ML20205L071
| ML20205L071 | |
| Person / Time | |
|---|---|
| Issue date: | 03/03/1999 |
| From: | NRC |
| To: | |
| References | |
| NUDOCS 9904140123 | |
| Download: ML20205L071 (137) | |
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OFFICIAI TRANSCRIPT OF PROCEEDINGS I
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Title:
POTASSIUM IODIDE (KI) l t
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- DATE: .'W ednesday, March 3,1999 PAGES: 360 - 494 l l 75 " .
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l 360 1 UNITED STATES OF AMERICA 2 NUCLEAR REGULATORY COMMISSION 3 ***
j 4 POTASSIUM IODIDE (KI) CORE GROUP MEETING 5 AmeriSuites Hotel 6 1520 West Baseline Road 7 Tempe, Arizona 8 Wednesday, March 3, 1999 9 The above-entitled meeting commenced, pursuant to 10 notice, at 9:00 a.m.
11 PARTICIPANTS:
l 12 ABY MOHSENI, Chairman 13 BILL MCNUTT 14 MARCIA CARPENTIER
( 15 JIM HARDEMAN l 16 ANDY SIMPSON 17 AUBREY GODWIN 18 JOELLE KEY 19 MIKE CASH 20 TONY SHERIDL 21 MIKE NAWOJ 22 ANDREA PEPPER 23 MIKE JAMGOCHIAN 24 BILL WILDS 25 O ANN RILEY & ASSOCIATES, LTD.
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361 1 PROCEEDINGS 2
t (9:00 a.m.]
3 CHAIRMAN MOHSENI: Yes.
4 MR. GODWIN: Yesterday you asked a question about, 5 did I recommend the medical personnel pass out the Tennessee 6 med act? I think I'd recommend it but I don't want that ,
7 implied that I was saying you necessarily had to do it that 8 way. Been thinking about some of the comments that was 9 made.
10 MR. SIMPSON: Well, I think your comment was you 11 preferred it.
12 MR. GCDWIN: Yeah.
33 MR. SIM' SON: It was surely not a pro-scription or 14 a prescription.
() 15 MR. GODWIN: Yeah, I want to make sure that I 16 .:asn't leaving a -- that it had to absolutely be with 17 medical personnel. But I do think it's better if you have 18 it, I think. People just relate better.
19 CHAIRMAN MOHSENI: And that would be a policy 20 issue for the states and local governments to decide on.
21 And, you know, FDA's position would help to support which 22 way you all want to go if you chose.
23 MS. KEY: Well, I just wanted to say, my -- I've 24 seem a little bit not supportive of the Tennessee position 25 and what I'm not supportive of is when I've went and ANN RILEY & ASSOCIATES, LTD.
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i 362 1 investigated it, I was very surprised to find out that there O
Na/
2 was no plan, that there was no organization. That there was ;
l 3 a lot of well, this organization thinks that organization is l
4 taking care of it. I've been disappointed in the way it's 5 being handled, I'm not disappointed that we're doing it. I 6 don't think we can back out at this point for a lot of i
i 7 reasons.
8 CHAIRMAN MOHSENI: Any member of the public with 9 any comments before we start? Good, thank you.
j 10 Mike, I think it's you.
- 11 MR. CASH
- Okay, we'll talk a little bit about 12 Alabama's use of KI. I don't know how many have read what I 13 have submitted before. There were some typos that need to l 14 be corrected and we will talk about that as we go along.
() 15 16 I think the simplest way is for me not to, meaning to bore you but to probably read this because I think it 17 will answer many questions that we won't have to have 18 brought up if we go through this pretty much the way -- show 19 the evolution of where we came from in Alabama, how we got 20 to where we are and what our current plan is. '
21 The initial information that I'll be giving you 22 was adapted from a presentation entitled, " Potassium iodide 23 use in Alabama". Which was prepared by Jim McNeese (ph) of 24 our office of radiation control in Montgomery. And he 25 presented this in January 1982 at a workshop on the O, ANN RILEY & ASSOCIATES, LTD.
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363 1 technical factors relating impacts from reactor releases to
() 2 3
emergency planning which held in Bethesda, Maryland.
that was in January of 1982.
Again, 4 A little bit of the background information; the 5 United States Food and Drug Administration requested 6 submissions of new drug applications for potassium iodide in 7 December of 1978 Federal Register. This was followed by a 8 revision of FDA labeling guidance published for KI in the 9 Federal Register and on August the 17th of 1979. By January 10 of 1980 state agencies were receiving prices and conditions 11 of sale for Thyroid Block TM, potassium iodide from Carter 12 Wallace, Incorporated. The advent of an approved supplier 13 of thir drug for radiciodine protection c rried with it the 14 necessity of a decision of how the drug would be used.
() 15 In January 1980 FEMA and NRC published New Reg 16 0654 for comment and interim use. This document required i 17 the state i.nd local emergency plans to address provision for 18 the use of radio protective iodine -- or radio protective 19 drugs for emergency workers. In November of 1980 Revision 1 20 of New Reg 0654 expanded the KI provisions to both emergency 21 workers and institutional individuals.
22 Now, the Alabama plan, early version -- and you 23 will see there has been some evolution in this -- because of ,
i 24 time considerations, climate and other reasons, the state of l 25 Alabama decided against having advanced distribution of
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364 1 potassium iodide to the general-public, would establish'ed a 2- mechanism for possible distribution to emergency ;orkers, 3 non-transportable indiviluals and selected general public 4 evacuees.
5 The state of Alabama decided to make provisions 6 for possible distribution of KI to number one, emergency 7 workers who may be required to enter the evacuation area.
8 Number two, certain institutionalized individuals and number 9 three, selected general public evacuees who may have 10 received radioiodine exposure during evacuation. Issuance l
11 of the drug would be made after the recipient signed an 12 informed consent statement.
13 The climate in Alabama is such that roadways are 14 seldom impassable due to weather conditions. Nor is serious
() 15 traffic congestion anticipated near either of the nuclear 16 power plants in Alabama.
17 Here's where I've made some changes in this next 18 sentence. During an emergency evacuation, evacuees from the 19 general public were projected to have received an exposure 20 to radiciodine that corresponded to a child's thyroid dose l 21 in excess of 10 rads, provisions would be made for l
22 distribution to KI to these evacuees upon their arrival at l
l 23 the reception centers. The drug would be ordered for 1
24 arriving' evacuees according to evacuation sectors. The 25 evacuees would be issued informed consent forms and upon l
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365 1 signature of signing would be provided sufficient bottles of I
2 KI tablets for three day's dosage for each member of the 3 family.
4- After extensive consideration of the matter, the l
5 Alabama Department of Public Health decided not to have 6 advanced individual home storage of KI for the following l
7 reasons: KI was packaged in bottles containing 14 tablets, j 8 therefore, each member of the family would not have their l 9 own supply; potassium iodide has a three-year expiration 10 date and must be kept up to date; administration of KI is 11 not appropriate if radioactive iodides are not being 12 released; some persons may take the KI and assume that they 13 are safe when, in fact, they should be evacuated. It is I
14 possible that many families would misplace or lose their KI f) 15 16 prior.to the time of need and there was no way to have advanced distribution of the medication to all groups, such 17 transients and other visitors..'
18 This next little bit is about public perception.
19 CHAIRMAN MOHSENI: Can I ask a question.
20 MR. CASH: Sure.
21 CHAIRMAN MOHSENI: Your first sentences, because 22 of time considerations. Where was the time considerations 1
23 here? You said because r* time considerations you chose not i 24 to pre-distribute.
25 MR. CASH: This, again, it was written by one of ANN RILEY & ASSOCIATES, LTD.
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366 1 my good friends, Jim McNeese, and I don't know what the time
(~N 2 considerations were. Aubrey was there at the time as the 3 director so he might could answer that question.
4 MR. GODWIN: It was considered that we could get j 5 it delivered to the potential patients in a timely manner, 6 we didn't have things to block it, block the traffic, so the I
7 evacuation times were in the order of two hours to three 8 hours9.259259e-5 days <br />0.00222 hours <br />1.322751e-5 weeks <br />3.044e-6 months <br /> there. So we could deliver it in a timely manner.
9 CHAIRMAN MOHSENI: Okay.
10 MR. GODWIN: So that was the time consideration.
11 It was not, as I understand it in Tennessee, you all do have 12 some congestion problems in yours, don't you, c
13 MS. KEY: Near Sequoia 14 CHAIRMAN MOHSENI: Okay, what -- l
() 15 MR. GODWIN: So there's a difference between 16 Tennessee and Alabama in that regard. '
17 CHAIRMAN MOHSENI: You know, initially when I read .
18 this, I got the impression that it would take too long to 19 pre-distribute and therefore, they decided not to.
20 MR. GODWIN: The time was how quick you can get 21 people in to deliver this.
22 CHAIRMAN MOHSENI: Okay. Mike may want to then 23 add a footnote and just clarify.
24 Mr. . CASH: I may change -- yeah, okay, clarify 25 that. Okay.
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l 367 1 This next is a little editorial comment but --
2 CHAIRMAN MOHSENI:
( And why did you chose 3 three-day's dosage?
4 MR. CASH: Aubrey? I was not at this time, okay.
5 MR. GODWIN: Because we felt like if we needed to 6 go longer we could get supplies from elsewhere.
7 CHAIRMAN MOHSENI: But here you have what, one 8 day, the sa.me person --
9 MR. GODWIN: Actually, we have two days.
10 CHAIRMAN MOHSENI: Any significance to that? The 11 difference two versus three?
12 MR. GODWIN: Well, you know, in Alabama, we felt 13 you could get it in at two days, actually felt that the 14 federal support would be there at two days and we were
() 15 demanding KI would a part of the incoming packages. Three 16 days was just to make sure.
17 CHAIRMAN MOHSENI: Okay, but certainly not 10 18 days. You've moved away, both states -- or three states now 19 --
20 MR. CASH: Well, this is the early plan now, it's 21 not the final plan. l 22 CHAIRMAN MOHSENI: Ah, got you, sorry.
23 MR. GODWIN: Yeah, yeah, that's right.
l
- 24 MR. CASH
- It changes later.
[ 25 MR. GODWIN: It changed.
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368
! 1 CHAIRMAN MOHSENI: Okay.
l l 2 MR. CASH: What the public perceives as a hazard
)
3 often has greater impact on government than the actual I i
4 hazard itself. Provisions were made by many states for the 5 use of KI for emergency workers and institutionalized l
l 6 individuals. The state of Tennessee distributed KI to 7 individual homes near the Sequoia (;ph) Nuclear Plant. These 8 events generated media attention. Public opinion had 9 significant impact on whae provisions the state made to 10 utilized radio protective drugs.
11 Government by the people will give the people what 12 the people believe they want regardless of scientific j 13 opinion. Okay, now this editorializing on the part of Jim 14 McNeese but it seemed it was pertinent to how we got where
( 15 we were. The population is or was, okay, depending on the 16 government to make every reasonable effort to protect them 17 from the perceived hazards of nuclear power plants.
18 In Alabama many of the general public that the 19 potassium iodide distributed by the state of Tennessee was 20 an effective preventive for the consequences of a nuclear 21 plant accident. If the state of Alabama had not made KI 22 available, the state would have been viewed by many citizens 23 in the Tennessee Valley, which is the northern part of l
24 Alabama, as guilty until proven innocent of denying the 25 public an effective protective measure. Indisputable ANN RILEY & ASSOCIATES, LTD.
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i 369 1 findings against the potential iodine release and a definite
{
2 no to the potassium iodide by the federal agencies would be 3 necessary to reverse this view. This information, again, 4 was all from Jim McNeese and this was back in 1982 when this
- 5 presentation was made.
l 6 Any questions on that part of it?
l 7 Now, the following information has been adapted l 8 from the FDA final recommendations.
l 9 CHAIRMAN MOHSENI: Let me ask you --
10 MR. CASH: Yeah, sure.
l 11 CHAIRMAN MOHSENI: Yeah, the question, you say 12 questions. Is this still a valid position?
l 13 MR. CASH: Again, this was at that time --
14 CHAIRMAN MOHSENI: It'n not qualified as being
() 15 "that time". It basically has a present tense.
( 16 MR. WILDS: I would say yes.
l 17 CHAIRMAN MOHEENI: Pardon?
18 MR. WILDS: This last paragraph.
19 CHAIRMAN MOHSENI: Uh-huh.
l 20 MR. WILDS: Getting down to actually the last l
l 21 sentence.
22 CHAIRMAN MOHSENI: Uh-huh.
23 MR. WILDS: I would say that, yeah, that's good l
24 enough. That's what we're thinking.
25 CHAIRMAN MOHSENI: Historically, did you move away O '
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E 1 i
i 370 1 from -- this is a paper wrote by someone, right?
2 MR. CASH: Right.
3 CHAIRMAN MOHSENI: What I'm asking is that the 4 concepts in this paper, is this still pretty much what you L 5 would advocate for other states to also -- you know, this is I 6 how you all think that government should do everything they 7 can and that, of course, the reversal of the potassium 8 iodide requires a very high threshold. The last sentence.
9 MR. CASH: It does require a high threshold, you 10 know.
11 CHAIRMAN MOHSENI: Yeah.
12 MR. CASH: For us to go back and say, okay, we're 13 not going to protect you as much as we have in the past is 14 going to be a bad perception, I believe. If people -- we
-s
) 15 don't people screaming, saying, hey, don't give us KI. Or J
16 we don't have people screaming to give us KI. They're very 17 -- feel comfortable around the nuclear power plar.t in most 18 cases, there.
19 CHAIRMAN MOHSENI: And -- correct. And you say 20 that the general public believe that the KI distributed by 21 the state was an effective preventive. Did this come as a 22 result of public education or just this was just baseline 23 knowledge that the public had. How's the public different 24 in your state with so much more -- it seems like they had 25 already formed an opinion. Was it based on public education t
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371 1
1 or what?
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[dN 2 MR. CASH: Some of it was probably on public 3 information from the newspapers and such or TV, perhaps, 4 even at that time. I would guess.
l \
5 MR. GODWIN: There was no elaborate public j 6 education program initiated by the department or utility, 7 anybody else. It was in the plan that it be made available.
8 Any kind of a questions came up, it was answered. Not many l 9 came up. It was made aware that in Tennessee that they had 10 pre -- advanced distributed them to the homes and so it was 11 not -- it was really a non-issue.
12 CHAIRMAN MOHSENI: Did you have public meetings 13 where the questions did not come up or anything?
14 MR. GODWIN: There was very few -- there was f 15 really no quote "public meeting" in the sense that you'd 16 normally think of it. There were a lot of meeting in which 17 agencies with members of the public would get together and ;
l 18 talk about how the plan was going to work. And you have the i 19 overall general one public meeting that's required on the 20 emergency plan at the plant. That was done. And I don't 21 even remember any specific questions coming up about KI at 22 that particular meeting.
23 But there was a lot of small meetings that went on 24 between the agencies and members of the public and the 25 agencies themselves constitute a part of the public in terms
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r 372 1 of getting educational information out. But there's no
(} 2 really developed program to go out and educate the public 3 that this is what's going this way and this is the way it's 4 going to go. Materials were in the plan, you know, we 5 showed the we just demonstrated it. The public health 6 nurses were trained, the Red Cross nurses were trained. As 7 suspected the biggar part of the decision was probably the 8 fact that health officer in Alabama talked to the health 9 officer in Tennessee and, you know, he just made the 10 decision. There was no requirement for a public meeting on 11 it so it wasn't held.
12 MR. McNUTT: Well, there's a public meeting 13 required for the formal plan approval.
14 MR. GODWIN: Yeah, that meeting was held but there
() 15 was no -- '
16 MR. McNUTT: There was no questions came up about 17 potassium iodide?
18 MR. GODWIN: I don't remember any questions coming 19 up at that meeting about potassium iodide.
20 MR. McNUTT: Was the public then informed that the 21 KI was available?
22 MR. GODWIN: It was in the plan. l 23 MR. McNUTT: Well, the public probably doesn't ;
1 24 read the plan, you know. '
25 MR. GODWIN: Well, you know, like I say, you know, l
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3 7 ~;
I we went around to all the agents talking about it and
/"'t 2 telling them various and sundry things, but there was no b 3 organized pattern to pick that out and say, okay, this 4 particular item is in the plan. It was discussed how to 5 evacuate and how things would go, what wou]d happen at 6 reception centers, and monitoring. And we may have 7 mentioned potassium iodide, I ."1st dcn't remember now.
8 You know, we had the public meeting that you're 9 required to have. But we also had a whole bunch of other 10 meetings as each part of it was put together and a lot of it 11 was done by the health department there not by the state 12 health department.
13 MR. McNUTT: Can I assume that it was also in 14 telephone books or an allusion in any of that material?
() 15 16 MR. GODWIN: There's nothing in the phone books that I recall, do you?
17 MR. CASH: Huh-uh, no.
18 MS. KEY: But it's in the calendar, right?
19 MR. CASH: Yeah. we sent a calendar out -- well, l l
l 20 Browns Ferry sends a cale:1dar out every year. I 21 MR. McNUTT: Is it in the calendar?
22 MR. CASH: And it is in a packet of information, j 23 yeah.
i 24 MS. KEY: Yeah, we have noticed recently that the 1
25 three calendars Far Supply (' p h) and Browns Ferry are '
l l
(" ANN RILEY & ASSOCIATES, LTD.
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I 374 1 slightly different. Some of that's the difference in the
(~N 2 states and some of it's a mixup and that's -- we're fixing 3 to get supplied laws borrowing agreement now. And we may l 4 adopt some of the language from Alabama, but we may not.
5 That's under --
6 A VOICE: Could I get a copy of one of those 7 calendars from somebody at some point.
l 8 A VOICE: Sure.
.i l 9 A VOICE: Somebody, I'd appreciate it.
i 10 CHAIRMAN MOHSENI: Okay, thank you. j l \
l 11 MR. CASH: Okay, now this next section has adopted !
12 from the FDA file recommendations for potassium iodide as a 13 thyroid blocking agent in a radiation emergency l 14 recommendations or recommendations on use, April 1982 to
() 15 show you how we got where we are now. I think we've talked 16 at this issue but I don't know if we talked about it all at l 17 one time before. l 18 The FDA concluded that risk on the short term use 19 of relatively low doses of KI for thyroid blocking in a 20 radiation emergency are outweighed by the risk of 21 radioiodine induced thyroid nodules or cancer at projected 22 radiation dose of 25 rem or greater to the thyroid gland 23 from radiciodines released into the environment. The FDA 24 recommends that KI in doses of 130 milligrams per day for 25 adults and children above one year and 65 milligrams per day ANN RILEY & ASSOCIATES, LTD.
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375 i
1 for children below one year of age be considered for thyroid 2 blocking in radiation emergencies to those persons who were 3 likely to have perceived a projected radiation dose of 25 4 rem or greater to the thyroid gland from radiciodines l 5 released to the environment.
- 6 The FDA recommended that planning officials 7 responsible for radiation emergency response planning l 8 incorporate an integrated system of public information on l 9 the use of KI and the system of medical contact reporting 10 and assistance as part of their emergency response planning.
11 Each state had the responsibility for formulating guides to 12 define if and when the public should be given KI and 13 instructed to use it. Citizens should be provided and 14 encouraged to read the patient information leaflet which 15 accompanies the drug.
16 If public health officials choose to evacuate 17 people-from the accident and if those people are moved i
j 18 promptly, the use of KI may not be necessary. Evacuation 19 when there's a logistically feasible option is a more 20 effective method of reducing or eliminating thyroid exposure 21 for radiation and may be a more desirable protective 22 measure.
23 The use of KI to reduce thyroid uptake of i 24 radiciodines in the event of accidental release of 25 radiciodines to the environment from a nuclear power plant
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)
r 376 1 is a public health countermeasure for which substantial f['}
v 2 planning is required. The decision as to when and for whom 3 it should be used remains the responsibility of the state 4 and local public health officials. For the most effective 5 ut.li?.ation of KI preplanning on a state, local or regional 6
I level is required. >
7 Planning should consider details of; number one, 8 the projected radiation dose to the thyroid from l
9 radiciodines released to the environment which would trigger 10 the use of KI as a thyroid-blocking agent and a specified l 11 procedure for estimating or determining such projected j 12 radiation does.
! 13 Mumber two, plans for rapid distribution of KI so 14 that potentially effected population groups could receive
() 15 and take the drug shortly before the exposure begins or as 16 soon as possible after its onset.
