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After pulling the Rain of Ash card from the random encounter deck, I reread the rules for rads in the Player Handbook (p. 80) There doesn't seem to be any penalty for accumulating permanent rads (other than the sickness that can be caused by exposure to "new" rads, temporary and/or permanent). According to the rules, a PC that starts with six permanent rads doesn't appear to have any disadvantages compared to a PC that starts with 1, and that holds true if any additional permanent rads are accumulated during the course of the game. For example, if they are both exposed to "new" rads, they both have the same chances of becoming sick, the same symptoms if they fall ill, and the same odds of accumulating permanent rads. That all seems a bit strange. It's more intuitive that the PC with more rads should become more ill.

What happens when a PC reaches the maximum number of permanent rad points accommodated on the standard char-sheet (there are 10 boxes total)? Death?

It seems like something's missing, or maybe I'm just missing something.

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Every time you gain a rad, you must immediately roll for STAMINA to resist radiation poisoning. The virulence of the disease is equal to +4 minus your total rad count.

So if you we have two PC, one (PC1) that have 4 Permanent Rad and one (PC2) that have no Rad at all and they both spend a shift in a Weak Radiation Hotspot, both will gain one Temporary Rad.
PC1 have a total of 5 Total Rad (4 Permanent and 1 Temporary) and PC2 will have 1 Total Rad (0 Permanent and 1 Temporary). PC1 must roll for Stamina with a modifier of -1 due to his Total Rad while PC2 must roll for Stamina with a modifier of +3 only because of his Total Rad.

If any one of them fails with the Stamina roll, they will get the disease 'Radiation Poisoning'. If they become sick, they take damage and follow the standard rules for being sick which means that if the fail, they will take 1 point of damage and they can't heal damage (this roll is rolled once per day). Each disease has a list of symptoms, for Radiation Poisoning this is vomiting, diarrhea and bleeding. These symptoms are something that the player should roleplay them and the Referee can stop rule that thanks to a certain symptom, a character can't do a certain thing or add a modifier to a skill roll.

PC1 in my example is in bad shape. The -1 modifier due to his Total Rads can be very dangerous. PC2 will most likely only be sick for a day of if he is unlucky to be sick.

Thanks, Fenhorn, for clarifying that the rules do indeed reflect that someone with more permanent rads has a greater chance of developing radiation sickness when exposed to "new" rads. I often miss things while I try to parse the rules.

The other part of my question still stands. Does nothing happen when a PC maxes out the permanent rads section of their char-sheet? No death? No cancer? No permanent attribute loss, or permanent radiation sickness?

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Thanks, Fenhorn, for clarifying that the rules do indeed reflect that someone with more permanent rads has a greater chance of developing radiation sickness when exposed to "new" rads. I often miss things while I try to parse the rules.

The other part of my question still stands. Does nothing happen when a PC maxes out the permanent rads section of their char-sheet? No death? No cancer? No permanent attribute loss, or permanent radiation sickness?

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Technically, there is no max. That is just a character sheet design choice. But if you get so much Rad, you will most likely die because if you for example have 11 Total Rad, your Stamina rolls will be with -7, even the top athlete with Strength A and Stamina A will only roll a d6 for his Stamina rolls.

Things like cancer is such a long-term effects and is not included in this game, but that perhaps would be something for the Workshop for those that have really long campaigns.

Thanks, Fenhorn. If anyone is interested, my application of the Rain of Ash (from the random encounter deck) and its immediate aftereffects are described in the latest campaign log post here:

https://forum.juhlin.com/forumdisplay.php?f=7

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