Physicians for Social Responsibility wrote in 2006 about the potential casualties from the kind of bunker-buster nuclear attack on Iran’s nuclear facilities that the US was considering at the time. The main jist of the report is contained in the following paragraph:
From our map we can see that within 48 hours, fallout would cover much of Iran, most of Afghanistan and spread on into Pakistan and India. Fallout from the use of a burrowing weapon such as the B61-11 would be worse than from a surface or airburst weapon, due to the extra radioactive dust and debris ejected from the blast site. In the immediate area of the two attacks, our calculations show that within 48 hours, an estimated 2.6 million people would die. About two-thirds of those would die from radiation-related causes, either prompt casualties from the immediate radiation effects of the bomb, or from localized fallout. Over 1,000,000 people would suffer immediate injuries including thermal and flash burns, radiation sickness, broken limbs, lacerations, blindness, crush injuries, burst eardrums and other traumas. In the wider region, over 10.5 million people would be exposed to significant radiation from fallout (those in the light green to pink zones on the map above), leading to radiation sickness, future excess cancer deaths, genetic abnormalities in future generations, as well as high rates of stillbirths, miscarriages, malignancies and hypothyroidism. Most if not all medical facilities near the two attack sites would be destroyed, or located within the radiation “hot zone” and thus unusable. Little or no medical care would be available to the injured in the aftermath of an attack, leading to many avoidable deaths.