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- The decomposition of water molecules due to ionizing radiation
- When x-ray photons interact with and ionize water molecules in the human body, the ionization causes the molecules to separate. This separation results in the productions of other electrons, ions and molecules which can cause biologic damage to the cells.

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Up to 60% of the human adult body is water:
- brain/heart: 73%
- lungs: 83%
- skin: 64%
- muscles/kidneys: 79%
- bones: 31%

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Target - the affected location in a cell or on a vital molecule
- In order to cause a serious effect, more than one hit of radiation is required on a specific target in the cell
- The cell will die after exposure to ionizing radiation ONLY if the master/key molecule (DNA) is inactivated in the process
- If x-ray photon passes through the cell without interacting with the master/key molecule (DNA) there are no measurable effects

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What happens when your DNA is damaged? - Monica Menesini

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The DNA in just one of your cells gets damaged tens of thousands of times per day. Because DNA provides the blueprint for the proteins your cells need to function, this damage can cause serious issues—including cancer. Fortunately, your cells have ways of fixing most of these problems, most of t…

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The three categories of radiation damage from ionizing radiation are:

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The three categories of radiation damage from ionizing radiation are:

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- Lethal damage (LD): irreversible and irreparable, leading to cell death
- Sub-lethal damage (SLD): can be repaired in a matter of hours, under normal circumstances, when no additional sublethal damage is added (second dose of radiation) that could lead accumulatively to lethal damage
- Potentially lethal damage (PLD): Under normal circumstances can cause cell death, but may be prevented, and is influenced by appropriate post-irradiation environmental conditions. In other words, when the PLD is not repaired, it is lethal.
- Potential lethal damage repair (PLDR) has been observed in experiments with radiation and chemotherapeutic drugs. This repair takes place post irradiation when cells are allowed time to repair instead of being allowed to proliferate (through to mitosis/division).

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- If the dose is delivered quickly in a single exposure at a high dose rate, there is almost no time to repair radiation damage, therefore, the damage/unit of dose absorbed is high. This is a dose much higher than what is generally used in diagnostic imaging.
- Acute symptoms do not appear in exposure to lower radiation doses, but there is damage to cells, which attempt to repair themselves. Very rarely, however, mistakes do occur in the repair process, resulting in genetic abnormality (mutation).