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Found one older thread regarding radiation rules but I could still use some clarification and see how other tables do it.

The rad count used for the virulence of the rad poisoning is one thing not totally clear. It is +4 minus total rad count. Now is the total rad count temporary rad+permanent rad or does it refer to the temp rad count that the PC has accumulated so far? If it is both temp and perm then radiation becomes much much more lethal but perhaps that is what the designers are after here?

A players total rad is his temporary rad and permanent rad, hence the word total.

Thas is how I apply it too.
This is that the permanent rads at character creation can make almost any rad intake death sentence.
Then again nothing wrong with that!