title: Reported radiation overexposure accidents worldwide, 1980-2013: a systematic review.
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.
authors: Episight Consulting, Summit, New Jersey, United States of America.
authors: Karen
authors: K
authors: Coeytaux
authors: Plastic and Reconstructive Surgery Department, Percy Military Hospital, Clamart, France.
authors: Eric
authors: E
authors: Bey
authors: Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge, Tennessee, United States of America.
authors: Doran
authors: D
authors: Christensen
authors: Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge, Tennessee, United States of America.
authors: Erik S
authors: ES
authors: Glassman
authors: Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge, Tennessee, United States of America.
authors: Becky
authors: B
authors: Murdock
authors: Celogos, Paris, France.
authors: Christelle
authors: C
authors: Doucet
mesh_terms: D005471:Fluoroscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D000069079:Radiation Exposure / Q000266:history* / Q000706:statistics & numerical data*; D018788:Radioactive Hazard Release / Q000266:history* / Q000706:statistics & numerical data*; D011878:Radiotherapy / Q000009:adverse effects / Q000706:statistics & numerical data