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The 1990 Clinic of Zaragoza radiotherapy accident was a radiological accident that occurred from December 10–20, 1990, at the Clinic of Zaragoza, in Spain.
Zaragoza is the capital city of the Zaragoza province and of the autonomous community of Aragon, Spain. It lies by the Ebro river and its tributaries, the Huerva and the Gállego, roughly in the center of both Aragon and the Ebro basin.
Spain, officially the Kingdom of Spain, is a country mostly located on the Iberian Peninsula in Europe. Its territory also includes two archipelagoes: the Canary Islands off the coast of Africa, and the Balearic Islands in the Mediterranean Sea. The African enclaves of Ceuta and Melilla make Spain the only European country to have a physical border with an African country (Morocco). Several small islands in the Alboran Sea are also part of Spanish territory. The country's mainland is bordered to the south and east by the Mediterranean Sea except for a small land boundary with Gibraltar; to the north and northeast by France, Andorra, and the Bay of Biscay; and to the west and northwest by Portugal and the Atlantic Ocean.
In the accident, at least 27 patients were injured, and 11 of them died, according to International Atomic Energy Agency (IAEA).All of the injured were cancer patients receiving radiotherapy.
The International Atomic Energy Agency (IAEA) is an international organization that seeks to promote the peaceful use of nuclear energy, and to inhibit its use for any military purpose, including nuclear weapons. The IAEA was established as an autonomous organisation on 29 July 1957. Though established independently of the United Nations through its own international treaty, the IAEA Statute, the IAEA reports to both the United Nations General Assembly and Security Council.
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss and a change in bowel movements. While these symptoms may indicate cancer, they may have other causes. Over 100 types of cancers affect humans.
On December 7, 1990, a technician performed maintenance on an electron accelerator at the Clinic of Zaragoza. On December 10, it returned to service after the repairs. On December 19,the Spanish Nuclear Safety Board was scheduled to make its annual review to the device, but due to bureaucratic reasons this review was delayed. The Spanish Nuclear Safety Board found the electron accelerator power was too high. On December 20, 1990, the unit was stopped, and was restarted on March 8, 1991.
Affected patients immediately suffered burns on the skin of the irradiated area, as well as inflammation of the internal organs and bone marrow. The first patient died on February 16, 1991, two months after irradiation. Fatalities increased until, on December 25, 1991, the last of a total of 25 patients died. However, the IAEA established that eleven of the deaths were due to the faulty maintenance.
Inflammation is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and initiate tissue repair.
Bone marrow is a semi-solid tissue which may be found within the spongy or cancellous portions of bones. In birds and mammals, bone marrow is the primary site of new blood cell production or hematopoiesis. It is composed of hematopoietic cells, marrow adipose tissue, and supportive stromal cells. In adult humans, bone marrow is primarily located in the ribs, vertebrae, sternum, and bones of the pelvis. On average, bone marrow constitutes 4% of the total body mass of humans; in an adult having 65 kilograms of mass, bone marrow typically accounts for approximately 2.6 kilograms (5.7 lb).
The number affected might have been higher, because 31 other cancer patients were receiving treatment with the accelerator, but the other unit at the clinic was in perfect working condition.
The radiotherapy unit was repaired without following the correct instructions. The unit, in service 14 years at the time of the failure, had a breakdown in the electron beam accelerator control system ('deviator'). Repairs incorrectly increased output power, so patients that should have received therapy at 7 MeV were instead treated at 40 MeV.
In physics, the electronvolt is a unit of energy equal to approximately 1.6×10−19 joules in SI units.
Initially, the hospital was thought responsible for the accident, and specifically, the management of the radiological unit. The manager of the hospital said that the maintenance technician was responsible, and the Health Minister blamed General Electric (GE), the makers of the radiological unit, who had contracted out the maintenance.
General Electric Company (GE) is an American multinational conglomerate incorporated in New York and headquartered in Boston. As of 2018, the company operates through the following segments: aviation, healthcare, power, renewable energy, digital industry, additive manufacturing, venture capital and finance, lighting, transportation, and oil and gas.
Finally, on April 6, 1993, the hospital, its staff, and the Spanish National Institute of Health were acquitted. The court found the technician who performed the repair guilty, and secondarily, found General Electric guilty. GE had to compensate the affected families with 400 million pesetas (around 2.4 million euros).
The device continued working until December 1996, when it was switched off and scrapped. This was done discreetly to avoid publicity.
External beam radiotherapy (EBRT) or teletherapy is the most common form of radiotherapy. The patient sits or lies on a couch and an external source of ionizing radiation is pointed at a particular part of the body. In contrast to brachytherapy and unsealed source radiotherapy, in which the radiation source is inside the body, external beam radiotherapy directs the radiation at the tumour from outside the body. Orthovoltage ("superficial") X-rays are used for treating skin cancer and superficial structures. Megavoltage X-rays are used to treat deep-seated tumours, whereas megavoltage electron beams are typically used to treat superficial lesions extending to a depth of approximately 5 cm. X-rays and electron beams are by far the most widely used sources for external beam radiotherapy. A small number of centers operate experimental and pilot programs employing beams of heavier particles, particularly protons, owing to the rapid dropoff in absorbed dose beneath the depth of the target.
A nuclear and radiation accident is defined by the International Atomic Energy Agency (IAEA) as "an event that has led to significant consequences to people, the environment or the facility." Examples include lethal effects to individuals, radioactive isotope to the environment, or reactor core melt." The prime example of a "major nuclear accident" is one in which a reactor core is damaged and significant amounts of radioactive isotopes are released, such as in the Chernobyl disaster in 1986.
In the field of medical procedures, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often in the treatment of cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that as a charged particle the dose is deposited over a narrow range of depth, and there is minimal entry, exit, or scattered radiation dose.
Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy, it is usually used to treat cancer. Radiosurgery was originally defined by the Swedish neurosurgeon Lars Leksell as "a single high dose fraction of radiation, stereotactically directed to an intracranial region of interest".
A radiation burn is damage to the skin or other biological tissue as an effect of radiation. The radiation types of greatest concern are thermal radiation, radio frequency energy, ultraviolet light and ionizing radiation.
The National Oncologic Institute or ION is a specialized hospital for cancer treatment, located in Panama City, Panama. Between August 2000 and March 2001, patients receiving radiation treatment for prostate cancer and cancer of the cervix received lethal doses of radiation, resulting in eight fatalities.
The Valencia Metro derailment occurred in Valencia, Spain's third largest city, on 3 July 2006 at 1 p.m. CEST between Jesús and Plaça d'Espanya stations on the Line 1 of the Metrovalencia mass transit system. At least 43 people were killed and more than ten were seriously injured.
Fast neutron therapy utilizes high energy neutrons typically between 50 and 70 MeV to treat cancer. Most fast neutron therapy beams are produced by reactors, cyclotrons (d+Be) and linear accelerators. Neutron therapy is currently available in Germany, Russia, South Africa and the United States. In the United States, three treatment centers are operational in Seattle, Washington, Detroit, Michigan and Batavia, Illinois. The Detroit and Seattle centers use a cyclotron which produces a proton beam impinging upon a beryllium target; the Batavia center at Fermilab uses a proton linear accelerator.
Intraoperative radiation therapy, or IORT, is the application of therapeutic levels of radiation to the tumor bed while the area is exposed during surgery. IORT is typically a component in the multidisciplinary treatment of locally advanced and recurrent cancer, in combination with external beam radiation, surgery and chemotherapy. As a growing trend in recent years, IORT can also be used in earlier stage cancers such as prostate and breast cancer.
Cobalt therapy or cobalt-60 therapy is the medical use of gamma rays from the radioisotope cobalt-60 to treat conditions such as cancer. Beginning in the 1950s, cobalt-60 was widely used in external beam radiotherapy (teletherapy) machines, which produced a beam of gamma rays which was directed into the patient's body to kill tumor tissue. Because these "cobalt machines" were expensive and required specialist support, they were often housed in cobalt units. Cobalt therapy was a revolutionary advance in radiotherapy in the post-World War II period but is now being replaced by other technologies such as linear accelerators.
Particle therapy is a form of external beam radiotherapy using beams of energetic protons, neutrons, or positive ions for cancer treatment. The most common type of particle therapy as of 2012 is proton therapy. Although a photon, used in x-ray or gamma ray therapy, can also be considered a particle, photon therapy is not considered here. Additionally, electron therapy is generally put into its own category. Because of this, particle therapy is sometimes referred to, more correctly, as hadron therapy.
Intraoperative electron radiation therapy (IOERT) is the application of electron radiation directly to the residual tumor or tumor bed during cancer surgery. Electron beams are useful for intraoperative radiation treatment because, depending on the electron energy, the dose falls off rapidly behind the target site, therefore sparing underlying healthy tissue. IOERT has been called "precision radiotherapy," because the physician has direct visualization of the tumor and can exclude normal tissue from the field while protecting critical structures within the field and underlying the target volume. One advantage of IOERT is that it can be given at the time of surgery when microscopic residual tumor cells are most vulnerable to destruction. Also, IOERT is often used in combination with external beam radiotherapy (EBR) because it results in less integral doses and shorter treatment times.
In March–August 1962, a radiation incident in Mexico City occurred when a ten-year-old boy took home an unprotected industrial radiography source. Four people died from overexposure to radiation from a 5-Ci cobalt-60 capsule, an industrial radiography orphaned source that was not contained in its proper shielding. For several days, the boy kept the capsule in his pocket, then placed it in the kitchen cabinet of his home in Mexico City. Having obtained the source on March 21, the boy died 38 days later on April 29. Subsequently, his mother died on July 10; his 2-year-old sister died on August 18, and his grandmother died on October 15 of that year. The boy's father also received a significant dose of radiation, however he survived. Five other individuals also received significant overdoses of radiation.
The Castelldefels train accident occurred on 23 June 2010 when a passenger train struck a group of people who were crossing the railway on the level at Platja de Castelldefels station to the southwest of Barcelona, in Catalonia, Spain. Twelve people were killed, and fourteen injured: all victims but one Romanian were of Latin American origin, with a majority from Ecuador.
The 1987 Zaragoza barracks bombing was a car bomb attack by the Basque separatist organisation ETA, which occurred on 11 December 1987. A vehicle containing 250 kilograms of ammonal was parked beside the main Guardia Civil barracks in the city of Zaragoza, Spain; its subsequent explosion caused the deaths of 11 people, including 5 children. A total of 88 people were injured, the majority of them civilians.
Radiumhemmet is a non-surgical cancer treatment and radiotherapy research institution in Solna, Sweden. Since 1938, it has been a division of what is now the Karolinska University Hospital. It was founded in 1910 in central Stockholm as the first oncological clinic in Sweden, succeeding a radium research and treatment institution at the Serafimerlasarett founded in 1906, and played a major role in the development of radiotherapy, especially in gynaecological cancers.
Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) is a cancer hospital in Karachi under administrative control of Pakistan Atomic Energy Commission, duly registered with the International Atomic Energy Agency(IAEA). Institute is one of the 18 medical centers spread all over the country where patients have access to diagnostic and treatment facilities either free of charge or at subsidized rates.
On 28 July 2017, a passenger train crashed into a buffer stop and derailed at Barcelona França station in Barcelona, Spain. Fifty-six people were injured, five seriously.