# What are the physical effects of a person living their entire life underground, and how would it affect them if they ever came up?

In my world, a group of high-ranking politicians and military officials (along with their families and a few skilled engineers) realized that WW3 was imminent, and decided to bunker-down, big time: Using the most state-of-the-art technology, they built an impenetrable underground fortress, and remained within it for about 200 years.

About 180 years in, a woman named Christina Anders is born, unaware of life on the surface. But the surface dwellers still exist, and after encountering a group of them, she decides she wants to go up.

The surface is a wasteland. The region they’re in is a giant desert basically, with only a few scattered regions of fertile plant growth, and dozens of still existing radioactive hotspots.

This question came to me the other day: since Christina grew up underground her entire life, would this have any dire effects on her survival in the wasteland? If so, what are good ways for me to deal with said problems?

Context- The bunker dwellers live underground enclosed within the bunkers confines. I imagine something like a small underground town, made of metal and concrete. They have air, and lighting and whatnot, and are completely self-sufficient, growing food and producing/recycling water. Also all this is done with modern day tech.

• @JBH: Did what you said Sep 3 '20 at 3:33
• Is the air system for the fortress a complete closed loop? Because if so she might discover she's allergic to something common above, and that her immune system is not prepared for the surface strain of super-flu compared to whatever fortress version might still exist Sep 3 '20 at 9:00
• Useful Google search undergound cities. Here's one link: gizmodo.com/… Sep 3 '20 at 9:19
• @JBH lacking any kind of information, I would interpret "WW3 was immanent" as being a setting in the future, so we should expect at least modern-day level technology at the time of construction, plus whatever researchers have done in the next 180 years until the character is born. Sep 3 '20 at 11:31
• @nonthevisor The point is "lacking any kind of information, I would interpret..." = "VTC:needs more details." Allowing respondents to make assumptions only encourages low quality answers. Sep 3 '20 at 14:10

### Crippling hayfever. Possibly anaphylaxis.

When apollo 17 astronauts were exposed to dust particles their immune systems had never experienced before, they had really bad hayfever. Your people have had purified air for generations, new pollen and dust will panic your immune systems.

You will hope you have kept some anti-histamines in reserve, as you'll probably need to take them for the rest of your lives.

If you're lucky, you'll only get symptoms outdoors in Spring. If you're unlucky, youl'll need to take it year-round.

### Supplement overdose

Assuming there previous diet was perfectly optimal (including supplements for things like vitamin d), and they come up and continued that diet, while getting exposure to lots of sun, they'd be a low risk of:

• vitamin d toxicity.
• hypercalcemia, or high blood calcium levels(digestive distress, such as vomiting, nausea, and stomach painn fatigue, dizziness, and confusion, excessive thirst, frequent urination)
• nausea, vomiting, poor appetite
• Stomach pain, constipation, or diarrhea
• Bone loss
• kidney disease and or failure.

Although this would take a long time to show up, theyd probably stop taking high levels of supplements long before it became an issue.

### Pandemic

You're bunker population, and the outside world, have gotten different viruses evolution over the 200 years. Merging these two biomes back together you'd see an outbreak of a new disease through your population. It may be a mild cold. It may be smallpox.

### Mental health issues:

• They'd find sleep very hard, their underground world was loud from machinery / air flow and dark, night in the wild is silent and, with the moon, can be quite bright.
• Some may be scared of open spaces.
• They'd have no sense of predators, and while they will be hunted by wolves, but wont be able to read the terrain / sounds / etc. They will be paranoid about any unexpected movement.

### Unable to read what their bodies are saying:

• Rain / snow / cold / exposure / frostbite / hypothermia would be a foreign concept. They wont know warning signs.
• Highly suspectable to Heatstroke / sunburn. Also wont know warning signs.

