The Lia radiological accident began on December 2, 2001, with the discovery of two orphan radiation sources near the Enguri Dam in Tsalenjikha District in the country of Georgia. Three villagers from Lia were unknowingly exposed. All three men were injured, one of whom eventually died. The accident was a result of unlabeled radioisotope thermoelectric generator (RTG) cores which had been improperly dismantled and left behind from the Soviet era. The International Atomic Energy Agency (IAEA) led recovery operations and organized medical care.
Source of the radioactive material
In the early 1980s, a series of eight radio relays were built to connect the Enguri Dam with the Hudoni Dam, which was under construction. The relays were in remote territory with no reliable access to electricity, and thus were powered with a series of eight radioisotope thermoelectric generators (RTGs) manufactured in 1983. Each RTG was a Beta-M type powered by strontium-90, and contained some 1295–1480 TBq of radioactivity. However, the Hudoni dam's construction was stopped as Georgian independence from the Soviet Union drew near. The stations and their RTGs were abandoned and eventually dismantled. The RTGs became lost at this time. Two were rediscovered in 1998, leading to no injuries. Two more were found in 1999, and again led to no injuries or significant radiation exposure. Two more were rediscovered in 2001, which led to the accident. The other two sources remain unaccounted for. The sources were not marked, and had been removed from the rest of the generator housing. They were heavy for their size, weighing 8–10 kg (18–22 lb) despite being only 10 cm × 15 cm (3.9 in × 5.9 in). Upon their recovery, it was determined the radiation emitted at the surface of the sources was 4.6 Sieverts (Sv) per hour. A fully absorbed whole-body dose of 5 Sv has a 50% chance of death. The original dose output at the time of their construction would have been much higher, but said output had decreased 40% since their construction due to radioactive decay. The actual dose received per hour would be lower unless physically touching the source, as radiation decreases with distance according to the inverse-square law.
Accident On 2 December 2001, three men from Lia (later designated as patients 1-DN, 2-MG, and 3-MB by the IAEA) had driven 45–50 km (28–31 mi) to a forest overlooking the Enguri Dam reservoir to gather firewood. They drove up a nearly impassable road in snowy winter weather, and discovered two canisters at around 6 pm. Around the canisters there was no snow for about a 1 m (3.3 ft) radius, and the ground was steaming. Patient 3-MB picked up one of the canisters and immediately dropped it, as it was very hot. Deciding that it was too late to drive back, and realizing the apparent utility of the devices as heat sources, the men decided to move the sources a short distance and make camp around them. Patient 3-MB used a stout wire to pick up one source and carried it to a rocky outcrop that would provide shelter. The other patients lit a fire, and then patients 3-MB and 2-MG worked together to move the other source under the outcrop. They ate dinner and had a small amount of vodka, while remaining close to the sources. Despite the small amount of alcohol, they all vomited soon after consuming it, the first sign of acute radiation syndrome (ARS), about three hours after first exposure. Vomiting was severe and lasted through the night, leading to little sleep. The men used the sources to keep them warm through the night, positioning them against their backs, and as close as 10 cm (3.9 in). The next day, the sources may have been hung from the backs of Patient 1-DN and 2-MG as they loaded wood onto their truck. They felt very exhausted in the morning and only loaded half the wood they intended. They returned home that evening.
Aftermath
Medical Two days after exposure, on December 4, patient 2-MG visited a local doctor but did not mention the mysterious heating source, and the doctor assumed he was drunk. The resulting treatment, however, did clear up the symptoms. On December 15, patients 1-DN and 2-MG developed burning and itching on the small of their backs, where the radiation source had been closest. Patient 1-DN lost his voice as well but did not seek care at that time. The wife of patient 3-MB and the brother of patient 2-MG learned that all three men were ill with similar symptoms, including increasing desquamation, especially on their backs. The wife and brother reached out to the police, who suggested that all three men seek medical attention. All three patients were finally hospitalized on December 22, and it was determined they had ARS. Patient 3-MB was released on January 23, 2002, as his injury was mild. The other patients remained in serious condition, and the Government of Georgia petitioned the IAEA for help treating them. The IAEA intervened: patient 1-DN was sent to Burnasyan Federal Medical Biophysical Center in Moscow, and Patient 2-MG was sent to the Percy military hospital in Paris. Patient 2-MG was hospitalized for over a year, and required extensive skin grafts, but survived and was discharged on March 18, 2003. Patient 1-DN's injuries lingered. He had received the greatest exposure on his back, as well as damage to his heart and vital organs. A large radiation ulcer formed on much of his upper left back. Despite intensive care, repeated antibiotics, multiple surgeries, and an attempted skin graft, the wound did not heal. His condition was complicated by tuberculosis, which prevented effective treatment of lung injury. He developed sepsis, and died of heart failure on May 13, 2004, 893 days after first exposure.
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