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.

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.

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 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.

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.