American Thyroid Association Endorses Potassium Iodide for Radiation Emergencies
November 7, 2001; most recent update July 24, 2002
This statement is supported by the American Association of Clinical Endocrinologists, the Lawson Wilkins Pediatric Endocrine Society, and the Thyroid Foundation of America.
The American Thyroid Association (ATA) endorses the use of potassium iodide (KI) to protect people from absorbing radioactive iodine released during a nuclear emergency. High levels of radioactive iodine exposure can cause thyroid cancer, especially in babies and children up to 18 years of age. KI reduces the risk of thyroid cancer in exposed populations. ATA advocates KI as an essential adjunct to evacuation, sheltering, and avoiding contaminated food, milk, and water.
In December 2001, the U.S. Nuclear Regulatory Commission wrote to the 34 states that have or are located within 10 miles of a nuclear power plant, offering two free KI pills for every person living within 10 miles of a plant. 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. As described below, ATA recommends a 200-mile radius of KI distribution, and therefore favors legislation that further broadens stockpiling.
No one can predict how far radioactive iodine might spread after being released in a fallout cloud from a nuclear power plant during an accident or attack. Thus, no one can predict how far from a nuclear plant the government should distribute KI if it is to protect every person who might be exposed to radioactive iodine. Because there is no right answer, ATA recommends three levels of coverage, determined by distance from the nuclear plant:
|1||0-50 miles||Distribute KI in advance (“predistribute”) to individual households, with extra stockpiles stored at emergency reception centers|
|2||50-200 miles||Stockpile KI in local public facilities such as schools, hospitals, clinics, post offices, and police and fire stations, for distribution upon notification by local health officials|
|3||>200 miles||Make KI available from the Department of Health and Human Services’ National Pharmaceutical Stockpile|
ATA supports the Food and Drug Administration’s dosage guidelines for KI. ATA believes that only city and state health authorities can recommend when to take KI and how much to take. Not every radioactive release includes the radioactive iodine that can cause thyroid cancer, and KI cannot protect against absorption of any materials besides radioactive iodine. Only health officials can determine which isotopes are released during a nuclear event, and, if radioactive iodine is released, what is the safe and effective dose of KI to take.
The logistics of effective KI stockpiling, distribution, and use are still being worked out. The agencies that distribute KI should be responsible for providing instructional materials and programs that explain how to use the pills and the reasons why they must be used as directed.
In sum, the American Thyroid Association recommends that:
- Potassium iodide should be part of an emergency plan that includes evacuation, sheltering, and avoiding contaminated food, milk, and water
- Highest priority for potassium iodide use and all other emergency measures should be given to babies, children up to 18 years of age, and pregnant women.
- Potassium iodide should be made available to populations living within 200 miles of a nuclear power plant
- Potassium iodide should be “predistributed” to households within 50 miles of a plant
- Potassium iodide should be used only under regulatory guidance
Editorial: “Say yes to potassium iodide,” by Peter G. Crane, reprinted from the Seattle Post-Intelligencer, February 14, 2002