Say Yes to Potassium Iodide

By February 14, 2002Potassium Iodide (KI)

By Peter G. Crane, Attorney
Reprinted from the Seattle Post-Intelligencer
Thursday, February 14, 2002

In the wake of Sept. 11, the federal government has taken an important step to improve the protection of the public against acts of nuclear terrorism. Three agencies have played key roles.

The Department of Health and Human Services announced that it was buying millions of doses of the anti-radiation drug potassium iodide, which can prevent thyroid cancer caused by dispersed radioactive iodine. The Food and Drug Administration issued new guidelines calling for more rapid administration of the drug in radiation emergencies.

Finally, the Nuclear Regulatory Commission advised states that free stockpiles of potassium iodide were available to them for the asking.

The crucial factor driving these agencies has been the data on the health effects of Chernobyl. At last count, some 1,800 children in the former Soviet Union have developed thyroid cancer as a result of the accident. Almost all were very young-in the womb or under 2 years old-at the time of exposure. In adults, thyroid cancer is usually slow-growing, but in the Chernobyl children, it has proved to be aggressive. In more than two-thirds of cases, the malignancy has spread beyond the thyroid by the time of surgery. The disease has a long latency period, so thousands more cases are expected in coming decades.

New York, Massachusetts, New Hampshire, Vermont and Maryland have hurried to take advantage of the NRC’s offer before supplies run out.

Washington, on the other hand, has rejected it.

Bob Nichols, an assistant to Gov. Gary Locke, advised the NRC in writing last week that the state did not want potassium iodide, even if it was paid for by the NRC. (Despite the written rejection, state officials claim the issue is still under consideration.) Washington taxpayers will thus be helping to subsidize the protection of children in other states while their own children go unprotected.

Washington’s decision is all the harder to understand in view of President Bush’s disclosure in his State of the Union address that plans of U.S. nuclear power plants had been found in al-Qaida hideouts in Afghanistan. The NRC recently warned operators of all nuclear plants that a captured terrorist had revealed plans to crash an airliner into an American reactor. Though the target was not identified, the NRC did say that on Jan. 23, the FBI had contacted the management of just one plant: the Columbia Generating Station, Washington state’s only operating nuclear facility.

Potassium iodide is a salt: cheap to make, with an almost unlimited shelf life. It is the same chemical used to iodize table salt. (Check the ingredients list on the box in your cupboard.) Its capacity to protect the thyroid derives from the gland’s appetite for iodine in any form-the same trait that puts the gland at such risk from radioactive iodine.

Administering potassium iodide has the effect of saturating the gland with iodine in a harmless form, thereby giving inhaled or ingested radioactive iodine no place to lodge and cause cancer.

The nuclear industry and its supporters have long opposed the stockpiling of the drug, fearing that it will raise public concerns about the safety of nuclear power. They often argue that it protects just one part of the body. True enough-but by the same rationale, you could equally well argue that soldiers don’t deserve to be issued helmets. The thyroid happens to be the most radiation-sensitive part of the body, especially in the young, and nothing is lost by protecting it.

Another argument often made against potassium iodide is that evacuation is preferable. Certainly, evacuation is preferable-if it is feasible.

But sometimes it isn’t. In any case, it’s not an either-or proposition. As the NRC has stressed, the drug is an adjunct to other protective measures, not a replacement for them. Sensible decision makers want to have more options in an emergency, not fewer.

Finally, the claim is heard that potassium iodide could produce a false sense of security, causing people to refuse to evacuate in an emergency. NRC Commissioner Nils Diaz recently ridiculed that suggestion. “Pills or no pills, they’re going to get the heck out of there,” he said.

Washington is not alone in rejecting the NRC’s offer. It shares that distinction with Illinois, which has long fought potassium iodide stockpiling. Illinois argues, among other things, that “loss of the thyroid is not life-threatening,” and that “hundreds of thousands of people live normal, healthy lives without functioning thyroid glands.”

The families of the more than 1,000 people who die of thyroid cancer each year would take issue with that position. Even for the 90 percent or so of patients who survive the disease — so far, I’m one of them — it has major impacts on the quality of life. And speaking as someone who has sat in too many hospital waiting rooms with young cancer patients and their devastated parents, you would not wish any cancer on your child, whether the cure rate was high or low.

Legislation is now working its way through both Houses of Congress to require stockpiling of potassium iodide around every nuclear plant. In the House, the first sponsor was Rep. Phil English, a Pennsylvania Republican. Jim McDermott, a Democrat from Seattle, is a co-sponsor. Another bill is now working its way through the Senate. Washington’s senators should join the list of sponsors. Perhaps Congress can succeed in providing Washington’s children the protection that Gov. Locke and his advisers have spurned.

Peter G. Crane is a former attorney for the Nuclear Regulatory Commission and was a member of the Nuclear Claims Tribunal in the Republic of the Marshall Islands.

This editorial is reproduced courtesy of Peter G. Crane and the Seattle Post-Intelligencer.
© 2002 Peter G. Crane


Potassium Iodide (KI) Information on the ATA Site

Questions and answers about potassium iodide (KI)

American Thyroid Association endorses potassium iodide for radiation emergencies

Web links for important documents about potassium iodide

Web links for state information about potassium iodide