In February 1999 a serious radiological accident occurred in Yanango, Peru, when a welder picked up an 192Ir industrial radiography source and put it in his pocket for several hours. This action resulted in his receiving a high radiation dose that necessitated the amputation of one leg. His wife and children were also exposed, but to a much less extent. The purpose of this report is to provide an account of the circumstances of the accident and its medical aspects.

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.

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.

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.

This publication provides a practical resource for emergency planning, and fulfils, in part, functions assigned to the IAEA in the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency. If used effectively, it will help users to develop a capability to adequately respond to a nuclear or radiological emergency.