ML20210S967

Comment on Proposed Rule 10CFR50 Re Stockpiling of Ki.Pros & Cons of Stockpiling or Predistribution of Ki to Households Difficult to Assess & There Will Be two-year-trial Period in Connecticut to Address Practical Issues Involved

ML20210S967
Person / Time
Site:	Millstone
Issue date:	08/06/1999
From:	Walterspiel J AFFILIATION NOT ASSIGNED
To:	NRC OFFICE OF THE SECRETARY (SECY)
References
FRN-64FR31737, RULE-PR-50 64FR31737-00011, NUDOCS 9908180249
Download: ML20210S967 (5)

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Juan N.Walterspiel MD FAAP

?) AU316 P4 :29 18 Rose Lane East Lyme CT,06333 Cr Tel/ Fax (860) 739 7614  %

E' E mail: WADBC@ aol.com 8-6-99 Secretary, US Nuclear Regulatory Commission Washington DC 20555-001 Re: Comments on KI

Dear Sirs,

Enclosed my comment and suggestion on the issue of KI.

Sincerely, n N.Walterspiel MD FAAP

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<O 9908180249 990806 64 31737 PDR u

EMERGENCY POTASSIUM IODIDE FOR DAY-CARE.

KINDERGARTEN AND SCHOOLCHILDREN One of the mailings we have received is the official booklet describing emergency evacuation plans and instructions for our families in case of an accident at NU's Millstone nuclear power plants. I Newspaper articles on whistleblowers, crowded storage tanks, valves, C-clamps, terrorists and the faneliar view of nuclear submarines on the Thames River, seem to suggest that a responsible approach is to never assume never.

This view has recently been supported by the Nuclear Energy Advisory Council. Some of the short-lived radioactive fission products that are I.

released into the atmosphere during nuclear accidents are iodine isotopes. These radioactive iodine isotopes are quickly taken up by the human thyroid gland, where they deliver a concentrated radiation dose.

Observations in populations exposed in Nagasaki and Hiroshima, downwind of nuclear tests on the Marshall Islands, and in Eastern Europe after the Chernobyl disaster proved repeatedly that thyroid abnormalities and thyroid carcinomas were induced and occurred years later.

This was ma t pronounced in children who were under the age of ten at the time of uposure.

A way to prevent this is the immediate ingestion of small and non-toxic amounts of the salt potassium iodide. abbreviated KI where K stands for potassium and I for iodine.

The timely ingestion of non-radioactive iodine fills (saturates) all the storage sites in the thyroid gland. Any radioactive iodide that is ingested or inhaled thereafter is excreted in the urine.

Nuclear plants, ships, and submarines, as well as some neighborhoods of nuclear plants in Europe are stocked with potassium iodide tablets.

Single doses were given to 16 million persons in Poland after the Chernobyl accident with only rare occurrence of side effects. This preventive measure resulted in a calculated reduction of 40% of the projected thyroid radiation dose.

The dose of potassium iodide that is effective in case of an accident is :

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! l l-130 mg/ day for adults and children,65 mg/ day (1/2 of 130 mg ) for infants, and according to safety experiments done in chimpanzees,100 mg/ day for pregnant women.

l KI tablets can be stored for prolonged periods of time when kept dry.

This is accomplished by using tightly sealed containers. KI tablets can

also easily be dissolved in milk or orange juice for administration to small children.

A protective dose should be given as soon as possible and before an

, anticipated exposure.110 wever a period of within two hours is still considered to offer significant protection and periods of up to 4 hours4.62963e-5 days <br />0.00111 hours <br />6.613757e-6 weeks <br />1.522e-6 months <br /> ,

still offer a 50% blocking activity. I Acute allergic reactions do not occur as KI is a salt whose two components, a potassium ion (K) and an iodine ion (I) are natural constituents of the human body.

Untoward and non lethal effects to a single dose have been estimated to occur in less than one in ten million. q The population should also be made aware that the risks in delaying any

ordered evacuation in order to individually obtain KI by far outweighs the potential benefits.

I A household distribution experiment around the Sequoia nuclear plant in Chattanooga TN showed that the population was willing and able to understand this issue without widespread mistrust against the nuclear

! industry or the military.

The pros and cons of stockpiling or predistribution of potassium iodide to households are difficult to assess and there will be a two-year trial period in Connecticut to address the practical issues involved.

Because the highest protective effect would be in children, we should explore the possibility of having a single dose available for our children at their respective day care centers, Kindergarten and schools first.

Official authorization to administer such a timely and virtually side effect-free first dose would require only a minimum amount of reliable

f assessment of the estimated magnitude of release during an ongoing accident.

Further decisions on the necessity of subsequent doses can be then be made when details are known and once the areas of precipitation have been mapped.

The experience in Eastern Europe has shown that areas of radioactive precipitation can he spotty and that precipitation certainly will not follow neat 5,10 or even 20 mile circles around the source (s) of release.

7 Juan N.Walterspiel MD FAAP lives in East Lyme and has three children in the school district. He is a faculty member ( Assistant Clinical Professor )of the Department of Pediatrics at Yale. Opinions stated in this article are his own.

Literature reviewed:

Protection of the thyroid gland in the event of release of radioiodine.

Recommendations of the National Council on Radiation Protection and Measurements. NCRP Report No.55. 7910 Woodmont Ave. Bethesda, MD 20814 August 1,1977 and March 31,1991

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Becker DV, Zanzonico P. Potassium iodide for thyroid blockade in a  :

reactor accident: administrative policies that govern its use. Thyroid 1997,7:193-197 Crocker DG Nuclear reactor accidents- The use of KI as a blocking agent against radioiodine uptake in the thyroid - A review. Health Physics 1984; 46: 1265-1279 l

Lewinski A, Swietoslawski J, Wajs E et al.

[ Effects of prophylactic doses of potassium iodide on the course of thyroid diseases ( 1986-1990) diagnosed due to the atomic accident at Czernobyl in adult patients at the outpatient endocrinologic hospital clinic in Lodz l Endokrynol Pol 1991;42: 321-351 1

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Halperin JA Potassium iodide as a thyroid blocker- Three Mile Island to day. DICP 1989; 23: 422-427 Noteboom JL, Hummel VA,Broerse JJ et al. Protection of the maternal and fetal thyroid from radioactive contaminatian by the administration of stable iodide during pregnancy. An experimental evaluation in chimpanzees. Radiation Res 1997; 146: 691-697 Fowinkle EW, Sell SH,Wolle RII . Predistribution of potassium iodide-The Tennessee experience. Public Health Rep. 1993;98: 123-126

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