Here's my own (pseudo-realistic, but still fun) take:
FALLOUT
Radiation damage is measured in rads, and an area that
poses a radiation hazard is measured in rads per interval
(per round, per minute, per hour, or per day). The shorter
the interval, the more dangerous the hazard.
For each full interval that a character is exposed to
fallout, he accumulates rads. The character must make a
Fortitude save (DC10 + total accumulated rads) or he takes
1 point of Constitution damage.
If a character’s Con is reduced to 0, or if at any time a
character’s accumulated rads exceed his Con score, he
dies.
Radiation Recovery/Resistance
Provided a character can retire to a fallout-free zone, his
body will begin to recover.
x In the least grim variant, all characters recover at the
rate of 1 rad per day.
xx In this variant, the charcter must succeed at a
Fortitude save (DC10 + rads) to recover 1 rad. If the check
fails, the character’s rad level does not change.
xxx In the most grim variant, the character must make
a Fortitude save as above in order to recover 1 rad. If
this check is failed, not only does the character’s rad
level remain, the character takes an additional 1 point of
Constitution damage.
In some campaigns, PCs may be able to purchase
medication to flush the body or speed the recovery rate.
One such example is prussian blue, so named because it is
literally a type of dye used in paint. A character who takes
prussian blue immediately after exposure can recover an
additional 1 rad per day.
Better still, of course, is the use of preventative measures
prior to entering an area of fallout. Hazmat suits provide
a fixed layer of radiation resistance (similar to any other
energy resistance) while iodine-based tablets form a
buffer to absorb a fixed number of rads before losing
effectiveness.
Variant: Mutations
In some campaigns, fallout does not simply kill; instead,
those exposed to radiation become mutants with unusual
abilities.
Using this variant, a player whose rads exceed his
Constitution score does not immediately die. Instead, the
character can opt to reduce his rad level by accepting one
or more mutations.
Once per day, a character who would otherwise die
from radiation can instantly reduce his rad level by 2 for
every 0.2 CR of mutations he accepts. (See Chapter X-x,
Creature Creation, for the CR cost of various abilities and
drawbacks.)
The nature of the mutations is entirely at the whim of the
GM (though he may solicit player input). The mutations
may be either entirely positive (adding 0.2 CR in new
abilities per 2 rads reduced, and thus permanently
increasing the character’s CR) or a balance of positive
and negative (for example, +0.1 CR of a positive effect
and -0.1 CR of a negative effect, for a total of 0.2 CR in
changes but a net CR increase of +0.0). Mutations should
never be entirely negative.