U.S. Rules On Radiation Pills Vary Widely From State To State

NEW YORK -- Potassium iodide pills have played a central role in Japan's nuclear response. And they've contributed to widespread paranoia in the United States, as people fearing exposure to radiation from thousands of miles away have snapped up the substance from drugstore shelves and online vendors.

But as a matter of U.S. emergency preparedness policy, the government's distribution of potassium iodide to people living near nuclear plants is a hazy and voluntary process that varies widely from state to state.

Although the Nuclear Regulatory Commission included potassium iodide in its emergency preparedness regulations nearly a decade ago, the decision on whether to distribute the radiation pills to the public was left up to individual states. Twenty-three of the 33 states that have people living within 10 miles of nuclear power plants have chosen to participate in the federal program.

The inconsistent standards across the country point to the difficulties in managing public perceptions of a nuclear disaster and reveal a lack of consumer education about how the pills work. State officials who have chosen not to distribute potassium iodide say they worry that residents might be lured into a false sense of security and not evacuate in the case of a disaster.

But doctors and other public health advocates have long urged for a more centralized approach on potassium iodide, which can reduce the risk of thyroid cancer for those exposed to radioactive iodine, particularly in infants and young children. Critics have long said that the federal government has shied away from requiring distribution of the pills to avoid any negative stigma attached to living near a nuclear plant.

"Everyone agrees with the need for evacuation," said Dr. Lewis Braverman, a professor at Boston University School of Medicine who coauthored a 2004 National Academy of Sciences report advocating the use of potassium iodide for anyone at risk from radioactive iodine. "But if that doesn't occur, or if it's slow, and you're worried about radioactive iodine in the atmosphere ... then I think it should be available."

Potassium iodide is available over the counter in drug stores, but not in great supply. As evidenced by the run on the substance at drugstores in the United States, the pills are often misunderstood.

If taken shortly before or after exposure to radiation, potassium iodide can be effective in reducing the risk of thyroid cancer, mostly for people under 40. But they are in no way a panacea for the effects of radiation, since exposure to other radioactive elements can lead to other illnesses, such as lung cancer.

Taking the pills effectively fills the thyroid gland with enough iodine to prevent the gland from absorbing radioactive iodine, a harmful isotope emitted from a nuclear reactor.

Nonetheless, other countries with extensive nuclear power industries, such as France, have consistent distribution of potassium iodide to households living near nuclear plants. For years, the American Thyroid Association and the American Academy of Pediatrics have pushed for greater and more consistent distribution of the pills.

Greater distribution doesn't mean greater intake, though. States that do participate in the program warn that the pills should only be taken as directed -- in case of emergency, while evacuating to a safe distance.

Following the 1979 Three Mile Island accident in Pennsylvania, a commission appointed by President Jimmy Carter recommended that the United States stockpile potassium iodide, but the Nuclear Regulatory Commission did not adopt a rule regarding the substance until 2001.

The rule now "requires that consideration be given to including potassium iodide as a protective measure for the general public that would supplement sheltering and evacuation." It applies to states that have populations within 10 miles of a nuclear plant.

At the time, the commission told states that there would only be a one-time distribution of the pills; since then the commission has told states they will continue to provide more supplies if they run out.

Individual states had to come up with a distribution plan and submit it to the Federal Emergency Management Agency for approval. Methods of distributing potassium iodide vary: some states stockpile it in case of emergency, while others make it available to the public at regular intervals.

Officials in states that have chosen not to distribute the potassium iodide to residents point out that the pills only address the thyroid gland, and not other parts of the body that could be harmed by exposure to radioactive elements. They also point out that pills could deter evacuation efforts.

"It's better for them to leave the area and get no exposure to radiation than rely on protection from one kind of radiation," said Chris Van Deusen, a spokesman for the Texas Department of State Health Services.

Other health officials said they decided not to distribute the pills because of logistical questions: how and when to hand out the pills.

"If we're telling people to get out, but they'd rather get potassium iodide first at some distribution point, it confuses our emergency plan," said Donn Moyer, a spokesman for the Washington Department of Health, which opted not to participate in the federal program.

But the inconsistencies are notable.

In Wisconsin, for example, potassium iodide is handed out in a county near two power plants but not near another one.

County officials near Wisconsin's two nuclear power plants along Lake Michigan did not want to distribute the pills. But potassium iodide is distributed in a county on the other side of the state, which is within 10 miles of a nuclear power plant in Minnesota.

Minnesota officials did opt into the federal potassium iodide program, so officials in the adjoining Wisconsin county felt it would be inconsistent if they were not also available in Wisconsin.

The Nuclear Regulatory Commission has not announced any specific policy changes since the Japan disaster, but noted that the commission is reviewing "all aspects of nuclear power plant safety and security regulations."