17 Number three, provision for supplies of KI l i
18 adequate for administration up to 10 days. A mechanism for 19 informing the public of the need for and the timing of l 20 taking KI and the need to read the patient information l 21 leaflet which accompanies KI together with a system of 22 medical contact rept .ing and assistance.
l 23 Number five, alternative protective actions and 24 six, plans for the acquisition, distribution and inspection 25 of periodic replacement of KI stocks.
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I
(
377 1 This is my interpretation of what I've read in the
(
2 summary. I believe it to be correct but if anycody has any 3 different opinions on that, certainly wish they should be 4 considered.
1 5 Okay, getting to the current information which 6 will take less time than getting to this point. The Alabama 7 plan, the current version. The Alabama Red (;ph) (1280 8 follows the recommendations of April 1982 FDA KI final 9 report. In about 1982 and I haven't been able to get that 1
10 date specific, but the decision was made to have KI 11 available for the public health nurses at reception centers 1
12 in affected. This is Alabama, of course.
13 KI will only be made available to evacuees from 14 evacuation sectors where they may have been exposed to a
() 15 release of radioactive iodine before or during evacuation.
16 KI will only be made available when ordered by the state 17 health officer or his or his designee. Around Browns Ferry 18 nuclear plant in north Alabama, there is enough KI 19 distributed to local health departments for the entire 20 population within the five mile EPZ and for 20 percent of 21 the remainder of the population within a 10 mile EPZ.
22 At Browns Ferry there are 561 people within a two 23 mile EPZ, 2749 in the two to five mile EPZ and 38,347 people 24 in the five to ten mile EPZ for a total of 41,000 within a 25 ten miles EPZ. The evacuation timec are two hours for the O ANN RILEY & ASSOCIATES, LTD.
Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
F i
378 l 1 two mile EPZ, two to six hours for two to five mile EPZ, and i
l 2
[~')
N_/
four to six hours for the five to ten mile EPZ.
l l 3 Around Farley nuclear plant in southeast Alabama, )
{
4 there's only enough KI for emergency workers. If needed, l
)
l 5 additional KI for evacuation of Parley emergency planning l 6 zone would be brought in from other locations within the 7 state. At Farley on the Alabama side of the river -- we
! 8 border with Georgia there at the Chattahoochee River --
l 9 there are 34 people within the two mile EPZ, 2200 people in 10 the two to five mile EPZ and 8,431 people in the five to ten 11 mile EPZ for a total of 10,665 people within the ten mile 12 EPZ. Evacuation times are 45 minutes for the two mile EPZ, 13 two hours for the two to five mile EPZ and six hours for the 14 five to ten mile EPZ.
() 15 The intervention level for the health order to 16 make KI available to emergency workers and evacuees in i
17 Alabama is a projected does of 25 rem to thyroid. The does 18 to the thyroid would be calculated by using Rascal or Midas 19 computer programs. The dosage for KI is the same as that 20 recommended by the FDA in 1982. Public health nurses can 21 get to the reception centers within a time of 15 to 45 22 minutes. If ordered by the state health officer, they would 23 make KI available to evacuees from designated sectors 24 described in the appropriate health order.
25 The evacuees would be given the KI drug leaflet to
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379 1 read. They would also have an opportunity to ask questions
() 2 3
and decide whether to take KI or not. If they decide to take KI, they must sign a release form before KI will be 4 issued to them. Counseling on KI benefits and risks should 5 not be an added burden to the public health nurses at the KI 6 . distribution point.
7 CHAIRMAN MOHSENI: Question.
8 MR. CASH: Uh-huh.
9 CHAIRMAN MOHSENI: The public arrives at your 10 reception center and you say above that's a projected does 11 of'25 rem thyroid is the trigger point for the health 12 officer to make KI available. And further up you say, KI 13 will only be made available to evacuees from evacuation 14 sectors where they may have been exposed to a release of
() 15 radioactive iodine before or during evacuation.
16 MR. CASH: Yes.
17 CHAIRMAN MOHSENI: Is that -- are they all 18 consistent -- being exposed to radioactive iodine you mean 19 at least 25 rem thyroid or any amount of iodine they would 20 have KI, but then the health officer would tell them at 25 21 ram, now take it.
22 MR. CASH: If the projected does is 25 rem but --
23 to the thyroid.
24 CHAIRMAN MOHSENI: When it's made available it's 25 also when it's asked to be taken or are there two different ANN RILEY & ASSOCIATES, LTD.
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I 380 l 1 trigger points?
l i 2 MR. CASH: Be the same trigger point.
l 3 CHAIRMAN MOHSENI: Same trigger point.
i 4 MR. CASH: Yes.
5 CHAIRMAN MOHSENI: What about monitoring? Do you 6 monitoring them prior to giving them KI or not?
7 MR. CASH: They are monitored when they come in, ;
i 8 monitored for contamination. Again, that's -
i i
9 CHAIRMAN MOHSENI: Before or after KI?
10 MR. CASH: Well, don't know that we've gotten 11 specifically through that point, at least in my thinking.
12 When they come into the reception centers, the people are 13 divided if they ca.ne from certain sectors, certain sectors '
14 they would go another way. Or if they came through a 15 (A) sector, but generally, if you get out of sector, you're not 16 going back through another one. That may have been -- you 17 wouldn't direct somebody across the way you thought that the 18 plume would be coming unless you had to.
19 CHAIRMAN MOHSENI: You mean by that that if --
20 when you say you direct people, if they came out of certain 21 sector, they would be directed -- where you thought there 22 may have been exposure, they would directed in one area. Is 23 that how you're suggesting it?
24 MR. CASH: We have a limited number of reception 25 centers that we would direct people away from -- the traffic SJRJ RILEY & ASSOCIATES, LTD.
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1 I
l 381 '
1 control person personnel would know where to direct the 2 people to.
3 CHAIRMAN MOHSENI: While they're still driving on 4 the road, not once they arrive at a reception center?
5 MR. CASH: Right. When you get to a certain 6 point, you could be told by this traffic control officer 7 where to 90.
8 CHAIRMAN MOHSENI: Which reception center to go to l 9 if you choose.
10 MR. CASH: Yeah, if you didn't know, for instance, 11 you could be told where they were.
12 CHAIRMAN MOHSENI: Yes.
la MR. GODWIN: I believe when they come to a 14 reception center, you're coming from some sectors where you
[ 15 know there's no contamination, they would normally bypass
%)
16 the monitoring step.
17 MR. CASH: Right, they rion' t go through the 18 monitoring.
1 19 MR. GODWIN: It's only those from a sector where 20 they might be contaminated, those are directed internal to 21 the reception center into monitoring. And I don't remember 22 whether they do the KI questions before or after they go 23 through the monitoring. I'm thinking it's after, but I may 24 be wrong on that. It's been a little long.
25 CHAIRMAN MOHSENI: So first thing you do is triage ANN RILEY & ASSOCIATES, LTD.
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382 1 them by asking them questions as to where did you come from.
[#} 2 At the reception center you're asking the questions so that
'%.s 3 you can triage.
4 MR. CASH: That is asked of them before they even 5 get to the nurses, to the nurses stations.
6 CHAIRMAN MOHSENI: Okay. But you also said 7 there's another point, traffic control point where also 8 another --
9 MR. CASH: Traffic control personnel.
10 CHAIRMAN MOHSENI: Is that -- but that's not 11 relevant. !
i 12 MR. CASH: That's not a part of this, no, no. No. j l
13 CHAIRMAN MOHSENI: Okay, that's not relevant, i 14 MR. CASH: No.
() 15 CHAIRMAN MOHSENI: So at the reception center, the 16 first thing you do is triage by determining whether or not 17 potentially they could be contaminated or not by having an 18 understanding of sectors that might be --
19 MR. CASH: Where they came from.
20 CHAIRMAN MOHSENI: Then they, the supposedly 21 potentially clean people go one side, potentially 22 contaminated people go to another 23 MR. CASH: Yes.
24 CHAIRMAN MOHSENI: Potentially contaminated people l
j 25 have another question to answer or not. In other words, if i
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r 383 1 the health officer says, potentially contaminated people 2 take KI. It's all contaminated people or do you have
[}
3 another triage for that group determining whether or not KI 4 should be given to these potentially contaminated people or 5 not?
I i 6 MR. CASH: I want to take just a second. Go I 7 ahead, Aubrey.
8 MR. GODWIN: They'll get the question, when they I
9 ask the question what sector they came from, if that sector l f
l 10 does not have projected doses above 25 ram, they will not 11 get KI.
12 CHAIRMAN MOHSENI: Okay. And still potentially 13 contaminated but not a projected?
14 MR. GODWIN: Right.
() 15 CHAIRMAN MOHSENI: So, there's another question 16 point -- decision.
l 17 MR. GODWIN: So when they come, when they clear l
l 18 the block, at some point they'll end up with a public health 19 nurse and.she's going to ask where you came from and if it's ,
I
! 20 not already marked on-there as to what sector it is, she'll '
l 21 put it on the sheet, there's maps above the form, and she 22 will know whether -- or he will know, well, that's a sector 23 that requires KI to be administered. If it is, they're to 24 KI stuff, if it's not they'll just pass on down the line to 25 the next station.
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r 1 l 384 1 CHAIRMAN MOHSENI: Do they also ask what time did 2 you leave the' sector whose projector at a this, at a certain
(
'3 ' hour was 25 rem or not. That's fine. Too much detail that )l 4 won't count.
5 A VOICE: The circumstances of the moment will --
6 CHAIRMAN NOHSENI: Well, I'm asking what these 7 guys, yeah, I know. I have my --
8 MR. CASH: It's not addressed in the plan but I --
9 CHAIRMAN MOHSENI: For example, you project --
10 initially you didn't project this sector to have 25 ram. ;
11 And you started the evacuation process, but while they were 12 evacuating a lot of them left and then an hour later the l
13 projections showed the 25 rem thyroid. Is there not kind of l
l 14 discrimination by the time they arrive at the reception
() 15- center or it doesn't matter anymore because they came --
16 it's.not time dependent anymore. j 17 MR. CASH: If they were out of the area there's no 18 need --
19 CHAIRMAN MOHSENI: How do you know?
20 MR. CASH: You ask them. Well, if they're sitting 21 here at the reception center at the time you rake that 22- determination, they're already out.
23 CHAIRMAN MOHSENI: That's right. So they're out, 24 however, the projections of 25 rem did not occur until, you 25 know, you have six houru evacuation -- up to six hours for a l
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1
)
I I
385 1 certain five mile EPZ. The first three hours people were
/ ~N 2 leaving, probably didn't get as much as the latter, you
%)
3 know, six hours. So is there a discrimination point there?
4 MR. GODWIN: It doesn't work quite that way.
5 CHAIRMAN MOHSENI: No, okay.
6 MR. GODWIN: Because you start at the plant when 1
7 you start your evacuation to come out so that the more 8 likely sectors get contaminated get evacuar- #rst.
9 CHAIRMAN MOHSENI: Okay.
10 MR. CASH: Perhaps in 45 minutes.
11 MR. GODWIN: Yeah, yeah. And that's true for 12 virtually all states as far as they can -- they got to 13 evacuate, they all go that way, yeah.
14 CHAIRMAN MOHSENI: And that's the parts that --
(Oj 15 and the closer in is likely the part that you get the 16 highest projection. Your projections are conservative 17 ground level release so you -- but these guys left sooner 18 than maybe --
19 MR. GODWIN: One thing you cannot assume that 20 everybody left the sector at the same time.
21 CHAIRMAN MOHSENI: Correct.
22 MR. GODWIN: In anybody's plant that I know of, 23 you can not assumption. You can all say, they start leaving 24 at this time and they completed leaving at this time.
25 CHAIRMAN MOHSENI: So there's no more decision l
l l
l l
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J
386 1 making for you to administer KI. If they came from a
/\ 2 contaminated area whose projection at any time was above 25 u_) ,
l 3 ram, you're going to give a KI to them.
4 MR. CASH: That will be determined by the health 5 officers when they --
6 CHAIRMAN MOHSENI: Well, the health officer --
7 MR. CASH: You know, he will sit and talk to my 8 boss.
9 CHAIRMAN MOHSENI: Okay.
10 MR. CASH. Who succeeded Aubrey there and the team 11 leader whoever happens to be there and available is to --
12 you know, and try to figure out this information talking 13 with the local FEMA folks, hey, were the people -- were they 14 'here or were they not there? Were they out already? When
[Vl 15 the traffic personnel know that everybody's out, you got --
16 you'll make decisions on an ad hoc basis at that time, I'm 17 sure. But the trigger level is 25 -- projected does of 25 18 rem to the thyroid.
19 CHAIRMAN MOHSENI: Does your plan have provisions 20 for 21 asking more questions to clarify who exactly got the 25 --
22 more likely got the 25 rem or is it enough to know that they 23 came from an evacuated area whose projections were 25 rem at 24 any given time.
25 MR. GODWIN: The plan doesn't address the issue.
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387 1 CHAIRMAN MOHSENI: So it's not written anywhere?
2 MR. GODWIN: No , but I think, you know, a certain 3 amount of logic applies. That if you've got -- two-thirds 4 of the people got out of the section before the iodine was 5 released, those who had already made to the reception center 6 by the time you found out you got iodides there and you know 7 that the, you know, that the front edge of the iodine cloud 8 wasn't there before they left, you're not going to go back 9 and give them iodine, potassium iodide. You're going to let 10 it go. It's only the ones that actually get the exposure.
11 But those are the things that you have to look at, the 12 scenario, as an accident unfolds to make those kind of 13 decisions. A prescript would be a little bit tough to do.
14 CHAIRMAN MOHSENI: No, I'm just asking what, you
()
15 know, I know that's not easy. But when I think of a 16 reception center I see long 1 .ss of people, potentially, if 17 there's a -- so it's not like it's a sequential thing. The 19 first person in line is the first person who actually left 19 the most potentially contaminated -- it's not necessarily 20 true.
21 MR. CASH: Not necessarily, no, no.
22 MR. GODWIN: You can't make that assumption.
23 CHAIRMAN MOHSEN7: So you can't just use that kind 24 of thing --
25 MR. GODWIN: You got to think about something f'g ANN RILEY & ASSOCIATES, LTD.
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388 1 else. A miniture (;p h) reception said this monitoring may I'i U 2 not be taking place early on because you have up to 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br /> 3 from the start of a decision that you need to be monitoring 4 before you have to complete monitoring. So monitoring is 5 probably not as important in this decision-making thing as 6 it is knowing whether there's actually iodine in the 7 atmosphere. And if you've got 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br />, you could easily 8 make the monitoring the last thing in this system. Don't 9 know many that do that, but you could 10 MR. CASH: And again, our plan calls for 11 separating the people when they get there depending on which 12 sector they came from.
13 MR. SHERIDAN: There may be iodine in the 14 environment, but you may not know exactly when it got there
() 15 so what --
16 MR. GODWIN: Well, that's possible, too.
17 DR. SEALE: So the timing, Aby, is to my way of 18 thinking is almost irrelevant. If there's a projected dose 19 of 25 rems to the thyroid and they're in that sector, that 20 downwind sector, then I would think they would be taking KI.
21 MR. GODWIN: Yeah, the only ones that wouldn't 22 take it would be tnose that had already gotten out before, 23 you know, it could have gotten there. And you can go by 24 wind speed as to when it could have gotten there 25 CHAIRMAN MOHSENI: So there is time, you're O ANN RILEY & ASSOCIATES, LTD.
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389 1 saying. I'm asking about your plans. I'm not asking what's f']
v 2 the answer. Obviously, Bill is providing a logical -- but 3 is this, I'm asking --
4 MR. CASH: The plan does not address that.
5 CHAIRMAN MOHSENI: Yeah, I'm asking what Alabama 6 does in reality versus what we wish you were doing. I mean 7 that's a story.
1 8 MR. CASH: Well, reality, KI, a distribution of KI 9 or making it available is not a reality yet. We've never 10 done it.
11 CHAIRMAN MOHSENI: But it's in your plans?
l
- 12 MR. CASH
- It's in the plan, that 's true .
13 CHAIRMAN MOHSENI: And it's in the plans as you 14 will give it to certain people and that's how I wanted to
() 15 kind of see how you decide who will get it and, you know, 16 the 25 rem is what you're saying, projected dose, there's no 17 more fine tuning.
18 MR. CASH: Well, I'll tell you what the plan says, 19 okay.
20 CHAIRMAN MOHSENI: Yes.
21 MR. CASH: I'll read it one more time. Our public 22 health nurses can get to the reception centers within 15 to 23 45 minutes. That depends on which county it is, north and 24 south and various locations. If ordered by the state health 25 officer, they would make KI available to evacuees from g ANN RILEY & ASSOCIATES, LTD.
(/
l
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390 1- designated sectors described in the appropriate health 2 order. I have cop es -- a copy of the health order, too, e
)
3 blank health order.
4 The evacuees would be given the KI drug leaflet to 5 read. They would also have an opportunity to ask questions 6 and decide whether to take KI or not. They're not being 7 forced to take it.
8 CHAIRM7.N MOHSENI: yeah.
9 MR. CASH: It's just being made available to them.
10 If they decide to take it, they have to sign a release form.
11 We've got that in here, too, before the KI will be issued to 12 them. Counseling on KI benefits and risks, again, should 13 not be an added burden to the public health nurses at the KI l 14 distribution point.
() 15 A VOICE: I'll make copies of that for tomorrow if 16 you want me to.
17 MR. CASH: Okay, that'll be fine.
l 18 CHAIRMAN MOHSENI: And how do you do the 65 i 19 milligram? Who breaks it? Is it the patient himself or the i 20 state nurse?
21 MR. CASH: Well, generally, I guess it would be 22 the --
23 CHAIRMAN MOHSENI: Nurse?
24 MR. CASH: The person receiving it for the 25 patient, taking that small a dose.
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r 391 l 1 CHAIRMAN MOHSENI: Like the mother is receiving it
/~D 2 --
!U 3 MR. CASH: Yeah, the mother could it, yeah.
4 CHAIRMAN MOHSENI: She actually has to break the 5 pill into as opposed to the nurse?
6 MR. CASH: I don't know that we've gone to that 7 point, but I would assume that, yes.
8 CHAIRMAN MOHSENI: Okay.
9 MR. McNUTT: How many nurses are there at the 10 reception centers?
11 MR. CASH: That exact number I don't know but we 12 can pull them in from adjoining counties uhere they've had 13 training and such, too, so --
14 MR. NAWOJ: Is that key to the number of evacuees r
( 15 that might show up there in order to get the KI distributed?
16 MR. CASH: If they were having a lot of people 17 show up, they could call for backup, yeah, certainly in that 18 case. Again, now, our EPZ's ar a little bit smaller in 19 population than some other people's EPZ's. We don't have a 20 quarter million people in our EPZ.
21 MR. NAWOJ: Yeah, but even if there's 10 people in 22 line and you're number 10 and the nurses there are trying to 23 explain to number one about KI, you may get antsy as number 24 10 in line.
25 MR. GODWIN: You might eavesdrop.
l l
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392 1 MR. CASH: That might happen, that s true. And,
(~) 2 again, the experience in Alabama is not the experience of
'v' 3 gone to an emergency and having to distribute this. It's 4 just that in our plan we call for the -- making KI available 5 to the general public if designated by the state health 6 officer.
7 MR. SIMPSON: Can I pick up on that aspect, too.
8 As you said the policy is to make it available to the 9 general public, 25 rem, all of those things we've been 10 through. But you seen to have two slightly different 11 implementations of that policy. In the one plan, situation, 12 you have the KI available at the reception centers today.
13 In the other you do not and you make reference to the fact 14 that you will get it there.
s~ ~
i 15 Why do you use two different implementations of 16 that kind of a policy?
17- MR. CASH: That decision was made a long time l 18 before I got into this and part of it, in north Alabama, the i-19 Tennessee Valley Authority makes it -- they provide the KI.
20 As I understand it, Alabama Power Company Southern Nuclear 21 made the decision a long time ago not to. This was allowed I
22 for whatever reason. But if we needed it in south Alabama, 23 we have enough to get people started with one tablet for the 24 people.
25 A VOICE: Using the emergency worker's provision?
()
\_)
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393 1 MR. CASH: Using the emergency worker provision.
2 And we could bring it in then.
3 A VOICE: I see, so you -- if you needed, you 4 would in fact use what you've set aside --
5- MR. CASH: Yes.
