In February 2001, an accident occurred in the Bialystok Oncology Centre in Poland, which caused five patients undergoing radiotherapy treatment to be given significantly higher does than intended. This report reviews this accidental medical overexposure, the subsequent dose assessment and the clinical consequences to the patients. It also discusses the lessons learned and provides recommendations for preventing similar events from occurring.

This report summarizes the assessment made of an accidental overexposure of radiotherapy patients that occurred at the San Juan de Dios Hospital in San José, Costa Rica, in August and September 1996. The assessment was carried out by an Expert Team convened by the IAEA in July 1997 at the request of the Government of Costa Rica. The findings of the Expert Team's assessment are presented in two parts: (1) an evaluation of the doses to patients by analysing the treatment records and physical measurements; and (2) a medical examination of patients, together with the autopsy findings for those who died. Thirty cross-sectional images are reproduced that show the dose reconstructions made for some of the patients. The purpose of the report is to foster information exchange with a view to preventing similar accidents elsewhere in the future.

A serious radiological accident occurred in Istanbul, Turkey, in December 1998 and January 1999 when two packages used to transport 60Co teletherapy sources were sold as scrap metal. This report gives an account of the circumstances which led to the accident and the medical aspects, and the lessons learned.

This publication provides guidance for designing and implementing radiotherapy programmes, taking into account clinical, medical physics, radiation protection and safety aspects. It reflects current requirements for radiotherapy infrastructure in settings with limited resources. It will be of use to professionals involved in the development, implementation and management of radiotherapy programmes

In late January and February 2000 a radiological accident occurred in Samut Prakarn, Thailand, when a disused Co-60 teletherapy head was partially dismantled, taken from an unsecured storage location and sold as scrap metal. This report gives an account of the circumstances which led to the accident, the medical aspects and the lessons learned.

On 21 June 1990 a fatal radiological accident occurred at an industrial irradiation facility at Soreq, Israel. An operator entered the irradiation room by circumventing safety systems and was acutely exposed, with an estimated whole body dose of 10-20 Gy. The accident, like earlier accidents at similar irradiators, was the consequence of the contravention of operating procedures. An IAEA review team investigated the causes of the accident. This report presents its findings and recommendations and describes the clinical management of the patient, particularly of the haematological phase. The medical treatment included the use of emerging therapies with haematopoietic growth factor drugs which may rescue the overexposed patient, albeit in this case only temporarily. The report is intended for regulatory authorities responsible for the regulation and inspection of irradiators, operating organizations and physicians who may need to treat overexposed patients.