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Re: Public Potassium Iodide Information



PA Milligan,
Thank you for taking the time to share your comments.
As mentioned in my original e-mail; "I'm eager to modify 
and 'fine-tune' it, wherever indicated."

That's why I 'hung it out here' in this forum...to be critiqued.

My response to, and future FAQ modifications based on, your 
comments follow below...

At 03:00 PM 11/1/99 -0600, you wrote:
>some comments on your web site:
>    
>   1) Iodine is one of many radioactive isotopes released 
>during a nuclear power plant accident or nuclear weapons 
>detonation, KI is effective only against internally 
>depositied radioactive iodine.    Your web site implies 
>that radioactive iodine is the major component of concern. 

The site is focused on KI and how it might help protect one 
from radioactive iodine. It's beyond its scope to attempt to 
explore other 'components of concern'.

However, I do state, in two different locations on that 
single page, that make it clear that radioiodine is not,  
and should not be considered, the only concern...

"It should be noted that you may also be directed to evacuate 
the area altogether well before you exhaust your KI supplies, 
and should immediately do so if directed, both because of 
persistent radioiodine and other additional, and very 
dangerous, radioisotope fallout contaminations in that area."

...and this...

"There are also many other very dangerous radioactive isotopes 
that can be released during a nuclear emergency for which 
immediate or subsequent evacuation could be declared, and 
should be immediately heeded, regardless of radioiodine presence."

>In fact as seen at the TMI-2 accident, the amount of noble 
>gases released was about 650,000 times as much as the amount 
>of radioactive iodine and KI doesn't protect you against noble gas >exposure.
>   2) the amount of radioactive iodine released at TMI was >trivial...about 15 curies.  The maximum iodine concentrations 
>in Poland were significantly less than the current 10 CFR 20 
>effluent release limits.  In order to cause thyroid cancer, 
>there must be enough iodine, additionally,  Poland  interdicted 
>food and milk supplies. and the authorities in Poland also only 
>recommended one dose of KI.  Your web site suggests that the 
>reason the Polish people didn't see the same increases in 
>thyroid cancer is because of KI.... and that's not the whole 
>picture...selective reporting like this is irresponsible.  
>(and I'm assuming that you  are trying to be responsible).

That's a point well taken, about the Polish experience, and I'll 
incorporate that into the next revision. (Probably within 48 hours.)

>   3) the FDA is revising the KI guidance..  World Health >Organization recommends only 12.5 mg to neonates and infants, 
>has a step increase in doses  by age. Safety beyond single 
>doses is unknown.  Poland implemented the above mentioned 
>WHO  KI guidance.  WHO also recommends that individuals over 
>45 do not take KI....as their risk of thyroid cancer is 
>essentially zero.

I was aware of the WHO recommendations, but chose to reprint 
the FDA KI 'patient product insert' in its entirety instead. 
After it I mention that "...the FDA is also considering 
reducing the amount of the dosage...". I wasn't too keen to 
go further than that and get out ahead of current, and accepted, 
FDA guidelines.

However, also sharing the WHO recommendations there, alongside 
the FDA insert, is a good idea and will be incorporated, too.

>    4) at each nuclear power plant, there is an emergency >notification siren system to alert citizens to a general 
>emergency condition at a nuclear power plant.  local officials  
>will be notified and will notify citizens.  It is somewhat >irresponsible to suggest to people that they scan radio 
>transmissions between workers at power plants and then drawn 
>their own conclusions from these discussions.  You my end up 
>with a lot of people sitting with their fingers on the "KI" 
>button and ingesting KI when it is not needed or administering 
>it to their children when it is not needed.   The safety of 
>multiple doses of KI has not been established, especially in 
>young children.  As the FDA will tell you, because a drug is 
>sold over the counter doesn't mean that it is free from side 
>effects.

If I could be convinced, that at the onset of a nuclear power 
plant emergency, that no employee there with family downwind, 
would ever think to call home, but would instead rely on the 
sequence of public notifications above to unfold and alert 
their loved ones to evacuate, then I could delete that whole 
section.

>    5) because there is an alert, unusual event , site area >emergency  or even general emergency at a nuclear power plant 
>does not mean that radioactive iodine will be released, it does 
>not mean that any effluents will be released. 

I don't say otherwise. I'm telling people to be alert and make 
use of any contacts or information sources they can develop to 
stay abreast of any future developing emergency situations.

