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.

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.