6 A VOACE: -- for the emergency workers for the 7 general population. So that's how you would -- okay.
8 MR. CASH: And we would bring more in, yeah. Now, 9 our adjoining state of Georgia, Jim is not here today, but 10 it's also a probable fact that if the people from Georgia 11- 'were exposed, heard that it was being given in Alabama and 12 they came over, they probably would not be denied just 13 because they happen to be Georgians, you know, on the other 14 side of the river. Although Georgia would not -- probably
( ) 15 note recommend that they take KI since they don't call for 16 it in their plan. But there is a difference between north 17 and south Alabama, Browns Ferry and the Farley plan.
E18 MR. NAWOJ: This is, this plan has not been 19 exercised, you know, drills or exercises --
20 MR. CASH: Oh, we exercise it.
21 MR. NAWOJ: -- as far as simulating, going through 22 the process?
23 MR, CASH: Simulating in that the FEMA evaluator 24 generally comes in and talks with the nurse and lets her
-25 _ explain how things will be done and things like that. As 1
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394
'l- far as handing out M&M's to a 1,000 people, we don't do 2 that.
3 MR. NAWOJ: No , no.
4 MR. CASH: The only other part in here was the l 5 program cost in Alabama, but -- would you like me to go over l
l 6 that part?
7 CHAIRMAN MOHSENI: Please. Yes, yes.
8- MR. CASH: In Alabama, Alabama Power Company 9 provides KI for emergency workers in the other J.N. Farley
(' 10 Nuclear Plant. The annual cost for 500 bottles of KI to 11 make one bottle of KI available for each off site emergency 12 worker is $158.33 with the latest cost of $95.00 of 100 13 bottles. That would be $495.00 every three years, that's 14 where the 158.33 comes from. With a projected cost of 250
() 15 16 per box annual, the cost would be $416.00 or $1250.00 every three years.
17 In the area surround Browns Ferry Nuclear Plant, l 18 the Tennessee Valley Authority provides KI for emergency 19 workers near the Browns Ferry Nuclear Plant and all the 20 population within the five mile EPZ and for 20 percent of 21 the population beyond the five mile but still within the 10 l
22 miles EPZ. The annual cost for 11,300 bottles of KI to make 23 one bottle of KI available for each of the targeted l 24 population is $3,578.33 at the latest cost of $95.00 per box 25 of 100 bottles. With a projected cost of $250.00 per box,
)
l O ANN RILEY & ASSOCIATES, LTD.
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395 1 the annual cost would be almost $9500.
2 Since Alabama --
f'}/
N.-
3 DR. SCALE: Excuse me.
4 MR. CASH: Sure.
5 DR. SCALE: Why do you replenish your supply every 6 three years?
7 MR. CASH: That's the shelf life.
8 DR. SCALE: Well, the FDA official shelf life is 9 five years.
10 MR. CASH: What we have supplied has a -- well, 11 you can get a letter of extension after the three years is 12 my understanding and I think it has been done some in the 13 past, but --
14 DR. SCALE: If there's a five-year shelf life
[Ol 15 according to FDA and they were doing the research to extend 16 it to seven and they had a reorganization and that, the 17 reorganization responsible for that dropped it so --
18 CHAIRMAN MOHSENI: Well, I have a letter here 19 dated January from Wallace Lamps (p h) that claims a 20 five-year product shelf.
21 MR. CASH: I believe that -- I don't have a copy 22 of our -- I mean the KI --
l 23 A 90 ICE: That's changed relatively recently.
24 MR. CASH: Yeah. I 25 A VOICE: Because we dealt with that in the l
f}
(_/
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l
396 1 letters of extension with the three to five.
2 MR. CASH: Yeah, this is January 13th, '99 when 3 this letter was written. It may change but that's the 4 reason.we did it because that's what was on the last bottles 5 we had, at the time we got them it was three years before 6 they expired.
7 MR. SIMPSON: We found out that same thing that j 8' you would get what it said on the product, had an expiration 9 on it and we felt that was the date -- we understood what 10 FDA said, but one of the specifics, _no hospital would touch 11 it once it got -- it said --
1 l
12 MR. CASH: Expired.
l 13 MR. SIMPSON: -- 1st of January, it's gone and you 11 better have the new stuff there. They are not messing with
() 15 letters of extension or anything else. If the bottle says a l 16 certain shelf life, that's it. FDA says five years, that's 17 very nice, but they're going to deal with what's on that 18 bottle. And so we had, in reality had to deal with that.
19 We knew the theoretical situation, but you had to deal with l
20 the reality.
I 21 MR. CASH: You know, whether it be five, 10 or 15
-22 years.
23 A VOICE: So the five years -- it's been the shelf 24 life for quite some time whe'ther --
~
25 MS. CARPENTIER: It doesn't matter if that's not ANN RILEY & ASSOCIATES, LTD.
Court Reporta rs 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
397 1 what the manufacturer puts on there.
(N 2 A VOICE: I think that -- well, it certainly is to
'N 3 the benefit of the manufacturer to have a three year --
4 MR. CASH: Or one year for that matter.
5 A VOICE: Six months.
6 MR. CASH: I don't know where that will lead so --
7 I'm not a chemist or pharmacist but it being sealed up, I 8 would think it would last longer.
9 MR. HARDEMAN: Are there associated costs with 10 storing this stuff?
11 MR. CASH: Let me go ahead and finish this part.
12 Since Alabama has chosen to store KI at selected local 13 health departments until such time that KI might be needed 14 at predetermined distribution centers, there are no
/'
i ( 15 identifiable costs associated with public education, x_-
16 staffing, training, management, follow-up, maintenance and 17 distribution. Doesn't mean there's no cost, we just haven't 18 been to identify it. We think that would be a low cost l 19 thought. Any cost involved with these areas of interest 20 will be covered as part of the standard rep training.
21 Storage space is provided in closets near the nursing 22 director in effected local health departments. So there's 23 no cost on that to us.
24 A VOICE: How about disposal?
25 MR. CASH: We give that back to the utilities.
ANN RILEY & ASSOCIATES, LTD.
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398 1 A VOICE: Oh. Well, what do they do with it, do 2 you know?
3 MR. CASH: For a while, I understand that TDA was 4 sent into Sea World. .But everybody else started doing that 5 so that may have --
'6 MS. KEY: Now, Sea World says we don't need that 7 much.
8 MR. CASH: We don't it, have plenty, so -- to give I 9 to their -~-
~10 MS. KEY: Sharks.
11 MR. CASH: Sharks or whales or whatever it was.
12 MS. KEY: Sharks.
l 13 MR. McNUTT: Grind it up --
14 CHAIRMAN MOHSENI~: That's interesting. I mean it
() 15 16 can be reused like that?-
MR. McNUTT: Yeah, I think we send ours down to --
-17 A VOICE: Mystic Aquarium?
18 MR. McNUTT: Mystic Aquarium, yeah.
19 A VOICE: No kidding.
20 A VOICE: God, this trip was worth it after all. I 21 CHAIRMAN MOHSENI: Good, thank you for your 22 presentation. Mike, good presentation. Any more questions .
I 23 for Alabama? '
24 I have one myself. You know, all the other states 25 that we discuss with, the public education seems to be a big ;
O
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! 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 1
I
399 1 item on their list of things to do if they choose to go with 2 KI. Even if they don't choose to go with KI,
( said up 3 there, they have to do some public notification and 4 information and so forth. But it seems like in the three 5 states that currently have KI, public education is not a big 6 issue. And is that true? Neither of the -- none of three 7 states said where public education is a costly effort, it's 8 a tremendous effort.
9 MR. CASH: I would disagree with that. I think 10 Tennessee said in the initiation of their program, it was a 11 very expensive project.
12 CHAIRMAN MOHSENI: Initially, yes. Okay. Yes.
13 MR. CASH: And now they just coasted on that.
14 CHAIRMAN MOHSENI: If you actually did not
() 15 pre-distribute, would you have the same public education 16 costs as when you actually take it, like Alabama and Arizona 17 to the reception center and the public is not aware until 18 such time that it's needed.
19 MS. KEY: I think that's sort of second guessing.
20 I don't know I think because of the attitude Tennessee had 21, when it decided to put KI out there that even if they hadn't 22 of pre-distributed it, they might have done a lot of 23 education. Even if they decided to leave it in health 24 departments just because that was the attitude to get the 25 people understanding what it is that they're dealing with.
1
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r 400 1 CHAIRMAN MOHSENI: But Alabama didn't go that,
/~D 2 why?
V 3 MR. CASH: Why we didn't go through it, I don't 4 know. But -- and we may pass it on in a second to a former 5 Alabamian. But what we do right now in our rep training 6 which we do year around, every year, we do talk about KI to 7 the people that we're training there whether it be emergency 8 workers or personnel equipment monitors or whatever, our 9 responders, however we have that. They live within these 10 communities generally, they take -- you know, they 11 participate with others, they don't Esk them any questions 12 about KI, you know. It may be that they've heard it long 13 enough. The new people that come in aren't terribly 14 concerned about it. You kncy, when we train new people.
rN
() 15 What the original was, Mr. -- Aubrey do you.have a 16 --
17 MR. GODWIN: Well, I think the approach.to dealing 18 with the public was similar to dealing with the public on 19 any other emergency plan. Generally, you do not go into to 20 a + ole lot of nitty-gritty details of how you're going to.
21 r un evacuation from hurricanes until the hurricane gets 22 th re because you can spend a lot of time and money and you 23 don't get much benefit out of it. When the hurricane comes, 24 you got 'to do it again.
25 Similarly, there's a lot of details that are in, s ANN RILEY & ASSOCIATES, LTD.
( Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washingtor, D.C. 20036 (202) 842-0034
1 401 1 tornados, hazardous materials evacuation plans, the public 2 just doesn't have any interest in until the time it comes i
)
l 3 about and that's the way we deal with it. This was just one L
4 of those nitty details that's in there. It's not hidden j 5 from anybody. It's a public record. It was discur, sed with i 6 appropriate officials. It was discussed at public meetings l
l 7 and it was not -- but there's no -- nothing different from, 8 you know, that got a hazardous material, you're going to 9 evacuate and you're going to send thc.. to this center. That 10 kind of detail'is part of emergency planning.
11 CHAIRMAN MOHSENI: Whac about the public, when you 12 go around and do your-regular training of the public -- you l
( 13 know, the big EP -- or issues altogether including KI. When i
14 you come to the point where you say, we have in the plan to j
) 15 give out KI to.you and you're the alternate decision maker.,
16 we'll tell you -- we'll answer any questions, do you also i 17 tell them that some people might be allergic to it?
18 MR. CASH: Oh, yes.
l 19 CHAIRMAN MOHSENI: And do they say, how would I i 20 know then whether I need to take it or not. And how do you l
l 21 --
i 22 MR. CASH: Sometimes they'l. ask that question.
I 23 But, you know, one of the indicators is being allergic to l 24 duell-fish.
25 CHAIRMAN MOHSENI: But it's not a big deal. They I l
ANN RILEY & ASSOCIATES, LTD.
Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 1
n 402 1 kind of --
2 MR. CASH:
} It's not a big deal and that. You 3 know, some say, okay, I'm allergic shell fish, you know.
4 CHAIRMAN MOHSENI: Okay. They --
5 MR. CASH: And so potentially I would not take it, 6 perhaps. -
, 7 MR. McNUTT: Well, excuse me. According to the t
8 -Food and Drug Administration, that isn't an indicator at i
9 all. You're presuming I guess that there's iodine in the 10 shell fish that -- and if you are allergic to iodine, you 11 would know that and so you just avoid that shrimp. But I'm 12 allergic to shrimp and I've been told by FDA that there is 13 some other chemical in the shrimp that I'm probably allergic 14 to and not the iodine. So that is not an indicator. But if
( f. 15 you are allergic to shell fish and you want to be very 16 conservative, then maybe you wouldn't want to take KI. But 17 I think if you'd ask them if you were allergic to iodine and 18 in this day and age you would know that because of all the 19 iodine in our diet, that would be more of actual indication.
20 MS. KEY: But just using the shell fish is
. :21 , conservative.
22 MR. McNUTT: Yes, that wo0ld be the conservative 23 approach, sure. ,
j 24 'MS. KEY: I think that's just what people's
! 25 attitudes are, let's just be conservative with this.
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403 1 MR. McNUTT: But I would think that we would
/~N 2 address that list better with the FDA representative 3 tomorrow.
4 CHAIRMAN MOHSENI: The current plans, therefore, 1
l 5 in those, the three states that have it, you haven't 6 experienced any public concern when you actually educate the 7 public about your plans and here's KI?
8 MR. SIMPSON: I think you have a difference here.
9 Where in Arizona and Alabama, they are, in fact, not 10 providing it in hand to the public. So therefore, the 11 questions are not likely to come up, the briefing has not 12 taken place with Mr. Smith and Ms. Jones, so that's not 13 going to happen as Aubrey says based on the hurricane 14 approach until you get there.
() 15 In Tennessee's case, they spent a lot more time in 16 educating because they, in fact, were putting it in the 17 hands of the public and did want them to understand what 18 they had, how to use it and what not to do with it. So that 19 obviously required more extensive education.
20 MS. KEY: We do have one case known of somebody 21 taking it when they weren't suppose to and it was an 22 emergency worker, it wasn't the general public.
23 MR. CASH: As part of our plan, this happens to be 24 for the use of the. county health department for the 25 administration of potassium iodide by the public health i
/~' ANN RILEY & ASSOCIATES, LTD.
Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
404 1 nurse or nurses. And we do have what our procedures are, we
~) 2 have -- and these are sent out by <>ur state health officer.
(G 3 We have information on thyroid block, potassium iodide, KI, I I
4 what it is and how works. How and when to take it and the 5 amount of dosage. Who should not take it.
6 CHAIRMAN MOHSENI: What do you say, who should not 7 take it.
8 MR. CASH: The only people who should not take 9 potassium iodide are people who knew they are allergic to 10 iodine. And then we go on a little bit, you know, you may 11 take it even if you're taking medications for a thyroid 12 problem; for example, a thyroid hormone or anti-thyroid drug 13 and pregnant and nursing women and babies, and children may 14 also take this drug based on the FDA guidelines.
O)
( 15 We have, you know, possible side effects and 16 procedures in issuing it. We have the foru that they're to i
17 -- has information on it for them to keep and their
{
18 evacuation zone. We have it where they sign it or the 19 parent signing for the child. Yeah, and who should not take 20 it is also included in here. And then we have a copy of our 21 blank potassium iodide order that -- this would be in 22 particular for the Farley Nuclear Plant. We have one like 23 this for Brown Ferry Nuclear Plant also. .This would be 24 signed by the state hbalth officer.
25 MR. NAWOJ: What about students that may be i
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I .
405 1 evacuated without their parents?
{
2 MP. CASH: Students are relocated from the 3 schools, they not evacuated, they're relocated.
- 4 MR. NAWOJ
- What about "aw, shucks", and the big i
5 yellow bus goes through the plume.
l 6 MR. CASH: Well --
1
( 7 MR. NAWOJ: And there's an indication there that 8 they should take KI, what do you do with that one?
9 MR. CASH: That would be a decision made by the 10 health officer at that time and if that were to happen, 11 again we're talking -- to start with we're talking about a 12 very unlikely event and the even more unlikely to be the aw, 13 shucks, as you refer to it.
I 14 MR. NAWOJ: Well, I think --
() 15 MR. CASH: I understand.
l 16 MR. NAWOJ: But --
17 MR. CASH: I know, I know. We say it slightly 18 . differently in some parts of the south, but I assume that 19 you may in New Hampshire, too.
20 MR. NAWOJ: First time it came out, I believe it 21 came out differently.
22 MR. CASH: Yeah, I understand.
23 A VOICE: Getting a sight better of that 24 descriptive term.
25 MR. CASH: Would you like copies of this available ANN RILEY & ASSOCIATES, LTD.
O. Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
406 1 tomorrow?
l [~h 2 CHAIRMAN MOHSENI: Indeed. Let me ask you, would
%]
3 the three states feel comfortable if we had copies of your 4 plans attached to the new reg as an attachment.
5 MR. CASH: Well, there's nothing to attach from us 6 as I've explained.
7 CHAIRMAN MOHSENI: I understand. I understand.
8 MS. KEY: I'm not sure how much there is. I'll 9 find it and I don't think there would be any problem with 10 putting it in.
11 CHAIRMAN MOHSENI: If you could send it to me by 12 mail so we -- the latest -- as an example of those three 13 states that have it for people to read what the plan would 14 look like if you wrote one.
() 15 MR. CASH: I don't think we'd have any problem 16 with that, but I'll double check to make sure and then we'll 17 submit it. You know, I mean it is public record so --
18 CHAIRMAN MOHSENI: Great. Because you got the 19 brief description, you have the description given here and 20 here's the exa .e of the plan that'goes into for it. Thank 21 you very me n.
22 Now, we have the Connecticut case study.
23 A VOICE: I think the Connecticut case should not 24 start until we get a five-minute. break.
25 CHAIRMAN MOHSENI: Sounds good.
l l ("N ANN RILEY & ASSOCIATES, LTD.
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l
407 l' [ Recess.]
2 CHAIRMAN MOHSENI: Let's go critical.
3 MR. WILDS: Just so you know, I'm going to 4 describe our EPZ's a little bit 5 CHAIRMAN MOHSENI: Okay.
6 MR. WILDS: And what we did. And then talk about
.7 some of the concerns that we've identified so far. Every 8 time I go back we identify more.
9 CHAIRMAN MOHSENI: Okay, let's start.
10 MR. WILDS: I'm waiting for my notes to --
- 11. A VOICE: It's re-booting.
12 MR. WILDS: It hasn't beeped enough times yet.
13 " CHAIRMAN MOHSENI: And we're going to get a copy 14 of your notes to be included in the report, right? You
() 15 haven't given it to me yet. Are you_ planning to?
16 MR. WILDS: If they let me.
17 CHAIRMAN MOHSENI: Who?
18 -
19 CHAIRMAN MOHSENI: OPM, Office of Personnel 20 Management?
21 MR. WILDS: Policy and Management.
22 CHAIRMAN MOHSENI: Policy and Management. -To let
'23 you kind of describe the plan for us? It's public domain, 24 isn't it.
25 MR. WILDS: Yes, yes.
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Court Reporters
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l 408 1 CHAIRMAN MOHSENI: Yeah, so that's what we're
(}
\_/
2 asking, just a synopsis of Connecticut's plan and then what, l 3 you may have some -- you may have to ask for permission to 4 share with us as obviously the kind of thought processes 5 that a state like Connecticut is going to go through for the 6 KI decision.
7 MR. WILDS: I'm all ready now. But what I tried 8 to do is go through some of the questions that you had in 9 the --
10 CHAIRMAN MOHSENI: Yes.
11 MR. WILDS: But what we did in Connecticut to 12 simply the instructions to the general public, we had -- our 13 EPZ's aren't -- they're broken up by sectors but we've went 14 further and we've divided them into like geo-political l C'N) 15 sectors and called them Emergency Response Planning areas.
l 16 And we've broken it down so that we have three emergency i
l 17 response planning areas that roughly correspond to the two '
18 five mile and the ten mile terrain.
19 This allows us to give ours on a town-by-town 20 basis instead of by sectors. Because what we found was that 21 individuals were getting confused where they lived relative 22 to the designations for each one of the sectors that we had 23 and especially like new residence. And everyone knows what ;
24 town they live in so when we did the evacuation on the town, 25 it was much easier for them to understand what was going on.
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1 1
409 1 When we talk about that we refer to our emergency response 2 planning area, but just nobody gets confused with that I'm
{}
3 just going to use EPZ and then you just remember that's what i 4 I mean by our planning area.
5 To give you a little demographics on our EPZ in 6 the 10 mile EPZ using 1990 census data, we vary from a high 7 on 206,000 population to a low of about 179,000, depending 8 upon the time of the year, the season, weekends and things 9 like that. Most of that population lies in the northern l I
10 semicircular portion because Millstone (; p h) is right on the 11 Long Island Sound so everybody basically lives in the 12 northern sectors. Fishers Island is a small area out in the 13 sound that's included but, you know, the really dense 14 populated area is in the north and that makes the population
() 15 density for our EPZ of about 400,000 people. If you were 16 take our density in the northern half, you know, and use the 17 same density, okay, the population density would be the same 18 as if we had 400,000 EPZ all the way around. ;
i 19 Evacuation times, estimates range from 395 -- this )
20 is evacuation times for the full 10-mile EPZ; 395 minutes 21 for like a fair weather week n,ight to 572 minutes for a 22 summer weekend with adverse conditions. So those are that.
23 In our Millstone EPZ, in Connecticut we have all 24 these special characteristics. We have 74 schools, 14 large l 25 industries, 27 day cares, facilities; 16 nursing homes, two l
/~ ANN RILEY & ASSOCIATES, LTD.
