offer 

the Veteran proper perspective as to radiation dose and 

the health condition for which they are seeking care (see 

www.epa.gov/radiation/understand/health_effects.html). 

Then, work with your patient to develop a care plan: 

•	 Perform a broad health screen 

•	 Consider current or latent effects of the exposure 

based on routine lab results 

• Develop treatment options 

• Conduct follow up appointments 

• Encourage healthy living 

For more available resources visit www.publichealth.va.gov/ 

exposures/radiation/providers/index.asp. 

SUPPORT AVAILABLE TO VETERANS 

Veterans may be eligible for free or low-cost VA health care. 

In addition, Veterans and their families may be eligible 

for disability compensation and survivors' benefits. To be 

considered for disability compensation you must file a 

claim. VA will check military records to verify exposure to 

the claimed environmental hazard or for qualifying military 

service. Familiarize yourself with available VA benefits at 

www.publichealth.va.gov/exposures/benefits/index.asp. 

VA offers specialized programs to address health issues 

related to deployment. Patients enrolled in VA health care 

can take advantage of these services as part of their overall 

health care plan: 

•	 VA Environmental Health Clinics: Locations at VA health 

care facilities nationwide provide specialized knowledge 

about potential environmental exposures and conduct 

exams for the Ionizing Radiation registry. A list of VA 

Environmental Health Coordinators is available online at 

www.publichealth.va.gov/exposures/coordinators.asp. 

•	 War Related Illness and Injury Study Center (WRIISC): 

WRIISC’s three locations nationwide provide medical 

evaluations and treatment plans for chronic, 

difficult-to-diagnose conditions related to deployment. 

Visit www.warrelatedillness.va.gov/ for more information. 

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MAY 2015 | W W W. P U B L I C H E A LT H .V A . G O V Office of Public Health 

U.S. Department of Veterans Affairs 

Veterans Health Administration