### Other:

They'd also he unfamiliar with the new environment and its risks, which would also affect them physically indirectly:

• Their eyes would struggle with bright sun. This would take a long time re-adjust.
• Theyd have no sense of direction and will get easily lost. Theyd have no long distance sense of distance either (that mountain looks so close!)
• Theyd be unable to walk or run long distance, even if relatively fit, having never walked more than a few hundred meters a day, the muscles wouldn't be used as much and they'd get sore muscles very quickly. (Depends on bunker layout)
• Theyd be unable to walk or run long distance, even if relatively fit, having never walked more than a few hundred meters a day - This is going to be far more dependent on occupation/hobby than bunker layout. Many service sector type jobs (store clerks, restaurant servers, etc) can do 5+ miles (8+ km) a shift. Which isn't huge, but isn't likely to be much different than any above ground town dweller or farmer does either. Sep 3 '20 at 17:54
• they will have all the outdoor survival instincts of a concussed lemming. They might not even know what warm clothes are or that outdoor things need to be waterproof.
– John
Sep 3 '20 at 20:20
• they may also have a lot of eye issues, there is some evidence a lot of basic eye issues are partially caused by everything in a house being close distance focus, and the eyes not getting any chance to focus on long distances.
– John
Sep 3 '20 at 20:23
• I doubt that the astronauts had hayfever. There is no organic material on the moon's surface. I'd propose that they had nasal irritation. The dust particles on the moon are not like dust particles on earth. The moon's dust particles are due to micrometeorite impact. Thus they have sharp and jagged edges.
– MaxW
Sep 3 '20 at 23:39
• In a state of the art bunker, there's likely to be a Gym, where you can excercise, so long distance walking/running shouldn't be a problem. Sep 4 '20 at 11:26

Assuming that the group will be able to steer her away from potential fatal errors from ignorance, here are some problems she may face:

1. Agoraphobia. Even if they had fairly large caves, the sky is far larger, especially since she's in a desert and there's no clouds. Slow acclimatization may be her best bet.
2. Eye issues. Much will depend on how bright the lighting is in the fortress, but they will not illuminate it as brilliantly as the desert can get. Sunglasses are important if possible. Otherwise she may have to try to stay inside during daylight hours, or use cloth to filter light
3. Sunburn. She has never been exposed to the sunlight's intensity and will burn badly. Sunscreen may not feasible in this era, so she may have to use clothing to protect herself, or avoid the bright days.
4. Heat and cold. Deserts tend to have severe variation between night and day in temperature, and she's not used to it. Following the guidance of her companions on clothes will help.
• you can get sunburn from therapeutic lights quite easily. If they have the most state of the art technology, surely the will have some good sunlight lamps / light therapy down there. You can find one in most public saunas nowadays. Sep 4 '20 at 14:32
• With regards to #2, I would add that they are also more likely to be nearsighted, as their eyes have likely never needed to focus on anything more than maybe a hundred meters away. Sep 4 '20 at 17:10
• @Daniel They might have good sunlight lamps, and probably use them for light therapy or Vitamin D manufacture, but they will be careful to avoid sunburn.
– Mary
Sep 4 '20 at 21:46
• @IronEagle Depends on how big the complex is, and whether it's in a large cave.
– Mary
Sep 4 '20 at 21:46
• Also don't forget VR-Entertainment. Somthing I would expect in a State of the art Bunker to help keep morale up. Sep 5 '20 at 11:53

If it is indeed a well-constructed underground habitat with sufficient ventilation, lighting, food production, medical facilities, and carefully managed population, there should be no physical effects at all. Ms Anders would lack only practical skills needed to navigate the outside world and communicate with surface dwellers.

It is fathomable that she would feel uncomfortable in big open areas or under a plain sky. But this is not necessarily a long-term condition. Once she adjusts to the new environment she should be completely fine.

I think that the only realistic possibility is lower resistance (up to no resistance) to bacteria/viri. Your bunker might be too clean and do not have enough microbial life for Ms Anders to develop immunity to pathogens common in the outside world. It is also probable that some bacteria/viri mutated in the past 180 years. If it is the case, she might also have some problems with indigestion while her digestion tract is being populated with the correct bacteria.

Apart from everything else: it's currently speculated that eye development is tied to sunlight, specifically the eyeball proportion gets out of whack if a person is too much in dim-ish light in their youth (compared to the outdoors). The result is myopia because the image is not focused on the retina despite the lens' capability.

Dunno about any developments in supporting or refuting this hypothesis.