Comments

[chowda]

08:51 PM on 04/28/2011

Lewis E. Braverman is a sadistic Level 3 Sexual Offender who engaged in indecent A&B of the breasts of all of his female endocrinology patients while he was at UMass Medical Center in Worcester, MA. The assaults were witnessed by other doctors who had a duty to intervene on the felony assaults and did not in order to protect their careers. He should be in jail.

[J.C. Convery]

08:55 PM on 04/04/2011

Thats the problem...they're merely a token. On many levels I agree with what you're saying. I grew up near West Valley and it's the things the media didnt report that were quite disturbing...The fact is the reactor blew up containment failed and we do have an emergency but it's not a global crisis. I'm sure if you look hard enough there are parts oif the former Soviet Union besides Chernobyl that are hotter and yet we pay no attention. I would say rather than report on the "global crisis" from Japanese radiation we should look at the bigger picture but I dont see it happening because there are no quick and easy ratings to grab from real news.

[Polly Hearn]

11:16 AM on 04/04/2011

As usual everyone is trading on fear because that is the easiest solution to the problem of nuclear power. Had governments been able to sit down with communities and explain the benefits and dangers of radiation, we would all be a lot less nervous. Historically, when a group of nuclear engineers sat down to plan power stations they were told they were dealing with material that could be used to blow up the world. Secrecy was the order of the day. That secrecy led to engineering mistakes and failure to inform populations what effects radiation would have on humans. It's time to start a policy of transparency and educate people about the
real effects of radiation. Any high school student should be able to tell us about the effects of alpha, beta and gamma radiation. They should also be able to tell us the difference between an alpha emitter with a short half life and a beta or gamma emitter which can do a lot more damage. Heck, even uranium, which is an alpha emitter is only damaging if you sit down and eat it. The heavy metal is toxic to the kidneys. But if you swallow enough of an alpha emitter, you
will have ionization particles whizzing around hitting organs, causing damage. Some particles hit the lungs, some lodge in the bone; iodine hits the thyroid. Now if everyone could study the problem objectively we could all figure out how dangerous atomic power is.

[PoloniumMan]

07:53 AM on 04/04/2011

I'm not sure why the Japanese handed out PI tablets. Their diet is so rich in iodine that I'm sure their thyroids are already saturated. One of the reasons that so many people near Chernobyl, especially children, developed thyroid cancer was that their diets were deficient in iodine. On top of that their government failed to take prompt action. If someone lives nearby a nuclear reactor and are concerned with effects of a release of I-131, they can make changes to their diet today such as including more fish. A change in diet would probably benefit their health in other ways too.

[aligatorhardt]

07:54 AM on 04/03/2011

This is further evidence of the fact that the nuclear power industry has no practical way to protect the public from radiation releases, and these pills are just a token effort. They like to pretend to be concerned with safety, but only to the extent of the appearance of being prepared. Even the nearly worthless pills will not be available or distributed in a manner that protects the public. To rely on evacuation as the only protection from damage is slightly better than nothing. Look at the situation in Japan to see how nearly helpless even the experts are at dealing with the out of control nuclear power facility. In the meanwhile people are dying, more will suffer cancers and many will have to just walk away from their property that took a lifetime to acquire. There is no reason to accept this level of harm when many alternate ways to make electricity are available.

[J.C. Convery]

08:44 PM on 04/03/2011

Really. you're actually worried about radiation from Japan? We could do away from the things in life which exp[ose us to radiation ..among the objects we woudl be getting rid of are peanut butter(no kidding) and bricks..hell lets just get rid of the sun while we're at it because I hear there is som serious radiation going on there.

We can never truly be safe from anything. We can make sure that peoplelfollow rules but for some reason the political right seems to like it when people get cancer so lets start dealing with them.

There is not enough radiation for there to be any significant risk in the US..buying antiradiation pills is just fueling the faux crisis created by the media to enhance thier ratings...foolish waste of money and makes it harder for those in need,,perhaps in Japan...to get said medication should it be needed.

[aligatorhardt]

10:18 AM on 04/04/2011

Try reading it again. Try to understand what the words say. I am not worried about Japan's radiation hurting me here, but I am disgusted that 104 nuclear power facilities are here in the US and they also rely on evacuation for safety when major accidents occur. They also refuse to alert the citizens at the start, being more concerned with their own inconvenience of trying to deal with moving large numbers of people out of an area. Evacuation of a city like NY is a joke. there is no way that volume of people can be moved suddenly. It is unacceptable that people must leave large dead zones and families must abandon their homes, not able to return.
 It is unacceptable that during a radiation accident that they cannot turn off the reactor. After two weeks, they are floundering around and radiation is being released to endanger everyone for many miles . Much of the contamination will remain in the soil and water to continue to degrade health.
  No one is asking for 100% safety, but nuclear power is not under control and is not needed so why put up with it being a greater risk than any other system of power production, and why put up with the units being installed in such hazardous locations? The iodine pills should be left for those who need them, but the pills are certainly a token effort at safety.

