The KI Story


It has been nine years since America felt the consequences of being unprepared for a terrorist attack. It has been eight years since Congress passed a law requiring the country to begin preparation for a nuclear emergency. Five years have passed since Hurricane Katrina, demonstrated the danger of relying on mass evacuations. And in the last few months, the Gulf spill has made us all skeptical of industry assurances that their technologies are so “fail- proof” that no back-up plans are required. Yet despite these failures, our government continues to refuse to implement the easiest method known to protect against radiation exposure – the stockpiling of potassium iodide (KI) tablets for use in a radiation emergency.Today, as was the case nearly ten years ago, we remain a nation at unnecessary risk.

I. The Problem – According to the bipartisan Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, our nation is unprepared for a nuclear emergency. It doesn’t matter whether the cause is the detonation of a nuclear device, a dirty bomb containing radioactive iodine from medical or industrial sources, or an accident or sabotage at one of the 104 nuclear facilities spread over 31 states, the greatest danger would be the threat to millions of people of developing radiation-induced thyroid cancer. Children, pregnant women, and all adults under age 40 are at the greatest risk.

II. The Right Therapeutic Treatment – Fortunately, there is a way to protect the thyroid from this threat. Known as potassium iodide (or KI), this simple, safe, inexpensive, over-the- counter tablet blocks radioactive iodine from entering the body and causing thyroid cancer. FDA has stated unequivocally that KI can provide “safe and effective protection against thyroid cancer caused by irradiation.”  Former Secretary of Health and Human Services, Michael Leavitt, stated without reservation that “[w]e also agree with the National Academy of Sciences conclusions regarding the need for KI” and that there are no “alternative and more effective” measures than these tablets. KI has been used heavily in the past. Millions received the drug following the Chernobyl accident, with studies showing that almost all who took it were protected.  But where KI was not available, thyroid cancer over the next 20 years spiked to epidemic levels, affecting people for hundreds of miles downwind of the release.

III. Congressional Mandate – Congress is aware of the importance of KI. In 2002, it passed the Bioterrorism Act which, among other things, directed the President to create guidelines for stockpiling and distributing KI.  The National Academy of Sciences, in a 2004 report requested by Congress, recommended pre-distribution of KI, local stockpiling outside beyond 10 miles around existing nuclear power plants, the development of national stockpiles, and the creation of a national distribution capacity.

IV. The Bush and Obama Administrations – Unfortunately, neither the law nor the study were implemented. At the urging of the nuclear industry, the Bush Administration chose to ignore the science and decided that a better solution in an emergency would be to conduct a quick evacuation of everyone who might be exposed. Those who could not evacuate would be required to remain indoors, preferably in sealed rooms, and to avoid all contaminated food and water. The feasibility of this approach was not considered, even when it meant that whole cities, like New York, would need to be emptied. Instead, the nuclear industry’s concern that stockpiling KI nationally might erode public confidence in nuclear power overruled the lessons of Katrina. Unfortunately, the Obama Administration has left this policy intact. While acknowledging the importance of KI and noting that “KI decreases the chance of developing thyroid cancer, particularly in children,” HHS Secretary Sebelius has stated that the emergency response plans developed by nuclear power plants which limit KI availability to just 10 miles around existing facilities, are adequate to protect the public. To anyone watching the actions of BP in the Gulf, this reliance on industry assurances sounds all too familiar. Moreover, the Secretary failed to address the possibility that the emergency might be caused by terrorism or a deliberate act of sabotage at a nuclear facility. Consequently, anyone beyond ten miles from a nuclear power plant will be denied the benefits of KI.

V. Nuclear Experts and the 10 Mile Safety Zone – The Nuclear Regulatory Commission (NRC) is fully aware of the need for KI beyond ten-miles. NRC guidelines call for thyroid protective actions in a radiation emergency if levels reach or exceed 5 REM. Yet two Commission studies predict children at a distance of over 100 miles from ground zero could be exposed to radiation levels in excess of 100 REM.8 Other reports provide similar findings. For example, at Chernobyl, 97% of the first 750 cases of thyroid cancer in Belarus alone occurred more than 50 km downwind of the reactor, with the NRC reporting “the vast majority of the thyroid cancers were diagnosed among those living more than 50 km (31 miles) from the site.” The 10-mile limitation also appears meaningless for radiation spread by nuclear weapons. A 26-year study by Brookhaven National Labs found that 1950’s nuclear weapons testing led to epidemic levels of thyroid damage among South Pacific Islanders exposed to fallout from tests that took place 180 miles away.

VI. The Florida Congressional Delegation – Frustrated by the lack of action, thirteen members of the Florida delegation, led by Representative Young (R-FL) and Representative Wasserman-Schultz (D-FL) wrote Secretary Sebelius in June 2010, asking her to reconsider her current position. Among other things, they noted the current policy on KI was not made in accordance with the Obama Administration’s new guidelines for prioritizing medical countermeasures, nor does it address the geographic difficulties inherent in trying to evacuate a state that is a peninsula. HHS sent the letter to the White House’s Office of Science and Technology Policy, where it remains today.

VII. Needed Action – The time has come for the federal government to act to assure that KI would be available if it is ever needed. A KI six-pack, enough tablets to protect an individual on a short-term basis, should be stockpiled in schools, post offices, hospitals or police and fire stations around the country. Long term protection, for individuals located within 200 miles of a radiation release who might be exposed, could be provided by distributing additional tablets from regional stockpiles. The expense would be minimal, especially when compared to the cost of doing nothing. A six-pack of KI tablets costs between $1.50 and $1.80 and has a shelf life of 10 years. The entire nation could be protected at a cost of no more than $40 to $50 million per year over ten years. Following the Three Mile Island nuclear accident, the Presidential Commission that studied the event cited its fear that a failure of the containment building could have led to a “catastrophic” accident. Their report was specifically critical of the fact that although authorities had known of KI’s value for over 25 years, none was available at the time of the accident. As a result, the Commission recommended that “[a]n adequate supply of…potassium iodide for human use should be available for distribution to the general population.”  Today, more than 30 years later, that recommendation remains unfulfilled.

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