Introduction: Globally, railway transport is increasing steadily. Despite the adoption of diverse safety systems, major railway incidents continue to occur. Higher speeds and increased passenger traffic are factors that influence the risk of mass-casualty incidents and make railway crashes a reality that merits extensive planning and training.

Methods: Data on railway disasters were obtained from the Centre for Research on the Epidemiology of Disasters (CRED), which maintains the Emergency Events Database (EM-DAT). This descriptive study consists of 529 railway disasters (≥10 killed and/or ≥100 non- fatally injured) from 1910 through 2009.

Results: The number of railway disasters, people killed, and non-fatally injured, has increased throughout the last hundred years—particularly during the last four decades (1970–2009), when 88% of all disasters occurred. In the mid-20th century, a shift occurred, resulting in more people being non-fatally injured than fatally injured. During 1970–2009, 74% of all railway disasters occurred in Asia, Africa, and South and Central America, combined. The remaining 26% occurred in Europe, North America, and Oceania, combined. Since 1980, railway disasters have increased, especially in Asia and Africa, while Europe has had a decrease in railway disasters. The number killed per disaster (1970–2009) was highest in Africa (n = 55), followed by South and Central America (n = 47), and Asia (n = 44). The rate was lowest in North America (n = 10) and Europe (n = 29). On average, the number of non-fatal injuries per disaster was two to three times the number of fatalities, however, in the African countries (except South Africa) the relation was closer to 1:1, which correlates to the relation found in more developed countries during the mid-20th century. The total losses (non-fatally and fatally injured) per disaster has shown a slight decreasing trend.

Conclusions: Despite extensive crash avoidance and injury reduction safety systems, railway crashes occur on all continents, indicating that this type of incident must be accounted for in disaster planning and training. Better developed safety, crashworthiness, and rescue resources in North America and Europe may be factors explaining why the number of crashes and losses has stabilized and why the average number of people killed per disaster is lowest on these continents.

Ca-DTPA was used for the medical treatment of plutonium and americium contaminations in the CEA and AREVA plants from 1970 to 2003. This report is a survey of the administered injections of Ca-DTPA as a chelating molecule. This report will be part of the registration process for Ca-DTPA by intravenous administration, submitted by the Pharmacie Centrale des Armées. Out of 1158 injections administered to 469 persons, 548 events of possible or confirmed contaminations were reported. These employees were followed by occupational physicians according to the current regulations. The first part of the report is a summary of the most recent findings. Due to its short biological period and its limited action in the blood, Ca-DTPA does not chelate with plutonium and americium as soon as these elements are deposited in the target organs. This justifies an early treatment, even in cases of suspected contamination, followed by additional injections, if necessary. The second part presents data concerning these 1158 injections (contamination routes, posology, adverse effects, ...). These incidents took place at work, were most often minor, and did not require follow-up treatment. A study concerning the efficacy of the product was conducted on a group of people having received 5 or more injections. These results were compared with the efficacy theoretically estimated. Posologies and therapeutic recommendations were proposed based on these observations. Additional studies are needed to confirm these findings. This document is the first summary in this field. It is the result of the collaboration of the occupational medical departments, the laboratories of the CEA and the AREVA and a working group CEA-AREVA-SPRA.

When preparing radiation treatment, the prescribed dose and irradiation geometry must be translated into physical machine parameters. An error in the calculations or machine settings can negatively affect the intended treatment outcome. Analysing incidents originating in the treatment preparation chain makes it possible to find weak links and prevent treatment errors. The aim of this work is to study the effectiveness of a multilayered error prevention system by analysing both near misses and actual treatment errors.

The system utilised in this centre has primary and secondary checking as two layers of independent calculation-checking. We studied near misses as well as the actual errors which were not picked up by these pre-treatment checking procedures over a year (5154 treatment plans). Furthermore, the primary checking was studied in more detail over three years (15,386 treatment plans) to increase the statistical accuracy.

For each reported actual treatment error originating in the treatment preparation chain, 13.8 near misses were found by primary and secondary checking and thereby prevented from becoming actual errors. The total frequency of near misses was 34.4 per 1000 treatment plans. The primary checkers reported 23 types of errors for manual treatment plans (without dose distribution) and 30 types of errors for computer plans. Computer plans also showed a near miss rate that was 42% higher than for manual plans. The high ratio of near misses per actual error demonstrates an effective error prevention system, independent of the quality of the initial treatment preparation. Complex treatment plans were shown to be particularly error-prone, thereby requiring extra vigilance when checking.

En 1998 et 1999, 160 incidents susceptibles d'avoir entraîné une exposition externe ou interne de travailleurs ou de membres du public et ayant fait l'objet de mesures et/ou d'estimations individuelles ont été signalés à l'ex-OPRI, organisme dont une partie a fusionné avec l'Institut de protection et de sûreté nucléaire (IPSN) en 2002 pour former l'IRSN. Cette étude décrit les caractéristiques de ces incidents en termes de lieu de survenue, circonstances de découverte et conséquences prévisibles ou réelles. L'analyse statistique de ces évènements montre une grande diversité des lieux de survenue, les principaux secteurs étant l'industrie nucléaire (57 % des incidents), les laboratoires de recherche (19 %) et le secteur médical (14 %). Au total, 369 personnes ont été concernées par ces 160 incidents et parmi celles-ci, 305 pour des suspicions de contamination, 54 pour celles d'irradiation et enfin 10 pour une suspicion de contamination et d'irradiation concomitantes. Les mesures réalisées ont confirmé la contamination chez la moitié des personnes concernées. En ce qui concerne le risque d'irradiation, sur 64 personnes susceptibles d'avoir été exposées, 34 ont reçu une dose non nulle, supérieure à 50 mSv pour quatre d'entre elles. Compte tenu de la fréquence des incidents de contamination, il serait souhaitable de développer des études spécifiques sur les radionucléides concernés, en particulier ceux utilisés dans les laboratoires de recherche et dans le domaine médical afin d'améliorer l'expertise en cas d'incident dans ces secteurs.

Le service de santé au travail du CEA/CADARACHE est un service médical de site chargé de la surveillance radiologique de l'exposition interne de l'ensemble du personnel travaillant sur le centre de Cadarache. Dans notre activité spécifique de surveillance du risque radiologique prédomine la gestion des expositions aux actinides, plutonium et américium principalement, avec environ 600 agents concernés. Nous présentons les protocoles de prise en charge des incidents de contamination que nous avons élaborés et mis en place en 1996 ainsi que le retour d'expérience sur plus de 1 500 évènements gérés jusqu'à fin 2002.

Cette note présente une étude de cas qui analyse les leçons à tirer en matière de radioprotection à partir d'un incident radiologique en vue de prévenir l'apparition d'incidents du même type. Cette note a été publiée en anglais dans la European ALARA Newsletter n$^{\circ}$ 2 (janvier 1997) et elle synthétise un des exemples recensés dans la base de données anglaise IRID (Ionising Radiation Incident Database) du “ Health and Safety Executive ", “ National radiological Protection Board " et de l'“Environmental Agency".