Re: Potassium Iodide -Reply -Reply -Reply

["J. J. Rozental" <josrozen@netmedia.net.il>]

Dear Charlie,


>The WHO also advises the variation of KI intake
>with age, ranging from 100 mg for adults to no more than 12.5 mg for neonates. 

a) There is no change considering  the reference I mentioned in the last e mail:
The WHO Manual on Public Health Action in Radiation Emergencies,
EUR/ICP/EHAZ 94 13/PB (*)

The WHO guidelines for iodine prophylaxis following a radiation emergency
involving the release of iodine isotopes are:

> 12 years.......... 100 mg
3 - 12 years .......  50 mg
1 month to 3 years..  25 mg
< 1 month             12.5 mg (**)

(*) adapted from  WHO Guidelines for Iodine Profylaxis Following Nuclear
Accidents, Environmental Series 35, 1989.
(**) For neonates recommend single dose

>Then there are the practical difficulties of actually administering KI in a
timely
>manner, preferably shortly before the inhalation of the radioactive iodine.  

I agree 100%. However, this is part of the Emergency Planning, and only
training, exercise, and good public communication can minimize all possible
difficulties. Therefore plans need to be made for storage and distribution,
and these plans should include consideration of predistribution of iodine
tablets to individual households with appropriate instructions. By the way,
dealing with emergency in a real scenario is dealing with all kind of
difficulties, specially to those ones that you will not learn in any
literature on Emergency Response.

>Enough said; it is a tricky problem.

Yes, the most important is that the Nuclear World has not been the same
since Chernobyl.

Best Regards,

J.J. Rozental
<josrozen@netmedia.net.il>
Israel



 
At 06:10 PM 7/22/98 -0500, you wrote:
>Dr. Rozental,
>
>You certainly are on target with reference to the WHO Manual.
Unfortunately, the
>problem is not that simple.  In May 1998, the WHO issued a draft revision
of their
>recommendations with significant changes.  Evidently, the WHO realized that the
>NCRP risk estimates for KI were several orders of magnitude low.  The use of KI
>continues to be recommended but with several caveats such as do not give KI to
>people who: are allergic to iodine, have ever had thyroid disease of any
kind,  or
>have dermatitis herpetiformis.  The WHO also advises the variation of KI intake
>with age, ranging from 100 mg for adults to no more than 12.5 mg for neonates. 
>The WHO also advises against the use of KI in the ingestion phase, even though
>almost all the thyroid cancer attributed to Chernobyl occurred outside the
plume
>emergency preparedness zone.
>
>In addition to the WHO warning, medical references such as the Physician's Desk
>Reference say the KI should not be given to people who are taking certain
>medications, such as those containing lithium or potassium, and that taking KI
>concurrent with a potassium-sparing diuretic can lead to cardiac arrest.  
>
>Then there are the practical difficulties of actually administering KI in a
timely
>manner, preferably shortly before the inhalation of the radioactive iodine.  
>

>
>Charlie Willis
>caw@nrc.gov
>
>