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The Radiological Accident in Soreq

English STI/PUB/925 92-0-101693-X
22.00 1993

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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.
Contents: 1. Introduction; 2. The irradiation facility; 3. Regulatory control; 4. The accident; 5. Actions and lessons; 6. Overview of the medical aspects; 7. Medical management of the patient; 8. Findings of the post-mortem investigation; 9. Lessons to be learned.

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