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ARCHIVED PAGE- No longer actively updated

States Mull Anti-Cancer Pill for Residents Living Near

Nuclear Plants

Indian Point Nuclear Power Plant, New York City
Source: EPRI

UPDATED FEBRUARY 2003- No longer actively updated as of August, 2006.

As states address ways to protect citizens from new terrorist attacks, policymakers must reconsider scenarios once thought of as only remote possibilities. For citizens residing near nuclear facilities, the possibility of a planned attack has public officials considering ways to prevent radiation fallout from resulting in some forms of cancer.

After the Chernobyl nuclear reactor accident in 1986, health officials observed a 100-fold increase in thyroid cancer among children residing in some areas near the plant rose. Potassium iodide, or KI, has long been known to prevent thyroid cancer if administered within two to five hours of a nuclear release. KI received U.S. Food and Drug Administration approval in 1982 and since then officials from the American Thyroid Association have urged its distribution. It works by filling the thyroid with gland with harmless iodine before radioactive iodine can be absorbed. The pills are believed to offer 24 hours of protection against the harmful exposure. And because thyroid cancer is one of the main causes of death after radiation exposure, especially for young children, officials in many countries now stockpile the drug.

In issuing the new rules, the NRC recognized the importance of state and local governments in the role of emergency planning. As such, the rules encourage consideration, rather than mandate election, of this option. Interestingly, before the events of September 11^th, only four states heeded the NRC's call. Reluctant officials cited swift evacuation as the most effective response to a nuclear incident. Some felt that KI may give citizens a false sense of security in the event of a radioactive release. Also, KI does not protect organs other than the thyroid from absorbing radiation, nor does it protect against radioactive substances other than radioiodine. And finally, like any medication, overdoses of potassium iodide can be dangerous. Some people may experience allergic reactions, including nausea or rashes.

In the aftermath of September 11^th, officials in many states began reconsidering issues surrounding emergency preparedness. Then, in December 2001, the NRC sent letters to the radiation regulatory agencies in the 34 states with populations within the 10-mile emergency planning zone of nuclear reactors reminding officials of the amended emergency planning regulations. As of January 2003, the NRC reports that 17 states (see map) have now requested and/or received potassium iodide tablets. Beginning in June 2003, the newly enacted bioterrorism bill (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) creates a mechanism to extend the radius of distribution to communities within 20 miles of nuclear plants.

Along with the rule change, the NRC will spend $1 million to fund a supply of potassium iodide for states electing to incorporate the drug into their emergency rules. The NRC has ordered approximately six million tablets for distribution. Residents of the states obtain KI through a variety of methods. In some states the drug is distributed directly to residents, other states are stockpiling it. Pharmacists in some states are required to carry the drug.

• Several bills have been introduced in the New Jersey Legislature addressing KI distribution. An Assembly Resolution was adopted in December 2002 asking the federal government to supply KI to all state residents residing within a 50-mile radius of a nuclear power plant.
• Connecticut, California, and Massachusetts all enacted legislation in the 2002 sessions relating to the stockpiling and distribution of KI.
• In January 2003, state health officials in California decided to more than triple the number of KI pills they distribute to residents, making the drug available to anyone who requests them, as well as area visitors.
• The NRC supplied Massachusetts with 550,000 pills and the state became the first in the nation to distribute them. The free pills were first available at local pharmacies in the 17 towns within 10 miles of the Plymouth, Rowe, and Seabrook N.H. nuclear plants, but when few were distributed, the stockpile was recalled to the Health Department. As of January 2003, only about 55,000 pills have been distributed.
• In New Jersey, the Department of Health and Senior Services asked parents of 25,000 children to sign written permission forms for their children to receive KI at school. The state plans to form "mini-stockpiles" of the drug, including an extra supply for schools that will serve as evacuation sites.
• South Carolina is sticking to evacuation as the sole component of the states' emergency plans. Officials there, according to the article, do not believe the limited protection the drug provides is worth the massive distribution effort and the effort could possible delay an evacuation.
• North Carolina officials also preferred to concentrate on evacuation as the most effective emergency plan, but finally after succumbing to public pressure, began distributing the pills in October 2002.

In December 2002 the U.S. Postal Service announced plans to make KI available to its 750,000 postal workers nationwide.

The NRC offers the following information for states considering KI distribution:

• Whether potassium iodide should be distributed to the general population before an accident occurs or as soon as possible after an accident occurs?
• Whether the risks of exposure to radioactivity will be lower if the evacuation of the general population is initiated (with or without the use of potassium iodide) or if the general population is sheltered and the administration of potassium iodide initiated?
• How potassium iodide will be distributed during an emergency?
• What assumptions should be made about its actual availability and use in the event of an incident if potassium iodide is predistributed?
• What medical assistance will be available for the individuals who may have some adverse reaction to potassium iodide?
• How medical authorities will advise the population to take potassium iodide and under what circumstances this advice will be given, e.g., methods for public education, information, and instruction?
• How the authorities will provide potassium iodide to transient populations? *

The American Thyroid Association recommends a 200-mile radius of KI distribution, and therefore favors legislation that further broadens stockpiling above and beyond the 20-mile radius recommended in the newly enacted Public Health Security and Bioterrorism Preparedness and Response Act of 2002. Below is the three levels of coverage recommended by the association:

For further information visit:

Centers for Disease Control and Prevention's National Center for Environmental Health KI website: http://www.cdc.gov/nceh/radiation/ki.htm

CONTACT
Stephanie Wasserman, Senior Policy Specialist, Health Care Program

Return to NCSL Health Home Page

* Browns Ferry Nuclear Plant , Tennessee