The Government and authorities in Brazil were faced with a tragic accident in Goiânia resulting from the misuse of a strongly radioactive medical teletherapy source not under radiation protection surveillance. The present report is divided into four parts: a chronology of destruction of the source, discovery of the accident and initial response; a description of the human consequences and the dosimetry and treatment of seriously exposed and contaminated persons; an account of the assessment of the environmental contamination and the remedial actions taken; and observations and recommendations. Appendices and annexes give an assessment of the effectiveness of international co-operation in the emergency response, and provide further information on: public communications; radiological survey equipment; guidelines for the discharge of patients; radiological protection; chemical decontamination; and the lessons learned.

In September 1987 a l37Cs medical teletherapy source was stolen, removed from its shield and ruptured, causing a radiological accident in Goiânia, Brazil. The causes and consequences of the accident were reported by the IAEA in 'The Radiological Accident in Goiânia' (IAEA, Vienna, 1988). Now, ten years after the accident, this TECDOC describes the experience of some of the scientists and physicians who were involved in the management, monitoring and treatment of the victims of the Goiânia accident. Many scientific papers have been published on the subject in different journals. This publication compiles up to date conclusions on the ten year follow-up of the health effects of the Goiânia accident and summarizes the experience that was acquired.

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.

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.

The radiological accident described in this report took place in Lilo, Georgia, when sealed radiation sources were abandoned by a previous owner at a site without following established regulatory safety procedures. As a consequence, 11 individuals at the site were exposed for a long period of time to high doses of radiation which resulted inter alia in severe radiation induced skin injuries. The present report, which is co-sponsored by the World Health Organization, provides information on the medical management of radiation induced skin injuries as well as a comprehensive report on the circumstances and details of the accident and the lessons to be learned.