Alright I believe I know enough about the Fallout universe in my own right to add my own 2 cents to the question.
I think that one of the big huge points of all the DLCs released for Fallout 3 was to actually visually show us how [censored] up the world is now.
"Whats that? California nuked? thats a shame. D.C. hit too huh? damn. Wait a second what the hell is this these places are even worse than the ones that got cleaned out with the direct blast of nuclear assaults!"
Which sums up the message I see Bethesda as trying to give us. The entire biblical reference of Fallout and the Fallout universe is water as a source of life, most well known being Fallout 3s story line and all human civilization was built on the banks of the rivers, on the banks of life. Nuclear warfare has tainted the earth, the sky, and most symbolicly the water that is the source of all life, destroying or twisting all existing life beyond recognition. Look at the evidence.
Locations for the DLCs The Pitt and Point Lookout, the only two that actually take you somwhere really beyond the DC wastes, are almost entirely water based and because of this the corruption from radiation, and thus human malice, sin, and folly, they are far less than inhabitable in current conditions for one reason or another.
This being said, ALL WORLD LOCATIONS WOULD BE EFFECTED BY NUCLEAR BLOW UPS OF MAGNITUDE EVEN APPROACHING WHAT HAPPENED IN FALLOUT.
Winds carried trace particles from a single meltdown in Russia near the end of the Cold War to afflict Cows and grazing livestock after the unstable molecules had been exposed to local plants and fauna. Let alone anything that [censored] huge.