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410 1 colleges, two prisons, seven elderly housing complexes, 2 three half-way houses and one hospital; is what we have.
{
3 MS. KEY: I think you all get the prize.
4 MR. WILDS: What was that? What was that?
5 MS. KEY: And we thought we had problems.
L 6 'MR. WILDS: It's also, you know, the other thing 7 that'is not included in here is that we have federal 8 facilities located within the 10-mile EPZ that is not, you i
9 know, the federal government is suppose to take care of 10 their own, but the Naval submarine base in Groton is located 11 in this EPZ, it has its hospital, day care facilities, on 12 base quarters and offices and all the administration.
13 Also in the 10-mile EPZ we have the Coast Guard 14 Academy with its hospital quarters and all that and those
() 15 16 two items are not included in our EPZ population -- or what we would do.
17 And another important thing that is interesting 18 about Connecticut is we have an Indian casino located in the 19 town of Montville. It is physically located just outside
.20 the 10-mile EPZ ring for sectors. However,. Montville 21 exte d just past that 10-mile ring and so when we, you 22 know, when we do emergency planning areas, we evacuate the 23 town of Montville and we just tell them to go all the way 24 to, you know, the town.
L 25 So in discussions with the Indian casino, I know l
l i
l i
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Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 j i
F~
411 1 that there are an additional 30,000 people on their facility
( 2 at any given point in time that would immediately dump off 3 into one of the major evacuation routes right on the edge of 4 that 10-mile. ring. And I expect that if we ordered an 5 evacuation of the town of Montville which completes 6 surrounds that casino, the Tribal Nation would order an 7 evacuation of the casino. So we would have to deal with --
8 CHAIRMAN MOHSENI: So that's done by the Tribe l 9 decision makers?
10 MR. WILDS: Yeah, they're --
l 11 CHAIRMAN MOHSENI: Are they connected 12 communication-wise with the utility, licensee?
13 MR. WILDS: No, not now.
14 CHAIRMAN MOHSENI: Is it through the state?
() 15 MR. WILDS: They're not connected in -- they're 16 physically outside the 10-mile EPZ iight now, the sector.
)
17- CHAIRMAN MOHSENI: Okay.
18 MR. WILDS: ,
So they're,not connected into the --
19 A VOICE: What do you mean, "co'nnected"?
20 CHAIRMAN MOHSENI: Whether they'get notification
- 21. the way the state gets natified. -
,22 MR. WILDS: No, they're not. -
23 CHAIRMAN-MOHSENI: No, okay.
- 24. MR. WILDS. We're negotiating. Right now, we're 25 starting to negotiate with them to find out, you know, how O ANN RILEY & ASSOCIATES, LTD.
Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 I
t 412 1 they would like to be, if they would like to have someone in I~h 2 the EOC, you know, to make those plans to be -- you know, we U
3 have to negotiate it. They're a sovereign entity of their !
I 4 own so --
l j 5 CHAIRMAN MOHSENI: Sure.
6 MR. WILDS: In our consideration for the potential 7 use of KI as a supplement, so far the Office of Policy and 8 Management has convened a state agency, a review team to 9 identify what we feel should be addressed so far in the 10 guidance and that working group at the state level consists 11 of the Office of Policy and Management, the Office of 12 Emergency Management, the Department of Public Health, the 13 Department of Environmental Protection and the Department of 14 Corrections, at this point. And at the last meeting we've
,~)
' 15 just -- you know, decided that we're going to have another
\J 16 -- include another member to the team and that would be an 17 EPZ town representative. And hopefully Tony will do that 18 for us, Okay.
19 No., and all the issues that we've identified so 20 far we've made them pretty generic to represent, you know, 21' cross-cutting sections of our technical and logistical 22 challenges that we think having a largely populated EPZ 23 would pose. And they're not Connecticut-specific.
24 But we've identified the following issues that 25 must be addressed or determined before we can make a l
[ ANN RILEY & ASSOCIATES, LTD.
( Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
413 1 decision. Number one, the NRC has finalize New Reg 1633 and j
)
2 the federal government has to finalize its policy. We have l
3 to consider the effects of' large EGB populations, the 4 effects of long evacuation times, the impact of KI 5 distribution on the evacuation of the public and know which l 6 method we use, how applicable other state and foreign KI 7 programs are to EPZ's with wide populations. Considering l 8 unnecessarily alarming the public, considering the misuse of i l 9 KI. We still have questions regarding the dosage, what's 10 the proper age groups, those dosage age groups indicators, 11 contra-indicators, public education program and outreach.
l 12 How are we going to handle special populations.
! 13 Funding is a big question for us. We did a 14 preliminary -- just a calculation for buying materials and l
() 15 16 we took the worse case scenario where we gave it out every house and then had 100 percent in reception centers. If we 17 do that the cost of the pills alone, without any other 18 expense is just under a million dollars for our EPZ, okay.
19 So we'have funding questions that we have to address.
20 A VOICE.: Well, we'll probably have to get NRC to 21- decide that.
l 22 MR. WILDS: Ye'ah, they're going to give those to L 23 us.
24 We also are -- we have concerns regarding the 25 impact of Price Anderson Iph) Act on the KI distribution.
O ANN RILEY & ASSOCIATES, LTD.
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414 1 American Nuclear Insurers, state KI is not covered under 2 that insurance, and that is, you know, that's not a
[
3 reimbursable expense so I can talk about that a little more.
4 We've got questions on who we're going to -- on the 5 logistics, stockpiling the K1, How much and what portions 6 of the EPZ. Logistics of moving the populations, 7 distributing of KI to all the populations in EPZ schools, 8 special needs, working parents, businesses, impact the 9 logistics of transient population.
10 The impact of implementing a KI on the present 11 radiological state -- radiological emergency response plan.
12 We're going to try address and take in the concerns of 13 citizen groups. We want to addrees and parceive the natural 14 effect of KI for all radiation exposure pathways. We have
() 15 concerns on potential liability. We have questions 16- regarding parental consent for minors. We want to consider 17 alternative KI distribution, alternative to KI distribution 18 like relocation of schools in the EPZ. And then we have a 19 question of the availability of additional personnel that we 20 would need attempting that distribution plan.
21 And right now, it was our understanding when we 22 read it that, I guess, the NRC felt we would have a decision 23 in place or have made some policy decision. So right now 24 with that, if that is the intent, then we believe it 25 wouldn't be appropriate to use this as KI study because we O ANN RILEY & ASSOCIATES, LTD.
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1.
415 i
1 haven't made any decisions. We're still identifying issues
() 2 3
we need to address and we can't make any policy, decisions or recommendations until the federal government finalizes it 4 KI policy statement and the NRC finalizes New Reg 1633.
5 That's a key factor for us on our decision-making process.
6 So that's very important to us.
7 We have concerns, we do not want to be in a 8 situation similar to the NRC that's in today by adopting a 9 policy'vithout federal guidance and then being forced to 10 possibly change that policy after implementation has been 11 promised because we didn't take into account some changes, 12 you know, in the federal policy of recommendations and that 13 was not known to us when we adopted our policy.
14 And our stsnce right now is until we are
() 15 officially notified, we believe the federal and guidance has 16 not been changed no matter what has been promised so far and 17 that our policy remains unchanged and today we do not issue 18 KI to the general public and basically it would 19 irresponsible for us to take any other stance until we got 20 the documentation necessary.
21 MR. NAWOJ: Is KI available for emergency workers?
22 MR. WILDS: Yes, KI is available for emergency 23 workers.
24 MR. SHERIDAN: Not all towns choose to use it.
25 MR WILDS: Yeah, we -- yeah. I guess the option O ANN RILEY & ASSOCIATES, LTD.
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416 1 to have KI available for all em'ergency workers is there.
2 Each town has the jurisdiction over their individual
)
3 emergency workers and each town must make that decision for 4 them self. Whether their emergency workers get KI or not..
5 Under the way Connecticut is set up, they have that 6 authority. The state has offered KI to all towns, all they 7 have to do is say, we want the KI for our emergency workers 8 and it's given to them.
9 MR. NAWOJ: The determination on whether or not to 10 ingest KI, the town's made that or?
11 MR. WILDS: Yes, the town's made that and --
12 MR. NAWOJ: How do they evaluate that? What's 13 their basis?
14 MR. WILDS: That's_up to how they want to do it.
() 15 At the state level, we evaluate it basically like everybody 16 else. We do projects and determine. And then at the state 17 level, we would recommend the issuance of KI to state 18 emergency workers and all of the state emergency workers get 19 it. That notification then goes out to all the towns that 20 base a decision on what it's going to do with KI and then 21 each town under their own jurisdiction, they have that 22 authority then to make that decision or not.
23 Presently the town of Waterford that has taken to 24 offer KI to emergency workers.
25 MR. NAWOJ: Oh, okay, so the town of Waterford has
]
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417 1 KI for emergency workers, the other towns --
2 MR. WILDS: Yeah, they --
3 MR. NAWOJ: -- have no KI whatever for --
4 MR. WILDS: They -- their health department and 5 their emergency response organization has specifically 6 chosen not to issue KI to their emergency workers.
7 MR. GODWIN: Well, I didn't think you could -- I 8 thought between FEMA and NRC you were required to provide 9 for it and make a decision. You might always decide not to, 10 but at least you had to have KI available for emergency 11 workers as part of your plan. Did I misunderstand the FEMA 12 position or that.
13 MR. McNUTT: Well, it should be made available, 14 but, you know, again you can't tell anybody to ingest
() 15 anything if they don't want to.
16 MR. GODWIN: Well, the towns won't even make it 17 available is the problem. He said the towns --
18 MR. WILDS: Some of the town have not accepted KI.
19 MR. GODWIN: They will not be taken and stored at 20 the towns to have it available for their emergency workers. .
21 A VOICE: And their plans have no -- in their j 22 plans there's no provision --
l 23 MR. WILDS: As far as I know, no. i 24 CHAIRMAN MOHSENI: But the state has it.
25 MR. WILDS: The state has it, yes. On the state ANN RILEY & ASSOCIATES, LTD.
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418 1 level we i'ssue KI to all, what we would call state emergency
() 2 3
workers. We have various agreements with different industries, electric both -- you know, we have different 4 individuals doing that. And all those workers get state 5 ' kits and they have KI.
6 MR. GODWIN: But this has not been a finding of 7 any type?
8 MR. WILDS: No , it has not been a findir.g.
9 MR. GODWIN: I would have thought it would have 10 because I understood -- I thought that was a requirement you i 11 all that it had to be available.
i 12 MR. McNUTT: It should be in their emergency l
13 workers -- you know, in their kit.
14 A VOICE: Does~Waterford also provide KI at this
() 15 point for the general public or you just wanting to do that.
16 MR. SHERIDAN: No. Let me just start off by, 11 first of all Ed gave you a very, I think, oversight or 18 overview of what our unique situation is. It's complicated.
19 I often think that New England, NE, stands for nothing easy.
20 Because what the geographic makeup and those of you from New 21 Hampshire have probably a better sense of what I'm talking 22 about than maybe some of you from down south, but it's 23 enormously complicated.
24 There's nothing easy about any of this and this is 25 why I gravitate all the time back to trying to keep this ANN RILEY & ASSOCIATES, LTD.
( Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
419 1 simple and trying to keep the government out of it as much
( 2 as we possible can. And there has to be room for individual 3 responsibility here. The minute you start talking about 4 providing, especially something for nothing, you're taking 5 on a enormous responsibility that is not easily resolved, at 6 least for New England. Maybe it's easier in some of the 7 southern states, but certainly in New England it's not an 8 easy response.
9 But I am -- what I think -- let me give you a 10 quick overview of what I think a more simple approach of 11 dealing with this issue because I think -- I'm just going to ;
12 hit on some of the highlights. FDA should really make their 13 decision on what's safe, what's not safe, what level.
14 That's fundamental, we all agree on that.
() 15 Probably the state is the best place to make a 16 decision as .o when it should be dispensed. I would say it 17 should only be dispensed at the host community following an 18 emergency. It also should be available to the general 19 public, over the counter. The town or the state should not 20 get into the business of_ dispensing medication. We're not 21 good at it. It's not what government is about. But we 22 should make -- and this, I hope that this document will make
! 23 an inquiry as to why it's not available over the counter 24 because I think that's crucial.
25 And then that gets you to the individual i
l O ANN RILEY & ASSOCIATES, LTD.
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420 1 responsibility. And those people who come in and scream
'N 2 well, why aren't they doing KI. Why aren't they making it (O
3 available, would make 90 percent of our concern would go 4 away if we'd say, "It is available. Go up to Brooks Drug or 5 TVS. Go pick it up It's available". In other words, keep 6 it simple here because the minute you start saying, oh, yes, 7 here it is. Now, you have to have your insurance, your 8 Price Anderson, your waiver forms, you are taking on, you 9 are becoming a druggist, basically.
10 And once the government does that then you're 11 going down a completely different path. The government does 12 have, like we have in every other situation, we do have a 13 responsibility for our volunteers, the emergency workers.
14 We should make it available to them. But we're covered, our I
() 15 own insurance covers us for that. That should continue.
16 When you start again, just to another couple of I
17 other points I'm making it available to the general public.
18 It's -- I want to say except in emergencies. Obviously, I 19 don't mean if there is an accident, we need to step in and 20 do what we would do normally anyway for the general public 21 and having KI at the host community is part of that 22 responsibility. But doing anything beyond that is a real 23 problem. It's setting ourselves and the whole industry up 24 for price gouging. We already heard from manufacturers how 25 the label -- what do you call it? The longevity date, the N
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421 1 --
2 MS. KEY: Shelf life.
)
3 MR. SHERIDAN: Shelf life, is now getting shorter 4 and the price is getting higher. Of course it is. If you 5 were manufacturing the damn stuff too, you'd be delighted 6 with this debate. I'm surprised they don't have a 7 representative here in the audience. No , seriously, they're 8 in business because they want to make money.
9 So as soon as it becomes a government sanctioned 10' program -- we all remember these famous $2,500.00 toilet 11 seats that were going into Air Force plans, that's what 12 we're talking about here. You're going to have the same 13 thing. If we come out suggesting that the government take 14 responsibility for this and eliminate any individual
() 15 responsiaility, that's exactly what we're doing. That may 16 be where we end up. I would be concerned about it, 17 personally. I think it's wrong.
18 Should KI be available? Absolutely. It should be 19- available for any one of our citizens to go up to the drug 20 store and pick it, put it in the car. Pick up a dozen 21 packages, pick up one for their neighbor. Pick up whatever, 22 you know, amount they want. That's nothing got to do with 23 us. We don't tell them when to take aspirin.
24 So we should educate them. Education at the 25 beginning; education at the.end. It has to be that they O ANN RILEY & ASSOCIATES, LTD.
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e 422 1 understand what it's about. And we also need to educate 2 them -- the likelihood, from all I've learned about nuclear 3 power plants, the likelihood of an accident occurring that ,
l 4 would require KI is extremely minimal. I think the 5 likelihood from terrorist groups causing a concern like is 6 probably much higher. And I think we need to sort of 7 address that in the pamphlet as it's getting finalized.
8 But keep it simple. That keeps -- that answers 9 about two-thirds of what Ed has expressed there, of his 10 concerns that he's expressed. We make it an individual .
I 11 responsibility. Make sure it's available. Does anyone here 12 know why it's not available in a pill form at the drug l
13 store?
14 CHAIRMAN MOHSENI: My guess ic that the market
() 15 isn't there. There's no market for it.
16 MR. SHERIDAN: Well, if we educate the public 17 there might be a market for it.
18 MR. GODWIN: Early on, there was an attempt to set 19 up through drug stores. And my understandiag was they 20 couldn't get it move and so they pulled it off the market l
21 and it's only special order now. 1 22 MR. SHERIDAN: But I think the point is it should 23 be available to the public, whether you can get it at the 24 drug store or maybe you have to mail order it from some j 25 place, but if you want it, there ought to be a pathway and I ANN RILEY & ASSOCIATES, LTD.
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y 423 1 think part of our task here is identify that pathway and
() 2 3
make that pathway available to the public. HMO's now, you know, you're co-payment is $6.00 if you go to the drug 4 store, but if you mail order it, it's $2.00. So maybe mail 5 ordering is the way to go, I don't know.
6 To summarize what I'm trying to say here, is that 7 we cannot, the government can, of course, we should not get 8 into the business of making KI available, vis-a-vis the 9 government. We should make sure it's available like every 10 other chemical or compound or drug is available and let i 11 individual responsibility take over at that point. We
-12 . definitely should make -- I believe we should have it. We
, 13 issue it to our emergency workers and if I had my way, I 14 would see that our local CVS had it, a truckload of it and l
l fn)
( 15. anybody who wants go up there and buy it.
]
- 16 I think it's one other step in our emergency, it's l
l 17 a precautionary step, you hope you never have to use, but it L
l 18 absolutely should be available. But keep the gr.ernment out 19 of the business because I'll tell you you're making an l I
20 enormous simple process enormously compliccted. And I don't 21 mean that to be offensive to any of the government workers 22 here, it's not. It's not intended to be. But we're making 23 something enormously complicated by the route that we seem 24 to be going in here.
25 And al'so, finally, there's a psychology thing here ANN RILEY & ASSOCIATES, LTD. -
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424 1 that's very important. If we, all of a sudden, come out and
() 2 3
say, you know, we're making this free. It's going to be everywhere you want, just come in and get your thing, your 4 pill What you're going to do is you're going to do 5 enormous harm to a very important industry in this country.
6 We all hear about global warming and you folks may 7 not have the same problems we have. We have terrible air l 8 problems in Connecticut. Connecticut is not able to meet 9 its air compliance requirement. And it's not able to meet 10 our -- we're not able to meet our air compliance 11 requirements not because of air that's being polluted --
12 pollution that's caused in Connecticut, that originated in 13 Connecticut. But pollution that ecmes outside of -- from 14 outside of Connecticut. If you look at your news program,
() 15 your weatiier, you'll ree tha' all the pre",.'.ing winds comes 16 over that part of the country.
17 We need a healthy mix, nuclear may nce b_ u.a only 18 answer, but it's one of the answers to our energy problems 19 in this country and it has to managed safely. So we need 20 that healthy mix of energy sources. And also, quite 21 frankly, it's the .ne energy that we can have plenty of and 22 aside from the Three Mile Island, we've handled it quite 23 responsible.
24 The most telling tale, as far as I'm concerned, if 25 you'look in -- and hopefully you'll all come to know some.
C) ANN RILEY & ASSOCIATES, LTD.
'V Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
c.
425 1 If you look at the three pools of waste that results from 30
() 2 3
years of energy production, it's enormously impressive.
That's what we have. That's what we have left over. If you 4' had the same amount of energy produced vis-a-vis oil or 5 fossil, you're going to put a hell of lot of pollution, 6 hundreds of hundreds of thousands of tons of pollution into 7 the air. We have to think about that as we go forward.
8 But keep it simple. There's a psychology problem 9 here if we all of a sudden say, well, the government is 10 making these cancer pills, or anti-cancer pills available.
11 And I'll tell you what the problem is; you are basically 12 saying that there's a problem with every nuclear power plant 13 or a serious potential problem because after all we wouldn't 14 be giving these things away free if we didn't think there
() 15 was'a problem. But if we treat it like every other concern 16 where we have people, look, if you want potassium iodide, go 17 up to the drug store, it's cheap. Go buy it for yourself if I
18 you feel uncomfortable. That's what I believe.
19_ MR. WILDS: Having -- we checked on the Price 20 Anderson, I got six little bullets, I think that was a 21 question at the last meeting. People weren't sure about 22 what Price Anderson would do The Price Anderson Act 23- provides that there be a-prompt handling investigation and 24 settlement of. claims for legal liability arising out of the 25 result of a nuclear incident or precautionary evacuation for O ANN RILEY & ASSOCIATES. LTD.
Court Reporterr, 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 1
426 1 the states and localities.
2 The Price Anderson Act additionally provides that 3 any legal liability arising out of or resulting from a 4 nuclear incident or precautionary evacuation shall include 5 all reasonable additional costs when shared by a state or 6 political subdivision of a scate in the course of responding 7 to a nuclear incident or precautionary evacuation. Some 8 costs are inherent within the local government and have to 9 be incurred. Specific state and local expenditures that 10 would qualify for coverage are still currently under review.
11 Okay. But do not appear extensive. So that's a concern 12 that we have.
13 Price Anderson Act does not provide for 14 reimbursement of any up-front costs associated with
() 15 precautionary planning measures, but the stockpiling or 16 distributing KI just in case there's a nuclear incident.
