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. 2015 Mar 19;10(3):e0118709.
doi: 10.1371/journal.pone.0118709. eCollection 2015.

Reported radiation overexposure accidents worldwide, 1980-2013: a systematic review

Karen Coeytaux  1 , Eric Bey  2 , Doran Christensen  3 , Erik S Glassman  3 , Becky Murdock  3 , Christelle Doucet  4
Affiliations

Reported radiation overexposure accidents worldwide, 1980-2013: a systematic review

Karen Coeytaux et al. PLoS One. .

Abstract

Background: Radiation overexposure accidents are rare but can have severe long-term health consequences. Although underreporting can be an issue, some extensive literature reviews of reported radiation overexposures have been performed and constitute a sound basis for conclusions on general trends. Building further on this work, we performed a systematic review that completes previous reviews and provides new information on characteristics and trends of reported radiation accidents.

Methods: We searched publications and reports from MEDLINE, EMBASE, the International Atomic Energy Agency, the International Radiation Protection Association, the United Nations Scientific Committee on the Effects of Atomic Radiation, the United States Nuclear Regulatory Commission, and the Radiation Emergency Assistance Center/Training Site radiation accident registry over 1980-2013. We retrieved the reported overexposure cases, systematically extracted selected information, and performed a descriptive analysis.

Results: 297 out of 5189 publications and reports and 194 records from the REAC/TS registry met our eligibility criteria. From these, 634 reported radiation accidents were retrieved, involving 2390 overexposed people, of whom 190 died from their overexposure. The number of reported cases has decreased for all types of radiation use, but the medical one. 64% of retrieved overexposure cases occurred with the use of radiation therapy and fluoroscopy. Additionally, the types of reported accidents differed significantly across regions.

Conclusions: This review provides an updated and broader view of reported radiation overexposures. It suggests an overall decline in reported radiation overexposures over 1980-2013. The greatest share of reported overexposures occurred in the medical fields using radiation therapy and fluoroscopy; this larger number of reported overexposures accidents indicates the potential need for enhanced quality assurance programs. Our data also highlights variations in characteristics of reported accidents by region. The main limitation of this study is the likely underreporting of radiation overexposures. Ensuring a comprehensive monitoring and reporting of radiation overexposures is paramount to inform and tailor prevention interventions to local needs.

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Conflict of interest statement

Competing Interests: The authors of this manuscript have the following competing interests: The salaries of authors KC and CD are from Episight Consulting and Celogos. No other competing interest was declared by any of the authors. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. PRISMA flow chart.
Search strategy for retrieving reported radiation overexposure accidents worldwide, 1980–2013.
Fig 2
Fig 2. Reported radiation overexposure accidents worldwide and sector involved, 1980–2013.
(a) number of reported radiation accidents (b) number of reported overexposed people.aPartial decade.
Fig 3
Fig 3. Evolution of type of overexposed people and type of injuries in reported radiation accidents worldwide, 1980–2013.
(a) Type of overexposed people (b) Type of overexposure.aPartial decade.
Fig 4
Fig 4. Distribution of sectors involved in reported overexposed people by region, 1980–2013.
See this image and copyright information in PMC

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