The initial destruction is harrowingly presented, with telling use being made of such details as official catastrophe defence plans, but that destruction is not the book's main theme. The "fall-out" of the title is the cloud of radioactive dust which envelops Janna, but it is also her falling out of "normal" society. The way in which society re-establishes itself and tries to ignore the seriousness of what has happened forms the core of the story and makes it relevant not only to nuclear accidents, but to our general attitude to grief and pain.
Stigmatised by her baldness as one of the Hibakusha - the survivors of radiation sickness - Janna resists pressure to wear a wig. She wants recognition of what has happened and she will not become invisible simply because the sight of her bald head makes people uncomfortable. Her angry refusal to conform is the driving emotion of the book, but the story is no mere rant.
Through Janna's experiences, Pausewang explores, very subtly, the idea of collective responsibility, and how it is weakened by our desire to shirk unpleasant truths.
Inevitably, some of the book's power to shock is lost in translation. "Schweinfurt" does not threaten an English reader as "Leicester" would. Nor will most English children appreciate the parallel drawn with the past when Janna's grandparents dismiss the disaster as "Unnecessary excitement. German hysteria", just as they dismiss their own Nazi involvement as exaggerated. But the book has not dated in the eight years since it was first published (except for a couple of anachronistic references to South Africa) and its central message is still clear and important. Janna, with her awkwardness and her angry refusal to conform and forget, is asserting our duty to recognise the problems of society and to take responsibility for them. She demands that we look steadily at the facts and at our own share in letting them happen. That remains an important message for all of us.