As if nuclear strikes on U.S. cities weren’t potentially damaging enough, an attack on America’s missile silos would kill millions due to acute radiation poisoning in a matter of days and spread radioactive fallout across the country, new modeling suggests.

A study published by Scientific American on Tuesday found that if the strategic launch bases were hit, most of the Midwest would be bathed in a more than lethal dose of radiation, with a worst-case scenario seeing most of the U.S. and Canada becoming uninhabitable.

Researchers at Princeton University’s Program on Science and Global Security estimate that in the first four days after the silos were struck, between 340,000 and 4.6 million people would die—though the average death toll would be 1.4 million. They predicted that 300 million people would be at risk of a fatal dose of fallout.

The study comes after the U.S. Air Force said last year that it would be replacing its Minuteman III intercontinental ballistic missiles (ICBMs), which have been in operation since the 1970s, with the more modern Sentinel missile from 2029.

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