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.

Under the Convention on Assistance in the Case of a Nuclear or Radiological Emergency, the Peruvian authorities requested assistance from the IAEA in relation to the radiological accident that occurred during non-destructive testing using a nuclear radioactive source in the district of Chilca, Peru, in 2012. This assistance related to dose assessment and medical management of those involved in the accident was provided during 2012 and 2013. The report gives a detailed account and analysis of the event, as well as, the actions taken in order to assist organizations responsible for radiation protection, source safety and emergency preparedness and response in identifying lessons to be learned that may help to prevent similar accidents.

On 17 November 1992 a radiological accident occurred at an electron accelerator facility in Hanoi, Viet Nam. An individual entered the irradiation room without the operators' knowledge and unwittingly exposed his hands to the X ray beam. His hands were seriously injured and one hand had to be amputated. The report details the circumstances of the accident, its medical consequences and the governmental response.

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.

In October 1994 three members of the public entered the radioactive waste repository at Tammiku, Estonia, without authorization and removed a metal container enclosing a radiation source, which one of them placed in his pocket. This action resulted in the death of one person and injury to a number of others. The purpose of this report is to provide information so that similar accidents can be avoided in the future.

On 5 February 1989, a radiological accident occurred at an industrial irradiation facility near San Salvador, El Salvador. Medical products are sterilized at the facility by irradiation by means of an intensely radioactive cobalt-60 source in a movable source rack. This source rack became stuck in the irradiation position. The operator bypassed the irradiator's degraded safety systems and entered the radiation room with two other workers to free the source rack manually. The three men were exposed to high radiation doses and developed the acute radiation syndrome. They received initial hospital treatment in San Salvador and subsequent, more specialized treatment in Mexico City. The legs and feet of two men were so seriously injured that amputation was required. The worker who had been most exposed died six and a half months after the accident from lung damage due to irradiation complicated by injury sustained during treatment. The report describes the accident and the response to it and presents lessons derived for operators and suppliers of irradiators, national authorities, medical staff and international organizations. Detailed information on dosimetric and medical aspects of the accident is presented in appendices and annexes.