[aligatorhardt]

10:26 AM on 04/04/2011

Furthermore to compare a peanut butter sandwich minuscule amount of radioactivity to the constant exposure of high concentrations of radionuclides  is completely false. The risk in the US from this is small, but every addition to background levels makes us less healthy. Besides, nuclear power costs extra as well. There is no reason to put up with the risk. We could have the same tragedy here with the same results.

[merlinspinoza]

02:13 AM on 04/03/2011

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[darma2u]

12:17 PM on 04/02/2011

"Critics have long said that the federal government has shied away from requiring distribution of the pills to avoid any negative stigma attached to living near a nuclear plant." ..So if we put our heads in the sands and ignore it and any other health issue, it will just 'die' away.

[Negin Anvar]

09:55 PM on 04/01/2011

I have been taking Iodoral for well over a year and feel absolutely fabulous. Love the stuff. I take it for many reasons. I spent a looooong time researching it. It was not a willy-nilly decision. Doing your research pays off.

[nopilikia]

09:43 PM on 04/01/2011

Pills only help if taken within 24 hours of exposure.

[schnauzergirl]

03:31 PM on 04/04/2011

and only against exposure to Iodine-131 which only has a halflife of 8 days. Besides, too much iodine (like from taking these pills for long duration instead of the short fix they are intended to be) can cause some health issues as well.

[Winston Grant]

06:52 PM on 04/01/2011

In light Of current events:
NOT distribuiting them, free of charge, to whoever is withoin the footprint of a Nuclear power plant
is WILDLY irresponsible and uncaring.
GE should buy enough for EVERYBODY--and go door to door distribuiting them.
It's only fair.

[Zeroes]

01:11 PM on 04/01/2011

Zero tolerance on radiation in food and water supply. Are you being brainwashed.

[jokerdanny]

11:42 AM on 04/01/2011

the take-way from this article is "Everyone agrees with the need for evacuation"...or to put it in laymen's terms..."RUN FOR YOUR LIVES!"

[Alison Rose Levy]

01:44 AM on 04/02/2011

Yes, run for your life is the tweet version of all the reassuring health information. And as one who has drilled into the science of radiation, that's the take-away. If you want to learn more, you should listen to my show with Helen Caldicott tomorrow: http://healthjournalistblog.com/helen-caldicott-on-connect-the-dots/

[talkofliberty]

11:39 AM on 04/01/2011

I am all for Government being prepared with a stock pile of emergency supplies of some sort, however not at the expense of limiting the free market distribution choices as well. Monopolies are never good.

[laucarlson]

11:37 AM on 04/01/2011

In Oregon, we can't get iodine now--had to show my car registration to get some iodine-based antiseptic for my livestock a few months ago, and that information was screened by the State Police. They made iodine sales illegal because it's integral to methamphetamine production. Two pharmacies told me it was against the law for them to carry iodine, even the kind for antiseptic use.
I guess I need to find a local meth dealer, so I can get some iodine . . .

[aligatorhardt]

08:01 AM on 04/03/2011

Isn't that ridiculous? Law enforcement is so darn lazy that they would rather take medicine out of the hands of patients on the off chance that it might slow down some drug dealer, than to make the effort to catch the few criminals. This is terrorism tactics, to punish the entire population of innocents instead of conducting the police actions required to apprehend criminals.

[ShamsT]

11:11 AM on 04/01/2011

"Critics have long said that the federal government has shied away from requiring distribution of the pills to avoid any negative stigma attached to living near a nuclear plant".

Yes, this is what critics have said but it's not true. The reason the federal government has shied away from requiring distribution is the risk of severe allergic reaction, anaphylactic shock and even death from KI itself. The risk of these severe reactions with the administration of KI to large populations has to be balanced against the risk of health effects from radioactive iodine. The federal government is faced with choosing immediate adverse health affects from KI administration versus possible adverse health effects 30 years down the road from radioactive iodine. Not an easy decision.

[laucarlson]

11:39 AM on 04/01/2011

Well, how can they distribute vaccines without liability? I would think dietary supplements, which is what the pills are, would fall under that legislation.

[aligatorhardt]

08:04 AM on 04/03/2011

Any substance that affects metabolism is a drug. Lawyer call things "dietary supplements" to avoid the FDA laws, so they can sell drugs without the need to show them to be effective or safe.