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Glenn D. Braunstein, M.D.

Glenn D. Braunstein, M.D.

Posted: March 19, 2011 11:43 AM

A U.S. Health Meltdown Over Japan's Nuclear Crisis


The panicked phone calls and e-mails from patients and friends concerned about the potential health effects of Japan's nuclear crisis won't quit. Turn on the television or radio, switch on the Internet and the fear is palpable: In California and across the United States, far too many people are worrying themselves sick over the remote possibility that they and their families might be exposed to massive amounts of radiation from Japan's nuclear power plant disaster, which was triggered by a devastating earthquake and a tsunami. Despite my attempts to resolve the anxiety among those who consult me, many can't quell their worry about what they consider to be an imminent danger. Why is this? What's feeding this boiling cauldron of fear?

What We Know from History and Science
Let's acknowledge there are perfectly rational concerns about the unfolding Japanese disaster and the health harms that radiation can cause. As each day passes, the world's concern rightly mounts as to the long-lasting damage that may be sustained in the region due to the nuclear mess in northern Japan. Experimental atomic blasts in the Pacific atolls in the 1950s and the atomic bombings of Nagasaki and Hiroshima in World War II showed that radiation exposure can cause myriad health horrors, including leukemia and other cancers. Extensive investigations into the health damages of the Chernobyl nuclear reactor meltdown clearly demonstrated that children and adolescents exposed to radioactive fallout had a hundred-fold increase in the risk of developing thyroid cancer.

While nuclear accidents cause some of their greatest contamination and health havoc in the areas of closest proximity, the crisis at the Fukushima nuclear plant in northern Japan has served to remind the public that some radioisotopes, such as radioactive iodine, are extremely volatile and easily become airborne, thrown into the atmosphere by releases of steam from a failing reactor. These plumes of radioactive particles then can travel hundreds of miles, pushed by winds and air currents aloft. This can mean that people hundreds of miles away from a nuclear accident potentially can receive considerable amounts of radiation exposure.

But as savvy as the general public has become about so many aspects of science and technology, it's been baffling to see how little people also seem to grasp the reality that as a radioactive plume drifts, the surrounding air dilutes its radioactive particles. It should be clear that individuals living 200 miles away from a nuclear reactor meltdown will be exposed to much less radiation than those who live 50 miles away.

So to repeat what scientists and public health experts keep saying: The U.S. West Coast is more than 5,000 miles away from Japan's Fukushima plant disaster and the amount of radioactivity that will reach our shores from it will be extraordinary low. It certainly may be detected by our sensitive Geiger counters. But it is highly unlikely that the levels will reach even the minimal amount that can harm people's health here.

A State of Unnecessary Fear
Americans have worked themselves into a panic, however, trying to secure tablets or drops of potassium iodide [KI], which research and experience show to be an effective measure to help protect patients exposed to radioactive iodine from developing thyroid cancer. If the danger were real and concrete, it would be natural for the cautious and wise potentially to want to stock up on potassium iodide. But many pharmacies never carried KI and those that did have run out because of panic buying. The reprehensible market profiteering that is taking place through Internet sites, where KI tablet packs that normally would cost $10 or so in a pharmacy are peddled for the obscene price of as much as $500 each, enhances the perception that one widely popularized potential antidote for the radiation exposure is unavailable. That only heightens the public anxiety.

Government officials and industry leaders, of course, should take their big share of blame for the present fear, with their creation of chronic distrust in their dubious pronouncements before, during and after disasters (think Three Mile Island and Hurricane Katrina). The situation in Japan, as far as the public is concerned, has been made perfectly confused, for example, by conflicting information from Japanese, American and international officials on issues such as how far around the power plant should people be evacuated.

Finally, we have the media, which, with its 24/7 news cycle and speculative commentary in place of genuine and factual reporting, has stoked both fear and frenzy about the Japanese calamity. Some of the reports that I have heard have taken a smidgen of real information and extrapolated it to a fancy far beyond the data. The constant bombardment of updates on the movement of Japan's nuclear plume and overblown reports of radiation detection on the West Coast only serves to frighten, not enlighten, us.

Separating Fact from Fiction
It would be nice if the facts would stop the panic. But I fear that it only will subside when the reactor disaster is over, the radioactivity that is released has been fully dispersed, and the levels of it that do reach the United States are confirmed to have been so minuscule as to cause no health harm. Still, for those who want to take them in, here are facts we know:

  • Some radioactive iodine has been released into the steam coming from the damaged Japanese nuclear power plant
  • At certain levels, radioactive iodine can cause thyroid cancer
  • Potassium iodide tablets and drops can block the uptake of radioactive iodine by the thyroid gland, but they do not counteract the effects of any other radioactive isotopes that are released
  • The amount of radioactive iodine that will reach the United States will be below the amount that has been associated with thyroid cancer
  • KI has potential side effects (see my prior blog post, "A Nuclear Accident Prescription: Why Japan Has Distributed Potassium Iodide Doses")
    • Because of its potential side effects and the minimal radiation (over and above background levels) that Californians and other Americans will be exposed to is well below those that can cause thyroid cancer, taking KI represents all risk and no benefit
    • The government stockpiles KI around the nation in case of nuclear accident or terrorist attack (say, via a "dirty bomb") and these stores will be released, if circumstances warrant. Neighbors of California nuclear power plants already have received KI as part of a Nuclear Regulatory Commission plan to get it to those who might need radioiodine protection the fastest in order to make this available as part of their home emergency kits.

    Is there any prescription for good that can come from all the sound and fury on this side of the Pacific about Japan's nuclear crisis? We should tap productively the heightened public awareness about natural disasters like earthquakes and tsunamis to reexamine and reinforce our emergency preparation at the international, national, state, local, family and personal levels. I also agree with President Obama that we must learn lessons from the tragedy in Japan to scrutinize the safety of our existing nuclear power plants and our emergency preparedness.

     

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