17 The ANI has -- ANANI representative stated informally that 18
~
there was a -- that this was not the type of thing that they 19 would pay for, up front or as a reimbursement. And, you 20 know, there's a belief that this relative new ground and a 21 very expensive proposal and they, you know, not in the 22 course of action would want to take this up unless they were 12 3 legally required to do so. So that's a concern.
24 There was some opinion that, you know, this is a 25' gray area and a reasonable argument could be made that if an ANN RILEY & ASSOCIATES, LTD.
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i 427 1 actual incident did occur, KI, and KI was distributed to the i
()
\,..)
2 public, these costs, you could almost argue should be 3 covered under the Price Anderson Act. But, you know, again 4 we' re not sure that that would be -- you would prevail . The 5 issue would still remain that somebody has to pay for the KI 6 and the Price Anderson Act only kicks in as a .esult of 7 nuclear incident or precautionary evacuation. If an 3 incident does not occur, there's no meanF to make any Claims 9 using Price Anderson and, therefore, whoever paid for the KI 10 is left with the bill, for the price, you know.
11 And ANI also stated that any non-nuclear bodily 12 injury would not be covered such as an allergic reaction 13 after a dose.
14 CHAIRMAN MOHSENI: What are you reading from?
() 15 MR. WILDS: These are just some bullets on some 16 questions that our Office of Emergency Management got for 17 me. Because I asked them to specifically research the 18 questions regarding the Price Anderson Act and how that 19 would play into the role of funding and reimbursement and 20 things like that in case we had an incident.
21 CHAIRMAN MOHSENI: Do you expect someone to look 22 into it further for clarification?
23 MR. WILDS: As we go, you know, further into our !
24 prc ist and, you know, once those final federal policy and l
25 New Reg comes out, you know, we would definitely be talking l I I l
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1 428 i
1 with them a lot more and finding out exactly -- you know, i
2 pinning them down to, you know, official stance for this.
3 CHAIRMAN MOHSENI: Does that affect your state's 4 consideration of KI?
5 MR. WILDS: Well, we're taking it into the 6: consideration. I mean, you know, it's one of things we had 7 'to consider because it sort of mixes in with our funding.
8 Like I said, you'know, using the present FDA guidance, you 9 know, one pill for 10 days. And, you know, the worse case 10 scenario where you mail it everybody in the EPZ and have 100 11 percent at the reception center, you know, we just did that 12' as like a high. Just the pills alone is ro ghly one million 13 dollar expense and that does not include anything else.
14 That doesn't include getting it to the houses, any public --
() 15 nothing, that's just ordering the pills. So, you know, the 16 funding, where we're at because everything is so, you know, 17 big --
18 CHAIRMAN MOHSENI: But was that, was that one 19 million dollar based on the 10 pill per person? 1 20 MR. WILDS: Yeah, that was 10 -- yeah. But, you 21 know, using the existing FDA recommendation given us because 22 that's what's in place right now.
23 CHAIRMAN MOHSENI: Sure. l I
24 MR. WILDS: We just did that calculation to see l 25 what, you know, find out how much money you were going to i \ ANN RILE 1 & ASSOCIATES, LTD.
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429 l
1 give us.
( 2 CHAIRMAN MOHSENI: It's certainly above the k
3 estimates that we made, you know at the time, three years 4 ago. 1 5 MR. WILDS: Well, oah, I mean, that, you know, 6 again, that's assuming l' pc cent distribution.
7 CHAIRMAN MOHSEK re.
8 MR. WILDS: I mean cepending upon, in your 9 decision on what you're going to do, if you decide to do 10 something other than that by 20 percent or whatever.
11 CHAIRMAN MOHSENI: Well, our estimate was 100 12 percent of the EPZ population.
13 MR. WILDS: And how many pills?
'4
. MR. GObdIN: Yeah, how many pills is the key
() 15 16 question. Because if you're talking about a bottle each.
MR. WILDS: One bottle person because that's the 17 FDA recommendation as it stands right now.
18 MR. GODWIN: Well, no that's not the FDA 19 recommendation. It's -- you got to have seven pills really.
20 MR. WILDS: Seven pills, yeah.
21 MR. GODWIN: So you could have one bottle for two 22 --
23 MR. WILDS: Seven to ten days --
24 MR. GODWIN: You could --
25 MR. WILDS: Yeah, you know, you get back to seven
(% ANN RILEY & ASSOCIATES, LTD.
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l 430 1 to ten days, you drop a pill, you do whatever you need, a t
)
2 couple. _You know you get down to the easiest way to j 3 distribute it is one bottle per person. So I mean --
4 CHAIRMAN MOHSENI: You did a rough calculation --
5 MR. WILDS: Right, that's what --
l 6 CHAIRMAN MOHSENI: -- based on the existing --
7 MR. WILDS: Right.
8 CHAIRMAN MOHSENI: -- FDA and then we did one 9 which obvioulsy we're not going say that's exact. We made a 10 lot of assumptions in our calculations.
11 MR. WILDS: Yeah, ours is just rough, too.
12 CHAIRMAN MOHSENI: But are we --
13 MR. WILDS: I mean we wanted to get an order of I
14 magnitude of what --
() 15 CHAIRMAN MOHSENI: Yeah, that's reasonable. An l 16 order of magnitude is really what you can come up with at 17 best right now given the flux in which, you know, we --
18 MR. WILDS: Yeah, because that would change 19 significantly if you go to one pill or two pills.
20 MR. GODWIN: I would predict that the cost per 21 pill basis will go up significantly though when they break
! 22 it down to a one or two pill package of distribution. Your 23 packaging is going to force it to. I mean it's not --
24 CHAIRMAN MOHSENI: Yes.
25 MR. WILDS: And that's also used in the new ANN RILEY & ASSOCIATES, LTD.
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431 1 pricing structure that we got in February sometime.
2 CHAIRMAN MOHSENI: Yes. I want to go back to what
{v~')
3 Tony said. And he said it very well, I think. The issue of 4 having the pill available, mechanisms of making it available 5 without government involvement. That's something that also 6 I heard Mike say yesterday that in the more populated areas, 7 obviously, management by government becomes such a 8 potentially questionable in effectiveness responsibility, 9 liability and value added, if you will. Where's the value 10 added? Why have the government in the middle.
11 The question was very well posed, I think. Should 12 this document address that option of, you know, as one of 13 the means of distribution is not even being in there, in the 14 picture, but hoping the market creates the incentives for
() 15 its existence, you know at the retail level since it is an 16 over the counter. But what can be done to do that? Is that 17 something that you want to explore more?
18 MR. GODWIN: Well, I think I heard something 19 slightly different there. I think there was really two 20 parts. That one part, the emergency phace, the government 21 would be involved in it, I believe I heard him say.
22 A VOICE: Yes. Absolutely.
23 MR. GODWIN: And the other part though, the 24 distribution out to the -- maybe with the distribution into 25 the home and the business areas, that would be done by FT's s ANN RILEY & ASSOCIATES, LTD.
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432 1 private industry. Now, to answer your question as you posed
() 2 3
it. I think we ought to discuss the pros and cons of that and I personally think it ought to be encouraged to have it 4 available in drug stores or however. Supermarkets, I don't 5 care where it's available as long it's available.
6 But I think that the down side of making that 7 stateme.nt is that there's going to be jurisdictions that in 8 the past would not have made the decision to provide it are-9 going to be forced into making a decision to provide because 10 the associated public education program that has to take 11 place if you're going to do'this, whether it's done by the 12 drug company or the utility or the government, will raise 13 the question 'm the public's mind, you know, I think they're 14 going to take the position that, okay, so it's very rare. q
() 15 But it's pretty cheap seeing the federal government is 16 already going to pay for it and I already paid for it.
17 So why don't we just go ahead and get these things 18 and have them around just in case. And I think they're 19 going to look at it, it's cheap and just in case they might 20 need it. So I think that the thing you need to recognize in 21 taking that position is that you're probably going force 22 more decisions to have it available as public stored supply 23 for distribution at reception centers.
24 MR. SHERIDAN: Yeah, I want to just add to that, 25- it absolutely should be and I've asked our -- the person in ANN RILEY & ASSOCIATES, LTD.
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433
'l charge of the KI in case of an emergency to -- one morning I l
1 2 just came in and I said, "Look, I need 100 cases today. Get 3 them for me". And the best he could do is to get them 4 within-two weeks. You know, that's -- as people respond to 5 the community none of us can be in that position. That's 6 irresponsible.
7 If KI indeed can help kids in this and research
- 8. shows that it can, particularly children. You look at the 9 charts that I saw on the Bellarough (ph) situation, it 10 clearly does prevent thyroid cancer. And in the unlikely 11 opportunity or at the unlikely event that there is an 12 accident at one of the plants, not having it available is 13 irresponsible. As the person in charge of my community, I 14 think it's irresponsible not having it available.
15 Absolutely.
16 But that's different than saying the government is 17 going to get into the business of telling everybody, you 18 know, here's yours, here's yours, here's yours. That's 19 really -- we're not good at that. We're just not good at 20 that as a government entity. So we're good at plowing snow, 21 we're good at doing a lot of things, but we're not good --
22 we're not in the drug business.
23 CHAIRMAN MOHSENI: So you're advocating that it 24 should be taken to a reception center?
25 MR. SHERIDAN: Absolutely.
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r 434 1 CHAIRMAN MOHSENI: By the government?
2 MR. SHERIDAN: By the government.
, Millstone has a 3 problem today getting --
4 CHAIRMAN MOHSENI: Why is then important that l
! 5 people purchase it on their own now or --
6 MR. SHERIDAN: Because there's an element of the 7 public who feel that they want to be proactive, want to just 8 in case.
9 MR. GODWIN: I would suggest to you there's 10 another reason, too, in addition to feeling, just feeling 11 good. If they have their own supply, they will be able to 12 take it in a much more efficient manner than the government 13 --
14 MR. SHERIDAN: That's right.
() 15 16 MR. GODWIN: -- could distribute it and increase their protection. If they got it with them and they hear, 17 hey, that area is one that's affected and 21 is appropriate l 18 for it. They know that in two or three hours they're going 19 it, but they can save that two or three hours. So there is 20 some benefit to them having it there at their home. That's I 21 why Tennessee made their decision that way. Because clearly 22 if it's available to them where they are they can take it.
23 MR. SHERIDAN: And even if it's only out of 24 400,000 families, even it's only 50,000 families that end up 25 getting it on their own and having it available, that's ANN RILEY & ASSOCIATES, LTD.
O Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034
435 1 50,000 less people we have to be responsible for at a 2 distribution center.
3 MR. McNUTT: So Tony, you're not saying that you 4 don't want government involved, you just want to have it i
5 available through the commercial market as well and then you 6 want to have the government get involved during the l
7 emergency?
8 MR. SHERIDAN: Yeah, I know what I'm saying here '
9 sounds like I'm trying to ride two horse with one backside, 10 I'm not. What I'm saying here, the government has a role in i
11 an emergency and we have to have it available for -- during 12 an emergency. You have to have it available in the event of 13 an emergency. But we shouldn't be in the business of trying 14 to give it out prior to an emergency. We should make sure 15 it's available with the appropriate education.
16 CHAIRMAN MOHSENI: What's the difference? You 17 talked so much about liability earlier. But now I -- you 18 know, initially the way you presented it, it made -- it 19 pretty much made sense to me in terms of the public is 20 responsible for his own safety. But then once you got the 21 government again involved at the end, it raised the question 22 as, okay, so it was available in pharmacies, but you can't 23 assume anyone picked it up.
24 MR. SHERIDAN: That's right.
25 CHAIRMAN MOHSENI: For all practical purposes you ANN RILEY & ASSOCIATES, LTD.
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436 1 can't --
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%J 2 MR. McNUTT: So now, Tony, you said you don't want 3 to complicate it and to me, you're complicating it.
4 MR. SHERIDAN: No, well, maybe I'm not explaining 5 myself properly.
6 CHAIRMAN MOHSENI: But you certainly aport 7 governments, other governments in a position of having to 8 pretty much recognize that, the fact that it's available at 9 CVS's,_now KI is part of every county and state's plan or it 10 ought to be and so, you know, you pretty much take away the 11 prerogative of the states or local governments in making --
12 MR. SHERIDAN: No.
13 MR. GODWIN: There's merit to it because what it 14 does is it -- first of all it'gets the KI to the people
() 15 quickly when it's needed. That's what --
16 CHAIRMAN MOHSENI: Well, that would have been 17 available if they picked it up from a health department as 18 Tennessee has it.
19 MR. GODWIN: Well, that's true but --
20 CHAIRMAN MOHSENI: Or Alabama.
21 MR. GODWIN: --
it's a whole lot easier to get it 22 from a drug store than it is from a health department. I 23 can tell you. Health departments are great and wonderful 24 places, but they're just not as available as drug stores.
25 CHAIRMAN MOHSENI: Agreed. Agreed. So there's an
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i 437 1 increment there, right.
2 MR. GODWIN: So it's easy for the public to get it 3 at the regular places that they normally get drug-type 4 materials which is primarily drug stores and grocery stores 5 and to a lesser degree your Seven-Eleven's.
l 6 The other point that I think is very important is 7 that it does relieve some of the load at the reception 8 center if you have even one percent.
l 9 CHAIRMAN MOHSENI: They could have picked it up 10 again. I'm saying the uealth department --
11 MR. GODWIN: But, you know --
12 CHAIRMAN MOHSENI: -- at least educates the member 13 who picks it up, too.
l 14 MR. GODWIN: But when you look at the combination
() 15 of the ability to distribute it, the cost, overall cost, 16 overhead to the public. Doesn't matter whether the public 17 gets it, they're going to pay for it. It is cheaper to the 18 public to get it through a regular drug dispensing process.
l 19 CHAIRMAN MOHSENI: Okay, so that reviews it --
l 20 okay.
l 21 MR. GODWIN: So there's a lot of reasons to go 22 with the front-end of it being, if you would, private 23 industry and the back-end of it being government emergency 24 support.
l 25 MR. SHERIDAN: Let me put it another way. The O
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i 438 L 1 government can't get out from under the responsibility of l.
2 managing an emergency. And what I'm saying is that KI is 3 part of the response to an emergency. And if we're 4 evacuating people as a result of an event, we ought to have 5 KI available at the whole community.
6 But there are a whole segment of the population l
7 that wants to be proactive. They want to be able to get 8 this and what I'm saying is that's the area of concern the 9 government should not be involved in. Other than educating 10 the public on KI being one of those --
l 11 CHAIRMAN MOHSENI: Okay.
12 MR. NAWOJ: Well, I think one of the roles of 13 government and one of the things they're good at -- let me 14 point out they're not good at dispensing KI or may not be --
() 15 is public information, public education, okay. Or something 16 they should be -- something they should be doing; providing 17 information to the public, okay. Particularly with respect 18 to this kind of issue.
19 Sometimes they're good, sometimes they aren't. )
i 20 But it's something they should be good at. Something the l 21 government should be doing is promoting emergency l 22 preparedness at all levels. One level that is continually l l
23 overlooked, I think, by emergency management professionals J 24 is the individual and the family preparedness. Although 25 there are programs, this would be an opportunity to promote O ANN RILEY & ASSOCIATES, LTD.
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439 l 1 preparedness at that level and we ought to take that.
[]
V 2 Folks out there can avail themselves of public 3 information material, they can read it, they can understand 4 it. They can go to their health care professional and see 5 if KI is appropriate for them to use in a radiological 6 emergency or not and then make a decision. And that 7 empowers them, the pathway then is, gee, I decided I need 8 KI, I'm going to go down to the drugstore, I'm going to mail 9 in the coupon or send away and get this stuff and put it in 10 my little emergency kit along with the batteries and the 11 flashlight and the battery-powered radio so if there's an 12 emergency, I'm prepared.
13 MS. PEPPER: But I see Aby's point. That if, what 14 you suggest, you know, that it be available to the public 15 prior to the emergency, that does take the power away from 16 the state to decide because if a whole bunch of your 17 citizens have it, they will call yo up and say, "When should j 18 I take it?" And you as a state have to make the decision 19 and then you have to come up with some kind of intervention 20 level when to recommend that they should take it because 21 they'll ask you.
22 MR. NAWOJ: Are you referring to them calling 23 me --
l 24 MS. PEPPER: Any time. '
25 MR. NAWOJ: -- during an emergency or prior --
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440 1 MS. PEPPER: Before or during. Before or during.
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b) 2 3
MR. NAWOJ: If they call me before an emergency, I will tell them, "Go see your physician, I'm not r. druggist".
4 MS. PEPPER: Uh-huh, but they'll --
5 MR. NAWOJ: If you want to take it, you have to 6 get some professional -- there's no incident, there is no 7 reason that I can you there is for taking it. There's no 8 incident at the nuclear power plant.
i l
9 MS. PEPPER: Right. But they will ask me, I'm one l 10 of the stato decision makers, they will ask me at what 11 level -- you know, if there is an emergency, when should I 12 take it. ,
13 MR. NAWOJ: I think that's right. I think we do 14 that --
l 15 MR. SHERIDAN: But that's where your education 16 comes in.
I 17 MR. NAWOJ: We do that now for our emergency l 18 workers.
19 MS. PEPPER: Right.
20 MR. NAWOJ: Okay. And to the extent there is to 21 be determined an intervention level for the public and I 22 think that's up for grabs at this point, there not being 23 one, the intervention level across the boards -- and I don't 24 think it discriminates in FDA, is 25 rem. So whether you're 25 an emergency worker, a member of the general public or l
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r-441 1 whatever, thnt's where it is. That determination is done by 2 most states and usually done reasonably well. And I say
)
3 that-in the context of an emergency unfolding, whether it be l
4 a real one or a scenario, you just don't know whether 5 iodine's'there or not. But the schemes, the procedures --
6 what do I want to call them -- that are followed to make a 7 decision are pretty well thought out.
8 CHAIRMAN MOHSENI: Sure.
9 MR. NAWOJ: Okay, that needs simply then to be 10 disseminated to the public. Emergency public information is j 11 required. In that emergency public information you can say 12 emergency workers in this area have been advised to take KI.
13 The public can infer from that that if emergency workers are 14 taking it, they should take it. The protection is the same.
( 15 If there's an intervention level that's determined for the 15 general public, you can apply the same rationale and process 17 of determining whether or not you've reached that 18 intervention level and perhaps, if you decided to do so, 19 make an announcement to the public that the intervention 20 level for the general public there. If you're a member of 21 the general public and you have KI, go ahead and take it.
22 CHAIRMAN MOHSENI: You see one of the other --
23 Aubrey raised his hand first.
24 A VOICE: Go ahead.
25 A VOICE: I'm not sure I want to go there but --
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n 442 1 MR. GODWIN: There's a scenario I don't think 2 people have really played out in this whole KI issue thet
)
3 might ought to be put on the table at this point.
4 Most states having made the decision not to 5 provide it for the public, I don't think you've really 6 looked at the downwind consequences of how this may play out 7 on it. That is, when they tell their emergency workers they 8 need to take i'., do they think that the members of the e
9 public aren't going to hear that there's a pill being given 10 to emergency workers to protect them from radiation.
11 If they think they're going ".o get away with that, 12 they certainly don't know very much about human nature.
13 Because daddy's going to tell mamma real quick, "I had to 14 take a pill for my radiation problem". And that word's
() 15 going to spread around. And if the word gets back pretty 16 quickly and it will that some members of the public could 17 have been protected but no pills were available for them, 18 unlike in some countries, there's recall in this country and 19 there's going to be a lot of folks paying a pretty hefty 20 price for not providing it for the general public in some 21 way, I'm afraid.
22 And I see that scenario getting to be played 23 pretty seriously. That this is only a modification of the 24 one that you were talking about earlier. Yes, you say it l
25 takes away affirmative decision which is what I alluded to.
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443 1 It does indeed take it away. But I think it's already gone.
2 I think that decision is already gone. We just haven' t
(}
3 played to the point in real events were it really gets out 4 of the bottle. In a real event, if you have iodine out 5 there and you tell your emergency workers to do it, to take 6 a pill,. and have some members of the general public in that 7 same area, you're going to have a hard time explaining why
(
8 you couldn't get them some pills, if it was appropriate.
9 You really are.
10 Now, you got some safety in the fact that they're 11 older adults. You could say, well, it could go up to 500 12 rem. You can play all these kind of dodges, but it's after 13 the fact and it's a whole lot harder to go with..