But, I agree, including a statement, such as yours above, would 
better assure that that point had gotten firmly across. I'll add 
it.

>    6) IT IS IMPORTANT TO STRESS THAT THYROID BLOCKING BY 
>KI HAS LIMITED EFFECTIVENESS, KI IS NOT A  MAGIC "RADIATION 
>PILL" (as has been reported in popular media).  KI is 
>effective only when ingested within 6 hours of radioactive 
>iodine exposure.  It is possible to contract thyroid cancer 
>even if one has ingested KI , since the thyroid gland is 
>susceptible to the effects of external exposure of radiation 
>and KI won't  block the thyroid gland from external radiation 
>exposure. 

I totally agree that there is a need for factual, publicly 
disseminated, information on KI. That was the original point 
of developing the KI FAQ page, to begin with. And, my 
eagerness to invite critical reviews of it here to assure 
it becomes as accurate, comprehensive, and useful as possible.

I'm not adding to any notions of KI being a 'magic pill'. 

Early on near the top of the KI FAQ page I carry this 
quotation from Cresson H. Kearny, Research Engineer Retired, 
Oak Ridge National Laboratory; "There is no medicine that 
will effectively prevent nuclear radiations from damaging the 
human body cells that they strike."

That seems clear to me, and all inclusive.

Also, the other two statements I referenced above at the top 
here, about "...other very dangerous radioactive isotopes..." 
for which evacuation may be necessary, also don't have KI 
sounding like much of a 'magic pill' here, either.

>   7)Concerned citizens should consult their doctors prior 
>to ingesting KI.  This is especially important when dosing 
>children.  

Immediatly following the reprint of the entire FDA KI 'patient 
product insert' on the FAQ page, I make this statement; "One 
additional precaution you might want to consider as prudent, 
if you are already on any continual medications, is to check 
with your doctor and/or pharmacist and inquire whether there 
is any possibility of any adverse reactions if you had to also 
begin taking KI, too. (Especially with any lithium based or 
potassium-sparing diuretics.) Better to find out now, rather 
than risk hesitating later or possibly suffering an adverse 
reaction."

However, I agree with you, this could be further expanded to 
include suggesting everyone checking with their doctors first.
I'll incorporate that, too.

>  Additionally, you  should list your name, experience and >credentials on your web site.  Since you are so freely 
>dispensing advice it would be useful for people to have a 
>gauge as to the credentials of the author.  You have 
>interpreted and quoted many sources...an complete bibliography 
>of your sources would also be useful

I agree, look for it in the next rendition.

Thank you for reviewing the FAQ page and sharing your comments 
and suggestions here. If you have any additional resources you 
think are pertinent, and could point me to them, please do so.

Thanks again,
Shane Connor

>Just my thoughts only.  
>
>    PA Milligan, CHP
>
>
>>>> Shane Connor <shanec@gvtc.com> 11/01 2:56 PM >>>
>Radsafers,
>
>Recent growing public interest in KI, fueled by NRC discussions 
>and media coverage of it, along with Y2K concerns of increased 
>nuclear accident and/or terrorism vulnerabilities, has pointed 
>up the lack of reliable KI information, readily accessible by 
>the public. 
>
>As an initial draft to bring together on one FAQ page the 
>answers to the typical questions the general public might ask, 
>I recently put up the Potassium Iodide Radiation Protection FAQ.
>
>http://www.ki4u.com/ 
>
>This is an ongoing research project that I am committed to 
>assuring is both accurate and comprehensive with practical 
>KI information appropriate for the general public.
>
>However, I admittedly do not possess the credentials, 
>nor the experience, of many regulars here on this list. 
>
>Before this FAQ possibly has a wider net audience, I am 
>inviting comments and/or suggestions from any here who are 
>so inclined to review it and share their thoughts.
>
>This KI FAQ page holds the potential to do much good, but 
>not if it inadvertently propagates anything potentially 
>misleading or, by omission, fails to tell the 'whole story'.
>
>I'm eager to modify and 'fine-tune' it, wherever indicated.
>
>I appreciate and look forward to any and all critique offered, 
>either here at RADSAFE or via my e-mail at webmaster@ki4u.com.
>
>Best Regards,
>Shane Connor
>
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The RADSAFE Frequently Asked Questions list, archives and subscription
information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html