Prescription for Disaster

If San Onofre is so safe, why are federal officials pushing anti-radiation pills on its neighbors?

Throughout Eastern Europe, thyroid cancer was notable for its absence only in Poland, where the landscape was dotted with Soviet nuclear-production facilities-and their healthy stockpiles of KI. By administering more than 17 million does of the drug, Polish officials were able to prevent any unusual increase in thyroid cancer.

Despite the Chernobyl experience, however, only three U.S. states operating nuclear plants have so far made KI available to the public: Tennessee, Maine and Alabama. The rest, most notably California, have refused to stockpile the drug at shelters-much less distribute it to residents around the state's two nuclear-power plants, Diablo Canyon and the San Onofre Nuclear Generating Station (SONGS). Not even Camp Pendleton-which is less than a quarter of a mile uphill from SONGS-has stockpiled KI.

That may soon change. "Right now as we speak, the Nuclear Regulatory Commission is voting on what the ultimate language of the proposed rulemaking on potassium iodide will be," said NRC spokesman Aby Mohnesni. The phrase "ultimate language" is significant. Last year, the NRC strongly encouraged states to distribute KI to everyone within 10 miles of a nuclear-power plant. That caused an uproar, mostly among the nuclear industry and state, county and local officials who claimed variously that the drug is ineffective and difficult to manage and could interfere with what officials regard as the preferred response to a nuclear disaster: evacuation.

In response, the NRC created a pill-review committee made up of representatives from the Federal Drug Administration (FDA), the Environmental Protection Agency (EPA), and the Federal Emergency Management Agency (FEMA), as well as the three states that already use the anti-radiation pills.

"The experiences of those three states," Mohnesni said, "was that predistribution of KI was not the best way to go." According to case studies gathered by the NRC, some residents in the three states immediately ate the KI pills they'd been given-and then called emergency officials to ask for more. In Tennessee, the NRC found, only 15 percent of the public showed up to claim their supply of the emergency pills, even after they had been advertised on local television and radio. Understandably gun-shy, Mohnesni says the NRC will simply recommend that states make KI available to the public without telling them exactly how to do it. "That's the kind of language that comes out of here," he said. "We're not going to say, 'You should have potassium iodide.' It's going to be up to the states to decide."

But state officials say it's not their decision. "The folks who really get to decide if KI is going to be implemented are at the local level," said Steve Woods, a senior health physicist with the California Department of Health Services (DHS).

Underlying the complex discussion about KI's utility is one simple point: its critics say KI doesn't work-or doesn't work frequently enough-and that dispensing it broadly before an accident would lull a power plant's neighbors into a false sense of security. "KI is not a panacea," Woods said. "It is only useful against one isotope. If you have a leak that isn't iodine, KI won't help you. Nor will it if you take it an hour or so after you've been exposed."

"The thing to remember about KI is that it only protects against inhaled radiation, not external radiation," added Dr. Deborah Gillis, an official with the DHS' environmental-health investigations branch. In the Chernobyl incident, Gillis said, most thyroid-cancer victims were contaminated after eating radioactive food-not because they inhaled particles of radioactive iodine. "The KI would only protect against what you inhale, not what touches your skin. It's estimated that the risk of getting cancer from external exposure to radioactive iodine would be greater than inhalation."

"That's why it's best not to be in the [radiation] plume at all," Gillis concluded. "KI only has a very small potential to prevent cancer. Getting people out of the path of the plume is much more important."

Officials argue against KI's effectiveness as a precursor to their preferred option: total evacuation of everyone in the path of "the plume." To that end, Gillis argued, distributing KI to individual households may only confuse an already hectic situation. "What if people aren't at home when the emergency happens?" she asked. "Will they go back home to get their pills instead of evacuate? What about the people who are allergic to KI? Do you try to segregate evacuees into allergic and non-allergic groups in the middle of an evacuation?"

As another official described the dilemma, "Handing out medication during a nuclear emergency is not a normal procedure."

"That's nonsense," says Osibin. "The state of California says it doesn't recommend that KI be made available to residents because it would interfere with an evacuation, which is nonsense in our case. There are only two evacuation routes out of here." Osibin points out that a general evacuation of the Diablo Canyon area would take between 18 and 24 hours. From Osibin's perspective, anything that could be done to protect residents during that crucial period ought to be done. As he puts it: "How would providing us with KI interfere with an evacuation that slow?"

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