14 A VOICE: And that's when you trying it.
() 15 MR. GODWIN: And you know, it's awful easy to say, 16 "I don't want to make the decision to do this because of 17 liability questions". All you've done is shifted the 18 liability to the other side of the decision. You have 19 liability for not making the decisions, too.
20 CHAIRMAN MOHSENI: Tony.
21 MR. SHERIDAN: Right. Well, I think in all of our 22 discussions frd.a here on in, I think we should try to decide 23 to draw a line between distributing KI or making it l
24 available is a better term, KI, prior to an accident and 25 making it available following an accident. I l
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444 1 If we can -- see, I would make the argument that
[~)
%)
2 making it available -- that there's a very big difference 3 between making it available prior to an accident and making 4 it available following an accident. I think the government 5 definitely has a role of making it available following an 6 accident. But the point I've been trying to make is that we
^
7 have a much limited role making it available prior to an 8 accident.
9 And that role should basically be limited to two 10 areas. One, education; and two, making sure it's available 11 across the counter in the drug stores. That I see clearly 12 in my mind is our only responsibility for KI making it 13 available prior to an accident. But following an accident 14 it becomes quite complicated and it's going to be different 15 in every area of the country. Connecticut certainly, as you 16 heard from Ed, it will be very different. But I think all 17 of our insurance concerns are much different -- most of our l 18 concerns are quite minimized, quite frankly, if we're 19 talking about making it available following an accident.
20 Very different set of circumstances.
21 And we do clearly have a role there and I didn't 22 want to mislead anyone earlier. I'm sorry if I did. But we 23 do clearly have a role as we do r<s following any kind of 24 emergency.
25 CHAIRMAN MOHSENI: Marcia.
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445 l 1 MS. CARPENTIER: I just wanted to comment on your l
I [~h 2 approach again and then add another wrinkle. I don't think l %-]
3 there's any philosophical problem with having the government 4 say provide a safety net in a wide variety of circumstances, 5 emergency and other, while still letting the private sector 6 take care of day-to-day life which would be the 7 over-the-counter availability.
8 But dealing with the fact that there's no 9 commercial availability to speak of at the moment, I wanted 10 to bring in another kind of organization that we haven't 11 mentioned yet. We've got government and private sector but 12 haven't talked non-profit organizations. And I'm thinking 13 particularly of the Red Cross. Now, my local Red Cross 14 sells these nifty little first aid kits as a fund raiser and l
() 15 16 I'm wondering if any of your communities have Red Cross chapters that might at some point in the process be involved 17 in sort of voluntary pre-distribution. Having it available 18 either by mail or at some drop-in location.
1 19 A VOICE: Very good point.
20 A VOICE: Well, just put KI in that First Aid kit 21 and do your fund raiser.
l 22 MS. CARPENTIER: It's a possibility, yeah.
23 A VOICE: Along right next to the Ibuprofen.
24 CHAIRMAN MOHSENI: Are you suggesting to be 25 concentrated within EPZ's or is it something that they would l
I
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i 446 1 do nationwide.
2 MS. CARPENTIER: I would think only where there's 3 credible need for it. And EPZ's are clearly one of those 4 locations. But it would be interesting to have somebody 5 from the Red Cross to discuss this issue. If it's something 6 that they can see themselves playing a role in.
7 CHAIRMAN MOHSENI: Good point. Can we -- FEMA has 8 good rapport with volunteer organizations. Is this 9 something that you can look into, Bill.
10 MR. McNUTT: Sure, I can do that. Our Red Cross 11 representative and have them bring someone in to speak to 12 us.
13 CHAIRMAN MOHSENI: I was thinking even a little 14 bit maybe more than that. Have tnem consider whether or not
() 15 this is feasible and whether or not they would reach a 16 point. I mean I'm thinking liability-wise. Would they not 17 have a problem of adding KI to their emergency kits or some 18 other form of making it available. If they don't have any 19 legal pr:blems, any other types of problems associated with 20 this, how willing would they be in cooperating in using 21 their good offices to do --
22 MR. McNUTT: We can only ask, yes. !
l 23 CHAIRMAN MOHSENI: Okay. And ask them to --
24 rather than come to talk to us, actually have a position of 25 some sort for us. .
l l
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447 1 MR. McNUTT: Propose the question to them.
2 MR. NAWOJ: Actually, they're already at the
- 3 reception centers for mass care.
4 MR. McNUTT: Sure they are.
5 MR. NAWOJ: It would be an adjunct to --
6 CHAIRMAN MOHSENI: Well, I think Marcia is saying 7 the non-emergency environment.
8 MR. NAWOJ: Well, y e * *.. , it could be both sides of 9 that.
10 CHAIRMAN MOHSENI: ' ~ ure . I appreciate, yes. You 11 can add --
12 MR. NAWOJ: And they'd kind of be a link.
13 MR. SHERIDAN: Well, again, let me just -- and I'm 14 just raising this as a question. I don't have an answer to
() 15 it. But it's a serious matter we're talking about and using 16 a non-profit to fund raise around it would cause me some 17 concern. I haven't thought it out clearly. It seems to me 18 that you're likely to have an agency -- and I'm not 19 suggesting the Red Cross would do this, but use some scare 20 tactics to try and raise their raoney, their annual revenues.
21 You know, I mean I'm sure we'd want to go down that roac'. .
22 But maybe, you know, that may be an unfair 23 statement to Red Cross, but I'd be a little bit concerned 24 about using that approach to -- you know, if -- I suppose if 25 there's not a market there and the drug stores don't carry N . ANN RILEY & ASSOCIATES, LTD.
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I i
448 1 it maybe that's one way of getting it out into the public
() 2 3
hands and make a contribution to Red Cross and you get your care package.
i 4 MS. CARPENTIER: Yeah, it's hard to say what kind 1
5 of market there would be if it were available in the stores.
6 It's one of these things, somebody has got to move first, 7 and, you know.
8 A' VOICE: Well, with education, you see, I think 9 it will be, there will be a market with proper education.
10 MS. CARPENTIER: Yeah.
11 CHAIRMAN MOHSENI: Yes.
12 MR. SIMPSON: A couple of things. Let me start 13 with the specifics we've been discussion and then I'd like 14 to move to another point. If the public has KI and
( 15 obviously, theoretically they could get it today in liquid 16 form and if in the future they have it available in a more 17 easily storable, takable form and you then have an 18 emergency, and the system is that it's available wherever, 19 elsewhere. You still have no idea who took it, who tom 20 what. How much, where it is. You've got a lot of problems 21 still that.have to be gone through in that regard.
22 But my, let me go back further to a more basic 23 point. Each of us here, presumably, have certain things.
I 24 Tony very clearly believes that the government has the l l 25 responsibility to put KI at a reception center. But unless j l
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449 1 I'm mistaken, that's not why we're here. We are here as an
("N 2 impartial body not to advocate one position or another; what
(
3 I believe, what Tony believes or Joelle believes in this 4 context is irrelevant.
5 What we're here to do is provide state and locals 6 the decision as to whether they take K -- provide KI or not.
7 And if they decide to take -- provide KI, the pros and cons 8 that go along with that. We're not here to advocate any 9 position whatsoever. And I understand where Tony's coming 10 from but that's not what this committee is here to do as I 11 understand it.
12 MR. GODWIN: But the report should cover private 13 distribution, alia, the drug stores as one of the 14 distribution -- as one of the places --
() 15 MR. SIMPSON: Oh , absolutely. Absolutely. That 16 comes down into -- '
17 MR. GODWIN: That I thought was his --
18 MR. SHERIDAN: That was my only --
19 MR. GODWIN: That was his point.
20 MR. SIMPSON: That comes down into if a state or 21 local chooses to do it, here is a method and then even here 22 are some of the pros and cons that relate to that method. ;
23 MR. SHERIDAN: Let me make it clear that I 24 ' expressed nry opinion.
25 MR. SIMPSON: Of course, and that was perfectly ANN RILEY & ASSOCIATES, LTD.
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450 1 well understood.
2 MR. SHERIDAN: And -- but I think the point is --
3 MR. SIMPSON: I understand that.
4 MR. SHERIDAN: The point is the draft, the 5 document when completed should, I think, put -- personally, 6 I'd like it to put a lot of emphases on individual 7 responsibility.
8 MR. SIMPSON: And I would agree.
9 CHAIRMAN MOHSENI: And should that be covered in 10 the general policy statements that we went through 11 yesterday? Is that up front saying, you know, emergency !
12 planning is based on --
1 13 MR. SHERIDAN: Yeah, that's w:at I'd like.
]
14 CHAIRMAN MOHSENI: Okay, I want to capture that.
15 Yes, Dick.
[%)I 16 MR. COWLEY: I guess I had a concern when we l
17 started talking about other ways of distributing KI to the 18 public or allowing the public access to KI. I thought we 19 were kind of -- when we started talking about putting in the 20 Red Cross kits and other options, to me that was a little 21 bit more, starting to go micromanaging the program instead 22 of giving the options.
23 If it was going to be permitted to be -- I mean j 24 it's -- I don't see where we have the right to te 1 the 25 public they can't have it in the liublic when it'F i
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451 1 non-prescription drug. We can't tell them they can't have 2 aspirin or any of the other over-the-counter
(}
3 non-prescription drugs. I can't see why it couldn't be 4 available to the public any way they want to get.
5 And an adjunct to that getting it to the target 6 populations might be the Red Cross in the certain areas.
7' MS. CARPENTIER: Yeah, I didn't pose that idea as 8 let's have this committee go talk to the Red Cross and get 9 them to do it nationwide. More along the lines of, well, if 10 you want to have private sector availability and CVS won't 11 carry it, who might. And that's a decision that could be 12 made on the local basis.
13 CHAIRMAN MOHSENI: Precisely. We were going to 14 explore whether or not that's another means of making it
() 15 available. The states should. The private sector not 16 finding initially the market for it, you know you need a 17 starter. Once you start, you know, that sets the fire going 18 and if then other CVS chooses to carry it after a while, 19 then, you know, nobody prevents the public from getting it.
20 It's not available because the market isn't there. That's 21 all.
22 MR. COWLEY: And like I said, I think I told you 23 yesterday or the day before that they have a local gun show 24 up in the Seattle area, there were CVB-700's for sale, there 25 was KI for sale from the same people. They didn't sell
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452 1 anything to do with~ guns, they sold survivalist equipment.
[} 2 And KI was a big part of it for the post-apocalyptic, you 3 know,. response.
4 And that's what they're -- and especially after 5 Y2K, I mean-they're pushing the heck out of it.
6 A VOICE: You mean it's Y2K pill, too?
l 7 A VOICE: And you say someone was offering 8 tablets, tablet form potassium iodide --
9 MR. COWLEY: Our bottle, the same bottle as we 10 carry in our. emergency worker kits. The same CVB (CVS?*) we 11 carry in our worker kit.
12 MS. CARPENTIER: Did you check the expiration date 13 on them?
14 MR. COWLEY: Nope.
() 15 A VOICE: No, he just --
-16 A VOICE: What was the cost?
17 MR. COWLEY: I just laughed as I went by. I just 18 thought this is kind of ridiculous but --
l 19 MR. McNUTT: What were they asking for them.
20 MR. COWLEY: I don't know.
21 A VOICE: Didn't check the market, huh?
22 A VOICE: Fourteen, ninety-five.
23 A VOICE: So there is a market.
24 MR. SIMPSON: As far as the availability I think 25 of KI to the public right now is, you know, market in O ANN RILEY & ASSOCIATES, LTD.
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453 l
1 demand. I mean if I was a pharmacist and I was looking at 2 selling, you know, a case a year, I probably won't stock it.
3 And I agree with you. My question is one that you l 4 found or that you discovered in your research as well as we 5 have in ours, is that it's not a case of, oh, it's there and 6 I can't -- I don't want to stock it. It's just flat in the 7 pill form, not in *. heir materials. It is not there. They 8 don't know how to get it. It's -- you know, I mean there's 9 a lot of stuff in that book that they never order for year 10 after year after year after year for their pharmacy, but 11 it's in the book. Tablet KI is not in the book as far as 12 I've been able to determine it so far.
13 MR. SHERIDAN: And I'd like to know why. That's a '
14 very important point. Thank you. Because it seems to me 15 that there's some kind of a conspiracy. I don't like --
16 need to use word. But why is it not there?
17 MR. NAWOJ: But that's a part perhaps of public 18 education. Pharmacists are members of the public, too.
19 MR. SHERIDAN: That wasn't the impression when I 20 talked with our local pharmacist.
21 MR. SIMPSON: That they weren't members of the 22 general public? I understand I've been down that road and I 23 know what you're saying is absolutely true. It's not in the 24 books, okay. You have to talk to the folks from Food and 25 Drug Administration. And they tell you that it's not in the ANN RILEY & ASSOCIATES, LTD. !
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454 1 books but they also tell you that there's this obscure
/T 2 little section here that talks all about the tablets and
\
3 it's available over the counter. The pharmacists don't know 4 that, they rely on their books. We need to give them 5 another page.
6 MR. GODWIN: You got to get them to go out of the 7 book and go directly to Carter Wallace, whoever. Whoever.
8 MR. NAWOJ: Right, sure.
9 MR. GODWIN: If they do that, then they find out.
10 MR. WILDS: My pharmacist, he didn't that -- you 11 know, he just said my distributor doesn't carry them. And 12 the distributors are not going to carry them unless there's 13 a need for them.
14 MR. NAWOJ: Unless they move it.
() 15 MR. WILDS: Yeah, if it's not going to be moved, 16 you know, they're not going to invest it. And I think j 17 that's why it's not out there. I think that if there was a l
l 18 demand and -- that it would show and distributors would 19 carry it, but -- you know. J 20 CHAIRMAN MOHSENI: Andrea.
21 MS. PEPPER: I think I remember reading somewhere )
22 in my file drawers of KI material something from Carter 23 Wallace that said, we deal only with government agencies.
I 24 MR. NAWOJ: Yeah, I think that's their policy.
25 MS. PEPPER: I think that's the deal.
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1 I
455 1 MR. NAWOJ: That is their policy.
I l 2 MS. PEPPER: They make it for government agency,
, ("')N
\-
3 period. They do not deal with the general public, they do l 4 not deal with regular drug suppliers and distributors and 1
5 stuff, they make it for government agencies.
6 MR. SHERIDAN: But the question is why did they l
7 enact that policy?
8 MS. PEPPER: You'd have to ask them.
9 MR. SHERIDAN: Yeah. )
1 10 MR. McNUTT It's the same, the same reason.
11 MR. SHERIDAN: Who's going to be the big l l
12 purchaser.
13 MR. GODWIN: The initial -- when it was first 14 licensed there was a company other than Carter Wallace got '
() 15 involved and they did try to put it across the counter and I 16 think they went belly up.
17 MT SHERIDAN: Well, let me ask the question here.
18 Would NRC Du valling, since they have made a commitment to 19 providing this drug, would NRC willing --
20 MR. McNUTT: I've got that memo with me, Aby.
21 MR. SHERIDAN: -- to either provide it to the 1
22 pharmacists free so that they can have it available in the )
23 appropriate parts of the country. Or provide -- or '
24 alternative find out why and do something about making sure 25 the pharmacists can purchase it so they can retail it to the I O ANN RILEY & ASSOCIATES, LTD.
k_) Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 i
456 1 .public. It seems to me that's an NRC, an area that NRC
T 2 could be very -- pre-emergency role.
b 3 CHAIRMAN MOHSENI: Or FEMA.
4- MR. McNUTT: Or FDA.
5 A VOICE: FDA.
6 CHAIRMAN MOHSENI: Or FDA.
7 A VOICE: Oh, let's don't dump on FDA again, guys.
8 CHAIRMAN MOHSENI: But, you know --
9 MR. SHERIDAN: But so far NRC has promised to make 10 it available free.
11 CHAIRMAN MOHSENI: Do you know the federal 12 government's draft language in some material says the 13 federal government -- and that's draft, that's not final --
14 when it's. final there is an age -- if it becomes final and
() 15 when it becomes' final, there will be an accompanying budget 16 associated with it.
17 Yes 18 A VOICE: I can assure FEMA's not going to pay for 19 it.
i 1
20 MR. WILDS: The idea of it going free -- I mean 21 we've brought it up in Connecticut but now, this is our 22- understanding, it's going out to mass. 'I guess this was an 23 e-mail to Mike, but it says; 24 "A nuclear safety Mass. residential and 25 cancer preventing pill. Residents near the O ANN RILEY & ASSOCIATES, LTD.
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r 457 1 Pilgrim Nuclear Power Plant in Plymouth, 2 Mass., are urging state officials to 3 stockpile potassium iodide pills in case of a 4 nuclear emergeacy. If taken shortly after 5 exposure-to radiation the pills can help l
6 prevent thyroid cancer and other diseases.
7- Federal regulators recommended the strategy l 8 last summer and have offered to supply the 9 pills free of charge."
l 10 A VOICE: That's the standard tag line on all the l 11 news items, I mean --
l 12 MR. WILDS: Right. But I mean it gets back to the 1
13- question of -- in here we know what the official stamp is.
14 And I think there has to be some detailed clarification --
15 CHAIRMAN MOHSENI: Yes, I he r you.
16 MR. WILDS: -- of what that. stamp is that can be 17 transmitted out to the public because -- you know, 18; everywhere you look the public is saying, this is free of 19 charge. I mean even at this point and no -- and there's 20 been no final policy decision ik or. you know, anything 21 like that. And that's what's making it very difficult.
22 MS. PEPPER: The public thinks that this is done i 23 deal.
l 24 MR. WILDS: Right, and it's free.
I 25 MS. PEPPER: And free.
l l
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r 1 l 458
\
1 MR. WILDS: And the pressure on us is if this is
! /" 2 free and the federal government is paying for it, why don't
! N-3 you do it.
I 4 MS. PEPPER: That's right.
5 A VOICE: It's free.
6 MR. WILDS: You know, and that free in there is 1
7 part of it.
8 MR. SIMPSON: And that combined with NRC's 9 recommendation that states consider KI as a part of their --
10 you know, those two things together put tremendous pressure 11 on the states. Almost impossible pressure.
12 CHAIRMAN MOHSENI: Could I suggest -- 1 13 MR. SIMPSON: It seemed very simple. It seemed 14 just a simple recommendation and an offer to be nice guys --
() 15 16 and guys is generic, ladies. Be nice guys at the federal government as they always are, offer to pay for it and that l
17 has opened up Genie out of the bottle. I 18 MR. SHERIDAN: Could I suggest a work exercise for 19 our next meeting that we have romsone from the federal level 20 answer these questions relating to availability. Why it's 21 not available in pharmacies and how can it be made 22 available.
1 23 CHAIRMAN MOHSENI: Maybe we can ask that question 24 tomorrow morning when Dr. Jean Temeck is here from FDA. She l 25 has looked into the issue and maybe we can get the answer
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459 1 tomorrow. If we don't get it tomorrow, we'll request that
[
2 FDA who is the agency, which is the agency that has that 3 kind of a responsibility -- we have done research.
1 4 If you recall it came in our draft New Reg, the i 5 research we did in just calling a few pharmacies and finding 6 out what's out there if somebody wanted to go. We went to 1
7 U.S. Pharmacopeia (ph) document as well. We came out with a 8 description in U.S. Pharmacopeia latest edition on what the 9 characteristics of this medication was, at what strength is 10 prescription level, at what strength is non-prescription 11 level. And the non-prescription level, the only thing that 12 was available was because of FDA's recommendation to use 13 during radiological emergencies and it said that you can get 14 it through your local community government public health.
() 15 You know, it wasn't like you can go to the pharmacy and buy 16 it. That's in U.S. Pharmacopeia.
17 Those are the research ee did and we put it on the 18 table. We are not a medical agency, neither is FEMA. We 19 were criticized for having actually pulled out stuff of side 20
~
effects as well -- everything that you found in U.S.
21 Pharmacopeia we cited. We said there are the information, 22 pieces of information in there and we'put it on the table 23 for everybody to look at, especially FDA, to speak on those 24 potentially strong words used with the usage of -- without 25 specifying length of time and so forth which we got O
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Court Reporters 1025 Connecticut Avenue, NW, Suite 1014 Washington, D.C. 20036 (202) 842-0034 n
f 460 1 clarification from different parts. .
)
f}
\,3 2 The FDA is looking at the issue precisely because 3 of all these issues that we raised. We did our homework in l I
4 terms of as a non-medical agency to get enough information 5 to get the attention of FDA and we did that. And I hope FDA I 6 will help us understand better what the -- how things have 7 evolved over the years, why is that only through states or 8 local government, the non-prescription medication might be 9 made available.
