[ RadSafe ] Restoration of KI to the Strategic National Stockpile

[Peter Crane]

RADSAFERs may be interested to know that in response to the Fukushima accident, the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE), the group responsible for maintaining the Strategic National Stockpile (SNS), decided in January 2013 to restore potassium iodide (KI) to the SNS.  This decision was communicated to me in an August 13, 2013, email from Dr. Daniel Sosin, Deputy Director and Chief Medical Officer of the Office of Public Health Preparedness and Response in the Centers for Disease Control and Prevention.  

 KI had been added to the SNS after 9/11 but then, amazingly, was removed from it in 2009, and the existing KI stockpiles in the SNS were disposed of as "excess."  The removal of KI from the SNS in 2009 marks the only occasion I know of in the past few years where a conscious governmental decision was made to reduce preparedness for acts of terrorism, whereas everywhere else, preparedness has been on the increase.  It was high time, therefore, that the decision was reversed.

I am trying to find out more about the status of this restoration of KI to the SNS and will keep the list posted.  It is important that not only pills be stockpiled, but also liquid KI, suitable for pediatric administration, since it is babies and small children who are most at risk.  

As the list may be
 aware, EPA is currently accepting comments on its Draft Protective Action Guides
 manual, which has a large section devoted to KI.  I filed comments in July, pointing out that the draft omitted any mention of the central Government document on KI, the NAS study published in 2004.  Likewise, it failed to mention the Nauman/Wolff paper on the use of KI in Poland after Chernobyl.  The seminal study of the safety and health of KI when administered on a mass basis, the Nauman/Wolff paper was the first journal article cited in the Federal policy statement on KI issued in 2002.  In addition, the EPA draft mischaracterized the FDA guidance on counterindications for the use of KI.  In my comments, I wrote that the serious problems in the draft warranted a sixty-day extension of time, to allow the document to get proper scrutiny.  Four days later, Gina McCarthy (then Assistant EPA Administrator, and in the meantime confirmed as EPA Administrator) issued an order extending the comment period by 60 days, to
 September 15.

The problems in the EPA draft suggest that the agency was influenced by those, inside the Government and out, who have long opposed any expansion of KI stockpiling, believing that to have it on hand for radiological emergencies might lead the public to believe that America's nuclear power plants are unsafe.  I think this reasoning is specious.  I've been an advocate of KI stockpiling for many years, as a supplement to other emergency preparedness measures, not a substitute for them.  KI is comparable to the lifejackets on ferryboats:  not likely to be needed, but a prudent thing to have on hand just in case.  Does the presence of lifejackets on ferries scare away passengers?  I can't believe that prepositioned stockpiles of KI, both for accidents and acts of radiological terrorism, would have any significant impact on how Americans regard nuclear power. 

The history of the Federal Government's handling of the KI issue is long and problematic.  My paper on the first 20 years of the process -- from 1978 to 1998 -- was presented at an international conference on radiation and thyroid cancer, held at Cambridge University in 1998.  The conference was co-sponsored by the European Commission, the National Cancer Institute, DOE, and Cambridge University itself.  For anyone interested, it is included in the volume Radiation and Thyroid Cancer, edited by Thomas, Karaoglou, and Williams, and published by the European Commission in 1999.

Peter Crane
Counsel for Special Projects, USNRC (retired)
kinderhook46 at yahoo.com