Radiation accidents: lessons learnt for future radiological protection.

PURPOSE To review major radiation accidents that have occurred over a 50 year period. To identify common factors, since feedback may prevent recurrence. METHODS Accidents are classified according to the difficulties involved in their management and to the delay between their occurrence and their recognition. RESULTS The rate of severe accidents increases with time, especially those involving the public, and accidents are not always immediately recognized. The real number of serious unrecognized accidents is unknown. Human factors, such as lack of elementary safety rules and inadequate training, play a major role in most of the accidents occurring in industry and in the medical field. CONCLUSIONS Common sense could have prevented many severe accidents that resulted in deaths and serious injuries. Delay in the identification of accidents results in severe consequences. Pre-planning is essential and may minimize the severity and the deterioration of the situation. Research efforts in the field of medical handling of severely radiation-injured victims should be maintained.