10 And over the years, the market did not develop 11 elsewhere because you have done your own research, you call 12 the pharmacy, they've heard of it, there's never been a !
13 market out there. Nobody went there and said I want it.
14 And, you know, they are in business, obviously for selling
() 15 medication not just stockpiling. And so we don't have what 16 we -- it hasn't been promoted as a medication that people 17 can actually go and buy and, you know the turnover isn't 18 there. It's not something that you can easily get the 19 private sector interested in. As Marcia offered, another 20 way of doing it with non-profit organizations, maybe. So we 21 can raise that issue tomorrow again with FDA and hopefully 22 we get an answer. But to this point --
23 A VOICE: You probably won't because I don't think 24 she's in the drug licensing and that's probably where it's 25 an issue.
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461 1 CHAIRMAN MOHSENI: That's right. You're 2 absolutely right, the FDA is a big agency. You got one side 3 working on one aspect of the medication.
l l
But still at least 4 it's the right agency to ask the question from rather than 5 NRC or I would say even FEMA in this case. We may have our 6 answers but they're authoritative answers for you to be able 7 to rely upon. We're not in that kind of business.
8 MR. GODWIN: Well, are we agreed though we are 9 going to say something about private distribution as being 10 something that should be 11 CHAIRMAN MOHSENI: I think it's been discussed 12 here enough Ltat --
13 A VOICE: We have to look at the pros and cons.
14 MS. CARPENTIER: Right.
15 A VOICE:
(D) If you make the decision --
16 CHAIRMAN MOHSENI: That's right.
17 A VOICE: -- as a state or local to distribute it.
18 MR. GODWIN: Well, regardless of when you make the 19 decision, that may take place anyway. Yeah.
20 MR. SHERIDAN: Yeah, right.
21 MR. GODWIN: I think we ought to acknowledge 22 there's a role for the private industry to distribute 23 material for a profit.
24 CHAIRMAN MOHSENI: But at the same time, at the 25 same time, because it doesn't have that kind of a turnover, l
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462
- 1 it may be a one-shot deal, you know, and then after a while l
l
) 2 you can't find it again.
l
(/
\_
3 MR. GODWIN: That's their problem.
4 CHAIRMAN MOHSENI: I know. What I'm saying is you 5 can't assume that that's going to work itself out by itself.
6 You have -- there's a need to make it -- if you rely on the l
7 private sector, you have to address the marketing aspect of 8 it. There's no way that you can rely on it becoming the 9 principal provider of the potassium iodide if the market is 10 not there. And if you thought public education creates the 11 market, then public education becomes a program that each 12 state and local government will have to actually fund, 13 develop and go out there. It may cake years for it to 14 actually translate into market.
16 MR. GODWIN: I would suggest to you that private 17 industry might have an interest in doing some education, 18 too. Have a good for that.
19 CHAIRMAN MOHSENI: Okay, those pros and cons will 20 appear in the document.
21 MR. SIMPSON: But I don't think anyone is 22 suggesting we're going to have the private industry be the 23 principal means of providing KI to the public.
24 MR. GODWIN: No.
25 CHAIRMAN MOHSENI: One. One of the many ways.
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463 1 And clearly it's not there now. Something has to happen to
(N 2 make it happen and I'm not MBA to tell you how you want to V
3 -- would have done it better.
4 MR. WILDS: And the availability of KI, I mean I (
5 just thought of something that happened. It has to be out 6 there somewhere because I had a researcher at the University 7 of Connecticut when I was working there and I don't know how 8 he got it but he was taking a KI pill every time before he 9 did an iodination. I'll have to go back and find out how he 10 got and where he got it from. But he did have access to it. I 11 So I mean it's some wheres out there.
12 MR. SHERIDAN: You know there's probably an easy 13 way of making sure that we generate a market for this. If 14 the nuclear power industry, I know our free plant in
() 15 Waterford, they have a yearly or bi-annual, actually, 16 purchase of KI. They purchase it through the local pharmacy 17 instead of going directly to Wallace labs. It may be enough 18 to create a market right there.
19 CHAIRMAN MOHSENI: By adding a, of course, markup.
20 MR. SHERIDAN: A little bit of additional expense.
21 CHAIRMAN MOHSENI: Yeah. But making the market 22 occur. I I
23 MR. SHERIDAN: Yeah.
i 24 CHAIRMAN MOHSENI: And how do you make the l 25 utilities, how do you recommend that they would choose a I
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464 1 more expensive path?
[ }
2 A VOICE: Exactly.
3 CHAIRMAN MOHSENI: Yeah.
4 MR. SHERIDAN: Well, yeah, but I understand. I 5- undarstand those are all -- they all have their own 6 challenges, but they're possibilities, yes. And once it 7 gets going,' hopefully it will have enough fuel to keep 8 itself alive.
9 MR. COWLEY: But by increasing the market, you may 10 'also cause the price to come back down a bit to stabilize 11 instead of continually going up so they milking the 12 governments all the time. If they know that there's another 13 market besides just government agencies.
14 CHAIRMAN MOHSENI: Okay.
() 15 MR. COWLEY: It may be small.
16 CHAIRMAN MOHSENI: But competition hopefully will 17 --
18 MR. COWLEY: It could.
19 MR. CASH: In Alabama the utilities provide the KI 20 for emergency workers in both -- near both plants. Now, TVA 21 is a quasi-governmental agency, but Southern Nuclear or 22 Alabama Power is not a-government agency. A large agency 23 but not a government agency. Now, they are able to get this 24 through Carter Wallace, whatever method they're using to get 25 'it .
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. c
F 465 1 Who -- I mean they pay for it. It doesn't come 2 out of our state budget. It doesn't come out of the money
- 3. of the state at all. You know, it's provided.
4 In other states,.I'd like to know who -- does the 5 state provide for emergency workers or it's not the utility.
6 MS. PEPPER: Comes right out of my budget, yes.
7 MR. CASH: Okay.
l 8 MR. WILDS: Okay, in Connecticut we provide for 9 emergency workers and that is provided by Millstone where it 10 doesn't permit, you know. When we go to change out our 11 bottle, we change out on a frequency with them and since 1
12 we're down at the power plant, really, you know, on a daily l
L 13 basis --
l 14 MS. PEPPER: Millstone pays for it but you all buy
() 15 it?
l 16 MR. WILDS: Yeah, Millstone pays -- no, they pay 17 for it.
18 MR. PEPPER: They buy it and pay for it just like 19 they do --
l 20 MR. WILDS: And they just -- we need so many 21 bottles for our kits and they give us that and we change 22 them out. 1
~23 A VOICE: What about in Pennsylvania?
l l 24 MR. SIMPSON: We buy it but it comes -- the 25 utilities are billed for that.
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466 1 A VOICE: Through funding, yeah.
2 MR. SHERIDAN: We buy it.
,3 A VOICE: Yeah.
l 4 MR. McNU1T: Well, Andrea, it comes out of your 5 budget but --
(
6 MS. PEPPER: Yes.
7 MR. McNUTT: -- isn't your funds from the utility.
8 MS. PEPPER: Yes. It comes as a small part of my 9 budget but all of our programs that are related to 10 preparedness are funded by the utilities by law so --
11 MR. CASH: How about New Hampshire?
12 MR. NAWOJ: We leave that up to the utility and
- L3 let them buy it for us. We've bought some in the past but, 14 you know, apparently it's cheaper for them to buy more of it
() 15 and just provide it to us.
16 MR. CASH: And again in Alabama and in Tennessee, 17 in the Tennessee Valley Authority areas, EPZ's, they provide 18 for the public also there. They buy it and get it to us and 19 we distribute it to our local health departments.
20 MS. PEPPER: So Carter Wallace deals with 21 utilities and government. agencies, period?
22 MR. CASH: Well, that may be the case.
23 A VOICE: In our case, our last buy was not Carter 24 Wallace.
25 MS. PEPPER: Who did you buy it from?
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467 1 MR. McNUTT: Roxanne (ph) ?
[~ 2 MR. SIMPSON: The other --
Q}/
3 CHAIRMAN MOHSENI: Ambex.
4 MR. SIMPSON: Ambex.
5 MS. PEPPER: Ambex, okay.
6 MR. SIMPSON: The new company. Much cheaper, 7 packaged in individual tablets in a blister-pack kind of l l
8 thing rather than --
l l
9 MR. McNUTT: Where is Ambex now?
10 MR. GODWIN: Where is Ambex?
12 A VOICE: Florida I think is their headquarters.
13 I don't think that's where they manufacture it, but I think 14 that's where their offices are.
() 15 MR. PEPPER: How much do you buy at a time?
16 MR. SIMPSON: I forget. We order one --
17 A VOICE: Is this the one?
18 MR. SIMPSON: That's it, yeah. The order came 19 that way. We ended up, I know we ended up with $15,000 20 worth which was a lot more than we expected to get.
21 MS. PEPPER: Okay.
l 22 MR. SIMPSON: Because we were doing it priced on 23 what Carter Wallace was offering.
l 24 MS. PEPPER: Okay.
25 MR. SIMPSON: So we got a lot more than we planned f%
(m,/
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468 1
1 on. I don't remember how -- I think we order 300 cases and l
2 ended up with a whole bunch more.
1 ()T 3 MS. PEPPER: Okay.
4 MS. KEY: I thought at the last meeting somebody 5 said there was some way of mail ordering it. That they had 6 seen it available mail order.
1 7 MR. McNUTT: Oh , yeah, that was that company 8 supposedly.
9 MS. KEY: That company has a mail order? Like I 10 mean I'm talking about like in the back of a magazine, you 11 want your KI you can mail order it. Like an individual 12 person can mail order.
13 MR. CASH: You go out and get an order with these 14 people in a specified time they will put it in the mail and r~
15 (T) get it delivered within --
16 MS. KEY: Right, that's different. That's not 17 what I'm talking about at all. I'm talking about -- I i 18 thought somebody said that an individual member of the 19 public could mail order KI if they wanted.
20 CHAIRMAN MOHSENI: Folks, I need to move on faster !
21 here so that we get you to get ready for the visit of the 22 EOC. Can we go over what Aubrey and Bill McNutt proposed in 23 terms of considerations, various considerations that go into 24 --
i 25 MR. GODWIN: I think we need to add this private 1
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l l l
n 469 1 distribution as a section of this.
t
'2 CHAIRMAN'MOHSENI: Okay. Will you -- Bill, would 3 you like to add something about the private distribution to l
L 4 the list of considerations that Aubrey put together and you 5 -added a few. things or changed a few minor things.
l 6 MR. McNUTT: I'll -- sure.
7 CHAIRMAN MOHSENI: Okay. Dick, did you capture l 8 that? Bill McNutt will add the private distribution portion L 9 to Aubrey's section on considerations. And let's quickly go 10 through considerations here. We're on --
11 MR. COWLEY: Repeat that again, Aby, I didn't 12 catch all of it.
l 13- CHAIRMAN MOHSENI: FEMA will add a paragraph on 14 the private distribution issues or considerations, you know,
() 15 16-of how we can use the private distribution mechanism with l pros and cons and add it to the section done by Aubrey under 17 considerations.
18 MR. GODWIN: Oh, that's not on the agenda. That's 19 no wonder I didn't have it.
20 CHAIRMAN MOHSENI: Huh?
21 MS. CARPENTIER: This in just a summary of the 22 discussion we just had, right? It's not a new --
23 CHAIRMAN MOHSENI: Correct.
24 MS. CARPENTIER: Okay.
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470 1 what we just --
2 A VOICE: The next thing is Marcia, I think.
3 MR. GODWIN: Yeah, we got the Canadian experiences 4 next.
5 CHAIRMAN MOHSENI: Okay, let's do Canadian before 6 we go into considerations.
7 MS. CARPENTIER: Okay. You have me down for both 8 Canadian and European experiences and that was the firct I 9' heard of the fact that you thought I was going to present 10 -all'of Europe. So we're going to have to have that as 11 unfinished business and figure out who does which case study 12 besidec Canada. I'll take a couple of them but I can't take 13 the whole continent and we can do that Friday morning.
14 CHAIRMAN MOHSENI: Okay.
() 15 MS. CARPENTIER: So, Canada. A couple of general 16 remarks on Canada before I start. There are three provinces 17 that have nuclear power plants; New Brunswick, Ontario and 18 Quebec. And protective action guides and just general 19 policies vary.from one policy to the other. That's 20 standard, not just KI. They have a decentralized system.
4 21 So essentially we're talking about three separate 22 case studies and I will take the two easiest ones first. I-t 23 think we can certainly get those done by noon. Ontario is a 24 little bit more complex and has a few more unresolved issues 25 so we might have to move that. But at least we will have O ANN RILEY & ASSOCIATES, LTD.
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l 471 1 gotten the easy ones out of the way.
i
)
2 I'm going to start with Quebec because first off, 3 it's not in the documents that you all received before the 4 meeting and also because they're doing something 5 interesting. They're the only province that's really 6 grappling with the new WHO recommendations. However, I 7 can't tell you what the final answer is going to be. They 8 have a process under way right now and we'll get something 9 in writing in about a month. So that will be presented in 10 more detail at the next meeting.
11 Quebec has one nuclear power plant. It's located 12 between Montreal and Quebec City in a predominately rural 13 area. The 10 kilometer zone around the plant includes three 14 villages and has a total population of about 10,000 and the
() 15 16 18 kilometer zone has a larger population center in it and that's 150,000. So we're talking about two very different 17 kinds of zones when you look at the problem. And as a 18 result of looking at two different kinds of programs, one 19 for the inner zone and one for the outer zone. They are 20 looking at some variation on pre-distribution to residences 21 in the i ser zone, the 10,000 population.
22 MR. GODWIN: This is prior the accident 23 distribution?
24 MS. CARPENTIER: Prior to the accident 25 distribution to residence. However, they are not talking i
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472 1 about distributing to everybody in light of the WHO
() 2 3
recommendations, they're talking only about pre-distribution for pregnant women and children four and under. So that's a )
4 different kind of policy than any that have been discussed 5 so far. Again, I don't know any details. They are not in a 6 position to provide them yet because they're still 7 discussing them.
8 Then for the outer zone, the 18 kilometer zone, 9 they're looking at stockpiling for distribution in the event 10 of an accident for the entire population. For an entire 11 150,000 population. So basically, they got two, two 12 components.
13 MS. KEY: So inner zone pregnant women and 14 children under four, did they have any clue about what kind 15 of dose?
16 MS. CARPENTIER: They are looking at the doses int 17 he WHO document but they haven't set it yet. And as for the 18 intervention level for the radiation dose, they're looking 19 at five rem dose for small children which I assume means 20 children under four, four and under. And 10 rem for larger 21 children and adults. And that's the outline I have as of 22 now.
23 MR. KEY: But they're not talking about 24 pre-distributing to that older population?
25 MS. CARPENTIER: No. No, but that would be the i
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473 1 intervention level.
2 MR. CASH: Now, which? This is which?
(
3 MS. CARPENTIER: This Quebec.
( 4 MR. CASH: Quebec, okay.
l 5 MS. CARPENTIER: Yeah, and that's their one plant.
6 And like I said I'll have considerably more detail next time 7 around because they'll have at least finished one round of 8 their process.
9 MR. McNUTT: So you're saying within the 10 10 kilometers, they are going to pre-distribute for this group?
11 MS. CARPENTIER: Yes, the pregnant women and 12 children four and under. That's assuming that the policy 13 that they're currently discussing becomes what they final 14 agree upon.
15 MR. McNUTT: Right.
16 MS. CARPENTIER: Yeah. And New Brunswick is the 17 other Province that's an easy case because they also have 18 only one plant and a relatively straight forward situation.
19 There's an interesting lesson to be drawn out at the end and 2n I'll tell you what I think that is. They do not have any 21 official policy endorsed by their executive authority. So 22 there's nothing really to cite at this point.
23 There's been a decision made by public health 1
24 officials to pre-distribute to individual residents within l 25 the emergency planning surrounding their one plant. And the ANN RILEY & ASSOCIATES, LTD.
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474 1 stock they currently have out there expires in the year 2001
[}
2 and between now and then they're hoping to get an executive 3 level policy to perpetuate the program. They had a case 4 'where the last time the stock expired, they let the program
.5 expire. The public said they wanted it and so they brought 6 it back. And so they figured if the public wants it, they 7 want to'have it official.
8 Their 20 kilometer EPZ has 3,000 residents which 9 makes it an easy case to start with. It's certainly not 10 comparable to Waterford or anything but it is one that's 11 easy to get to. They also have something that was in place 12 before they decided to distribute KI that makes distribution 13 very easy. Once a year they have a demographic survey of 14 the araa, of all 3,000 residents and this is done by summer
() 15 interns, summer students. And it deals with a lct of 16 information; you know, who's in the household and so on just 17 so they can keep track of who's around.
18 But they both do public education and distribute 19 the KI as part of the survey because they're going door to 20 door anyway, they didn't have to put a new program into 21 place. And this has a couple of features that ensures that 22 a new resident will get a supply of KI within a year. Gives 23 them a way to do updates and so on without greatly increased 24 costs over what they were doing anyway.
25 So far compliance has been excellent. There's O ANN RILEY & ASSOCIATES, LTD.
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475 1 only been one household that's refused to participate which
( 2 is amazing to my mind, but that's what they got. As far as 3 ongoing public education, they provided everyone with a 4 refrigerator card about KI so that they have something 5 available all the time. However, even with all of this they 6 found that after one year about two-third of the residents 7 could locate their KI. They still knew where it was and 8 would be able to find it and use it, someone directed them l
9 to use.
10 Now, I don't know how to evaluate that two-thirds 11 number. Clearly it's two-thirds under probably the best 12 case scenario that you could get for pre-distribution before i
13 the accident to residences with a small population and 1 14 annual reminders and so. And even in an easy case like
() .15 this, you could say, well, oh, wow, you can get as high as 16 two-thirds or you can say, gee, you can only get two-thirds 17 of the population even under ideal conditions.
18 But I think that's -- you might even use this as 19- an endpoint given the cases we've got out there. Because
- 20 chey've only got two-thirds one year later, they have also 21 decided to distribute KI in the event of an accident at road 22 blocks at the way out of the evacuation zone.
23 New Brunswick, like everybody else sees this as a 24 supplement to evacuation and they do not rely on sheltering.
25 Their intervention level is thyroid doses of 50 rem or above ANN RILEY & ASSOCIATES, LTD.
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476 1 and they are very likely to revise this downward to 10 rem g 2 in the future. As far as what they're giving to households, 3 I don't know and my contact doesn't either. He's looking 4 into it. But when I get an idea on what kind of pills 5 they're distributing and how many each household gets and so 6 forth, I'll put that in the document as well.
7 MR. GODWIN: That 50 rem applies to adult as well 8 as children?
9 MS. CARPENTIER: I believe so. But that's 10 something I can check. Okay, those are the two easy ones.
11 Where it's pretty obvious where the holes are and what I 12 have to do to fill them in. I want to just stop for a 13 minute and see if there are any questions before doing the 14 hard one which is probably more to the point for a lot of 15 you.
h 16 CHAIRMAN MOHSENI: Do you have any indication of 17 how they measure the dose. And how do they do it; is it 18 projection or is it actual 19 MS. CARPENTIER: No, but I can ask.
20 CHAIRMAN MOHSENI: Okay, thank you. They do have 21 reception centers like we do?
22 MS. CARPENTIER: They didn't talk to me about 23 reception centers. They just said on the road on the way 24 out. Presumably at traffic control points or something.
25 CHAIRMAN MOHSENI: And so -- okay. I was ANN RILFY & ASSOCIATES, LTD.
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l 477 1 wondering if they have a place where they could be
(i 2 monitoring like we do.
V 3 MS. CARPENTIER: I can ask that as well.
4 CHAIRMAN MOHSENI: Okay.
5 MR. NAWOJ: You mentioned -- what was it, a 10 and 6 an 18 mile zone.
7 MR. GODWIN: Kilometers.
8 CHAIRMAN MOHSENI: Kilometers.
9 MS. CARPENTIER: Kilometers, yeah, that was 10 Quebec.
11 MR. NAWOJ: Kilometer, excuse me.
12 MS. CARPENTIER: Uh-huh. l 13 MR. NAWOJ: And then a 20 kilometer?
14 MS. CARPENTIER: And that was New Brunswick.
f,-~ ) 15 Different provinces, I assume they're using different 16 planning basis.
