Lessons from the accident with 137Cesium in Goiania, Brazil: Contributions to biological dosimetry in case of human exposure to ionizing radiation.

Human exposure to ionizing radiation has increased over time, mainly due to medical applications, occupational and environmental exposure, as well as accidents involving radioactive materials. In September 1987, an accident with 137Cesium occurred in Goiânia city, Brazil; the accident started with the removal of a 50.9-TBq 137Cesium source from an abandoned radiotherapy unit. Among the radiation-exposed victims, at least 50 individuals showed symptoms of whole-body and local acute irradiation, and also external or internal contamination. In this report, the purpose was to review and summarize the main results of cytogenetic studies carried out with victims of 137Cesium, for blood collection performed shortly after the accident, and following several years post-exposure. The importance of dose estimates by biological dosimetry is highlighted, and also several lessons that were learned from the initial to follow-up (7-10 years after the accident) studies, mainly by applying the fluorescence in situ hybridization (FISH) method. A relevant aspect discussed on the basis of the results obtained in those studies refers to the incidence of chromosomal translocations, which were directly compared to the initial frequencies of dicentrics that were previously used to estimate the absorbed doses. In general, translocation frequencies were two to three times lower than the dicentric frequencies, and the differences were dose-dependent. Furthermore, regarding attempts to perform retrospective dosimetry (10 years post-accident), the dose estimates using translocation frequencies for victims of 137Cesium indicate the feasibility of this approach only for low level exposure (below 0.5 Gy), while for higher doses there are some limitations, and the requirement to apply appropriate correction factors, which were discussed on the basis of literature data. Apart of this, in general terms, important aspects to be mentioned refer to the need for better care and control of radioactive devices, as well as adequate education programs for professionals and also the population.