17 MR. NAWOJ: Okay. Is -- does that mean that there 18 are different types of plans or are they all --
19 MS. CARPENTIER: Don't know that either. .
20 MR. GODWIN: There's probably no centralized 21 decision. Each part --
22 MR. NAWOJ: The New Brunswick one is a PW and I l
23 think the others are can-dos (p h) but I'm not sure.
24 MS. CARPENTIER: Okay, I'll definitely find out, 25 put that in initial remarks on Canada generally. l f
(_ ,
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478 1 MR. NAWOJ: Maybe the other way around. And if 2 that's so, is it becauue of the design of the reactor that 3 they have different zone sizes?
4 CHAIRMAN MOHSENI: So New Brunswick had for 5 everyone? All the same level for everyone, not the WHO?
6 MS. CARPENTIER: No , as far as I can tell. Yeah, 7 as far as I can tell New Brunswick has an older policy 8 that's still using a one, one level approach.
9 CHAIRMAN MOHSENI: Okay. Okay, thank you. Thank 10 you very much.
11 MS. CARPENTIER: Okay, I can definitely get 12 started on Ontario, that has the most unresolved issues and 13 I'll tell you as I go what issues I know already are 14 unresolved and how I'm going to try to fill them in so you l () 15 can, you know, we don't have to spend time discussing them
- 16. because we don't know. No one here does or if you do, tell 17 me. But if you find anything else call it to my attention 18 and I'll see what I can do about filling in that 19 information, too.
20 Ontario is the most colicated case and they have 21 the EPZ's that are probably most like Connecticut's and 22 other urbanized areas in terms of large populations.
23 Considerably more difficult problems associated with any 24 kind of protective measure. They have a policy in place and 25 I've got copies for everyone -- and we'll distribute it at ANN RILEY & ASSOCIATEC LTD.
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1 l
l 479 l 1 some point -- that requires the municipalities to make KI f"'
v 2 available to members of the public and even if they're 3 exposed to plumes containing radiciodines. At the moment i
4 this means stockpiling in all cases. Nobody is 5 pre-distributing to residence before an accident taxes I
l 6 place.
7 Now, how this works in practice is determined at 8 the local level and they have an official called the local 9 medical officer for health that makes this determination.
10 This is the same person who deals with other health issues; 11 immunizations, beach closures and so on. And in addition to 12 central stockpiles for distribution later, they do have 13 limited pre-distribution to schools, hospitals and nursing 14 homes and in the case of schools, they have parental
]
() 15 permission slips on file.
16 And a general comment about Canada; it seems that 17 they do consider liability issues but it's not as a big a 18 deal as it is in the United States. I don't think it drives 19 the process to the same extent and I just don't think 20 personal injury lawsuits are as common there so that's a 21 difference between the countries that should be kept in 22 mind.
23 There are three commercial nuclear power plants in i
24 the province. From now I'll be talking about 10 kilometer 25 EPZ's for these plants. There's a plant in suburban Toronto ANN RILEY & ASSOCIATES, LTD.
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I 480 l'
that has an EPZ with between 400- and 500.000 residents.
/ 2 And there's another one a bit further away from Toronto that 3 has 100,000 which is having an exercise at the end of April..
4 U.S. will be playing and it will be interesting to see what
! 5 they do there.
6 The third plant is in a less urbanized area and 7 it's only got 20,000 in the EPZ. There are two other l 8 facilities that they consider the EPZ for the two plants in L 9 Michigan crosses into Ontario potentially affectirg 10,000 ;
10 people and there's also the Chalk (ph) River site. north of 11 Ottawa which has a research reactor. I have the least 12 information about those two and they're sort of special 13 cases that I'm going to have to look into differently from 14 the Ontario hydro plants.
() 15 -How it works with Ontario hydro is that the plants 16 ake care of the stockpile and plant employees are 17 responsible for bringing the stockpile to reception centers.
18 This is something that --
it is reflected in law. They have 19 a polluter's pay principle and that applies here but it also 20 is negotiated. It's not the polluter's pay principle in the 21 cases it has a stick attached to it so they have discussed 22 this with the utility and come up with plans to do this.
23 Now, since it's local, my next step is to start 24 talking to local governments and utility people and find out 25 exactly what they intend to do. How much KI they stockpile
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l 1
481 1 in each case, especially for the bigger EPZ's. And what f
2 assumptions they're making about how many people come to 3 reception centers and so on. But I haven't done that yet 4 and when I do, I'll have more detail for you there.
5 The local medical officer for health determines 6 when distribution takes place. Doses that are -- doses of I 7 KI that are in use are the standard 130 milligram doses and j 8 they're discussing the same issues we're discussing about 9 diving pills. They haven't come up with any conclusion 10 either. The intervention level is 10 rem and that's -- the 11 10 rem goes to the thyroid and that's for everybody. And 12 again, details, I'm still working on detail., for each 13 individual plant and I'm particularly interested in working 14 up a detailed case study for the Pickering (ph) plant m
( 15 because it's got the biggest EZP (sic).
(
16 MR. KEY: Is this everything in Canada? Th s 17 covers all the plants in Canada?
18 MS. CARPENTIER: That's all the plants in Canada.
19 MS. KEY: So is that federal law that says that 20 these individual provinces need to c,onsider it or have each 21 of the provinces on their own decided to consider it?
22 MS. CARPENTIER: I think they've made the decision 23 individually because the decisions are so different. New
,4 Brunswick came first. And my understanding from Ontario is 25 that they were faced with the same thing that Connecticut's
(~h ANN RILEY & ASSOCIATES, LTD.
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482 1 faced with now. People came to Ontario and said, well, why 2 aren't-you doing what New Brunswick is doing and they said, 3 well, the situation is light year's difference. And Quebec
'4 is the last to move and like I said, they're just starting 5 now.
6 MS. KEY: So it appears to be from the public 7 driven not federally driven, or anything for that?
8 MS. CARPENTIER: Well, there's no unified federal 9 PAG's for anything in Canada; not for evacuation or for 10 anything else.
11 MS. KEY: Right.
12 MS. CARPENTIER: And I don't know where the KI 13 came from originally in the first case.
14 CHAIRMAN MOHSENI: Thank you, Marcia.
() 15 MS. KEY: What year did New Brunswick -- you said 16 New Brunswick was first?
17 MS. CARPENTIER: New Brunswick was first.
18 MS. KEY: When did they start doing it?
19 MS. CARPENTIER: I don't know when they got into.
20 CHAIRMAN MOHSENI: Bill McNutt and Aubrey.
21 However you want to do it. You have a few minutes, you want 22 to just touch base, touch on important aspects of the 23 considerations?
24 MR. GODWIN: All right. I guess, you know, the 25 issue is that we -- is there any issues we left out that
{ -
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483 1 need to be put in there is all I know.
2 What do you think, Bill?
3 MR. McNUTT: I'm not sure I know what Aby wants.
4 CHAIRMAN MOHSENI: I want to give you a chance to 5 actually highlight ~what you -- what's in there and the 6 significance of those and whether or not it's exhausted 7 enough for us or do we need to add anything.
8 MR. McNUTT: Well, I don't think -- I mean of you 9 want Marcus (ph) to go through this thing, line by line, he 10 can do that.
11 CHAIRMAN MOHSENI: Not line by line, but issue by 12 issue, maybe. You know, Aubrey can touch base and you all 13 can react.
14 MR. McNUTT: Okay, well, he has a copy so here we )
-s i
( ,/
15 go.
16 CHAIRMAN MOHSENI: Okay. Look, we don't have much 17 time either. I wanted to just spend a few minutes on the 18 top level issues. Yes?
19 MR. WILDS: Bill wrote a proposed rewrite?
20 CHAIRMAN MOHSENI: Yes.
21 MR. McNUTT: Yeah.
22 CHAIRMAN MOHSENI: That's fine.
23 MR. WILDS: How about if Bill just goes over what 24 gaps you were trying to fill in or whatever.
25 MR. McNUTT: Well, I don't -- I don't know. I jN, ANN RILEY & ASSOCIATES, LTD.
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r 484 1 mean'I just took what Aby did and -- I mean Aubrey did and 2 this is what I did. And --
3 MR. WILDS: Oh, okay. I didn't know, okay.
4 CHAIRMAN MOHSENI: For example; there's on -- one 5 paragraph says; 6 "The planning basis for determining the 7 amount of resources required at reception 8 centers is 20 percent. However, if KI is 9 made available increased numbers of the l
10 population may arrive. It's" -- if not it --
11 "If state and local governments opts to 12 provide KI at these centers, additional
. 13 resources may be necessary; i.e., monitoring 14 instruments and personnel "
() 15 MR. GODWIN: Where are you reading.
16 CHAIRMAN MOHSENI: " Making it" -- huh?
17 MR. GODWIN: Where are you reading? What page?
18 At the bottom of the page, what's the number down there?
19 CHAIRMAN MOHSENI: 25; Roman Numeral XXV.
20 MR. GODWIN: Thank you.
21 CHAIRMAN MOHSENI: XXV.
22 MR. GODWIN: Okay.
23 CHAIRMAN MOHSENI: Middle of the page, the 24 planning basis for determining the amount of resources 25 required at reception centers. Do you have it?
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I 485 1 MR. GODWIN: Not yet.
l 2 MS. CARPENTIER: Which version are you working j 3 from?
4 CHAIRMAN MOHSENI: Okay, the version I sent --
5 MS. CARPENTIER: February 26th?
6 CHAIRMAN MOHSENI: Maybe I --
7 MR. GODWIN: That's probably not the version you 8 sent because we have to come back to --
i 9 CHAIRMAN MOHSENI: Okay. Okay, good, fine, j 10 MR. GODWIN: It looks like it's at 20 --
11 CHAIRMAN MOHSENI: Let me look at the other.
'12 MR. GODWIN: Looks like it's en page 24 of the 13 document we have.
14 CHAIRMAN MOHSENI: Okay.
() 15 MR. GODWIN: One page off.
16 MS. KEY: Oh, here it is, okay, yeah.
17 tiR . GODWIN: Yeah, that's you all's version.
18 MR. WILDS: Right.
19 MS. KEY: Okay.
20 A VOICE: That's where Aby's reading from.
21 MR. GODWIN: Right. Right. Yeah, that's very I 22 similar to the statement I had where I had -- I was talking 23 about 20 to 25 percent. In some cases, it would be all at 24 the reception centers that are available.
25 CHAIRMAN MOHSENI: Okay.
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Y 486 i 1 MR. GODWIN: And therefore the reception centers 2 may be too small and may go up to nine percent.
3 A VOICE: Yeah, I mean the point is --
4 MR. GODWIN: Both of us had the same point.
5 CHAIRMAN MOHSENI: I'm just giving that as an 6~ example saying, yeah, those are --
l i 7 MR. McNUTT: It's a consider ratio.
8 CHAIRMAN MOHSENI: Yes. The planners ought to be 9 aware that, depending on how you decide to distribute your
! 10 KI, the way things are set up today reception centers may be l
11 impacted. I mean that's all --
12 MR. McNUTT.: That's right.
l 13 CHAIRMAN MOHSENI: That's all you're --
14 MR. GODWIN: We're both trying to make the same *
() 15 16 point.
l CHAIRMAN MOHSENI: Well, actually it's really <
17 obvious point that we're trying to kind of capture and put 18 in. Maybe, if anybody offers any more little nuances here l
i 19 and there so that the states appreciate what this means. ;
20 There's another one that, you know, when the
' I 21 public is advised -- that Aubrey had. That they should 22 receive some medication, this responding fraction may be in 23 excess of 90 percent. I don't know what the basis for that j 24 --
l 25 MR. WILDS: Yeah, that was my question. Where i l
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l 487 1 does that come from?
I
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2 MR. GODWIN: Where did that came (sic) from. I 3 think you'll get a better response whenever they're told 4 that they can get something at the reception center. You 5 tell them they need monitoring, you tell them they need a 6 pill. I think more than 90 percent -- and that's a personal 7 opinion.
8 MR. WILDS: Okay.
9 CHAIRMAN MOHSENI: Okay. Okay.
10 MR. GODWIN: That's what you want to do it for?
11 CHAIRMAN MOHSENI: Yes. Yes. I thought maybe 12 there was a study or something that you referred to. Okay.
13 So, you know, we may just have to kind of reference how 14 we're using. The 20 percent is well referenced, It's a
() 15 FEMA requirement in the --
l 16 MR. WILDS: Well, yeah. Well, because I think in I 17 Bill's draft he did state that the planning basis is 20 i
18 percent and you need to consider that there may be an 19 increase. It may not be a wise idea to state that you can 20 expect greater -- if we put in the document that we can 21 expect greater --
22 MR. GODWIN: Let's say, it may be in excess.
23 MR. WILDS: Right. But still when, you know, 24 they're going to take it that there's some justification for 25 that.
l
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488 1 MR. NAWOJ: And what is documented about the 20 1
2 percent is that it's rarely reached in other types of 3 emergencies. Not that it's a hard number, that you can 4 expect 20 percent. It's a planning basis for --
5 CHAIRMAN MOHSENI: It's a planning and evaluation e
6 basis for FEMA's rep program. It really -- you.nnow, who 7 knows what the event will do to us and we don't have that 8 much history, 9 MR. GODWIN: But if we have a situation or create 10 an emergency where we had something required of the public, 11 other than just going by to register and to get quarters, we 12 probably would have a higher percentage.
13 MR. McNUTT: Well, I don't know. I mean if you 14 have a flood and you say come to the high school,
() 15 ' historically a lot of communities get a relatively small, 16 around 10 percent or so folks that respond.
17 MR. GODWIN: But if you had as -- in order to get 18 your money to pay for compensation for your damages, you get 19 a lot bigger percentage. And I'm saying in this situation, 20 you're saying, you're going to be telling them to go there 21 to get some potassium iodide to reduce the radiation and j
22 I'll predict you'll get a whole lot bigger response in that j l
23 case than you would just in an ordinary emergency. You just 1 l
l 24 do a straight evacuation, I agree you don't get that many.* I 25 MR. McNUTT: I'm not sure I agree with that. I i
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489 1 think conceptually maybe a few percentage points, but I'm l
() 2 3
not sure it's going to be'a huge impact.
MR. GODWIN: I believe it will be.
4 MR. McNUTT: I couched it the way I did because I
-5 just want to bring it to the planner's attention.
l 6 CHAIRMAN MOHSENI: Yeah.
1 7 MR. McNUTT: I don't know what it's going to be.
8 And when I did the original research back on the 20 percent, 9 _you know, it was for natural emergencies as well as a couple 10 of chemical. The average reporting at the time of this is 11 like 15 percent.
! 12 MR. GODWIN: Right.
13 MR. McNUTT: So -- and then as low, in some 14 incidents, as three percent so --
() 15 MR. WILDS: Yeah, I was just going to ask Bill, 16 you know, and you've answered my question basically, if l
17 there was any other -- you know, emergency responses. I was i
18 _ thinking of like chemical response. Somebody may need to be l 19 advised to go to the reception center to be checked or j 20 monitored or --
21 MR. McNUTT: They go to friends, relatives and 22 hotels.
23 MS. KEY: Yeah, but do they ever have -- I mean 24 this is a situation where you're talking about something out I 25 there that people consider very harmful and then you're i
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490 1 saying, well, you know, something that might to some degree 2 counteract it, it seems to me you're going to get a lot of
)
3 more people.
4 MR. GODWIN: Yeah, I would predict -- you can tell 5 them they're going to be monitored. You can tell them 6 they're going to get potassium iodide. I think you're going 7 to get a full center in a hurry.
8 MS. KEY: You're not just saying you're getting 9 out of harm's way, you're also saying you're going to 10 benefit by it.
- 11. A VOICE: A statement on now it says that.
12 CHAIRMAN MOHSENI: Okay.
13 MR. GODWIN: But it doesn't say anything else 14 because you never had one of these to run it by. So I mean,
() 15 you know, both -- there's no way we can, either one of us 16 can win this. And I don't want people to get caught short.
17 CHAIRMAN MOHSENI: Look. Pros and cons are okay 18 to write. In other words, you can say in some cases, this 19 may be the case, in other cases it may not be, so let's --
1 20 MR. NAWOJ: I have a problem with putting in the 21 90 percent and not having a basis for it. !
, i 22 A VOICE: Absolutely.
23 CHAIRMAN MOHSENI: Okay, then does --
24 MS. KEY: Maybe say considerably more than the 20 1
25 percent --
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491 1 CHAIRMAN MOHSENI: Did Bill's version avoided 2 making that by still kind of reminding you that who knows --
3 MR. NAWOJ: I mean telling you to consider that 4 there may be an increase; I think that's good. Putting in 5 there -- putting in there that it's --
i 6 CHAIRMAN MOHSENI: It says, " Additional resources 7 may be necessary."
8 MR. GODWIN: Yeah, but that's such a whimpy 9 statement. Not that -- don't take that literally, Bill.
10 MR. WILDS: I think that's a fairly strong 11 statement. I like Bill's language I guess is what I'm 12 saying.
13 MR GODWIN: I think it needs to have more to than 14 just "may be required."
() 15 MR. WILDS: Well, I think for you to state 90 16 percent, you have to have more justification --
17 MR. GODWIN: I'll give the 90 percent because I --
18 you know --
19 MR. WILDS: Because that's your feelings.
20 MR. GODWIN: But I think -- you know --
1 21 MR. WILDS: Because I can tell you if there's 90 T
22 percent in here and, you know, without any justification, 23 we're going to be looking at -- in our jurisdiction --
24 CHAIRMAN MOHSENI: Oh, gosh, yeah.
25 MR. WILDS: Yeah, you know --
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492 1 MR. GODWIN: But I tell you what --
() 2 3
CHAIRMAN MOHSENI:
higher at reception centers.
You're going to go four times L
1 4 MR. WILDS: -- you throw that number without 5 justification for it.
6 MR. GODWIN: I'll tell you what. I believe you're 7 going to go far more than 20 percent.
8 MR. SIMPSON: I think the states as they consider
! 9 this thing at reception centers will look into that and what 10 they anticipate in their circumstances, will happen.
11 CHAIRMAN MOHSENI: Correct. Yeah.
12 MR. SIMPSON: So I think that's where that needs 13 to be.
14 MR. GODWIN: I would suggest that you need to have
() 15 16 stronger wording than Bill had, still.
CHAIRMAN MOHSENI: Suggest language to us. That's 17 fine. I mean I don't --
18 MR. NAWOJ: I don't think a number without 19 justification --
20 MR. GODWIN: Yeah, I agree. 1 can't argue with 21 that.
22 MR. NAWOJ: As strong a language as you want is 23 okay.
24 CHAIRMAN MOHSENI: Let me also ask about this 25 sentence in there.
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493 l
1 MR. GODWIN: The point was to get the issue out 1
2 that it's going to be a major increase. That's what I see.
3 I see a major increase and I think people that don't take 4 the time to think it through could end up getting caught.
5 And I don't want the people getting caught because we don't 6 have enough emphases on it.
7 MR. SHERIDAN: Let me say where -- how I think 8 that the host community will differ. And differ because 9 you'll find more, I think more parents bringing their 10 children. Whereas now, you wouldn't find quite as much of 11 that. Think-about yourself and your own children. If you 12 know you could have your children monitored there and that 13 there was something that would protect their thyroid gland, 14 I think you'd make sure your children were brought there.
() 15 16 So I think you're likely to get more people bringing more families, more children than you would otherwise if KI is 17 available to there.
18 CHAIRMAN MOHSENI: We have to cut this at this 19 time, unfortunately. This is a crucial part. Can we --
20 MR. GODWIN: We can pick it up Friday.
21 CHAIRMAN MOHSENI: Yes, absolutely. We need to l 22 actually have more discussion on these aspects of it because 23 this is crucial to the states. Let's do most of it Friday l
24 then what we can't get around doing it today. We're off the 25 record.
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F 494 l '.
L 1 [Whereupon, the meeting was recessed, to reconvene i
-2' at 8:30 a.m., Thursday, March 4, 1999.]
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REPORTER'S CERTIFICATE This is to certify that the attached proceedings before the United States Nuclear Regulatory Commission in the matter of:
NAME OF PROCEEDING: POTASSIUM IODIDE (KI)
CORE GROUP MEETING CASE NUMBER:
PLACE OF PROCEEDING: Tempe, AZ were held as herein appears, and that this is the original
( transcript thereof for the file of the United States Nuclear Regulatory Commission taken by me and thereafter reduced to typewriting by me or under the direction of the court reporting company, and that the transcript is a true and accurate record of the foregoing proceedings.
} 4%
f ohn Hanley C
Official Reporter Ann Riley & Associates, Ltd.
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