Twenty Eight Years After Chernobyl – Use of Potassium Iodide

iosat potassium iodide





On April 26, 1986, an explosion occurred at the Soviet Chernobyl Nuclear Power Station in Ukraine, about 80 miles north of the city of Kiev on the border with Belarus.  The resulting radioactive cloud contaminated an area half the size of Italy and exposed nearly 8,400,000 people in Belarus, Ukraine and Russia.1  Millions of others, in Poland, Scandinavia, and throughout Western Europe were also affected.

Today, we continue to see the effects of the world’s worst radiological emergency.  Tens of thousands of people who were unable to take protective action have developed radiation induced thyroid damage, with estimates as high as 50,000 cases of thyroid cancer expected by this year.  In 2000, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported their findings that:

“It is 14 years since the accident, and yet the worst may still come…The number of people with thyroid cancer began to increase about five years after the accident. This number continues to rise…the number has exceeded expectations.  Over 11,000 cases of thyroid cancer have already been reported.”3

The wide spread of the radiation came as no surprise to health-physicists at Sandia National Labs, working for the US Nuclear Regulatory Commission (NRC).  Six years prior to the Chernobyl accident, Sandia issued a study of expected consequences of reactor accidents on the scale of Chernobyl, noting that “cancer deaths and thyroid nodules could occur over…[large] distances (100’s of miles)” and predicting significant thyroid damage among people located as far as 200 miles downwind.4

Chernobyl was the third time that a radiation release led to epidemic levels of thyroid disease.  In a 2006 study among Japanese atomic bomb survivors, researchers found that close to half, 44.8%, of those still living suffered from some form of thyroid damage, and concluded that “A significant linear dose-response relationship was observed”5  Similar high levels of thyroid disease occurred among residents of the Marshall Islands who were dusted with fallout following a 1954 weapons test in the South Pacific, even though the test took place nearly 180 miles away. 6

These events demonstrated that radiation could cause thyroid damage over a very large area, and led to the realization that existing US nuclear industry practices to limit protective measures to just 10 miles around nuclear plants were clearly insufficient.  Nowhere was this better illustrated than in Belarus, where 97% of the first 750 cases of thyroid cancer due to Chernobyl occurred among people located more than 30 miles downwind of the reactor.7

In fact, commenting on the increased incidence of thyroid cancer caused by Chernobyl, the World Health Organization noted The increase has been documented up to 500 km from the accident site.”8

But more unexpected was the finding that the cause of the cancer could be traced to just one type of radio-isotope known as radioactive iodine (RAI).  Because RAI is absorbed by the thyroid, its presence led to the large increases in thyroid cancer and other thyroid diseases.  Although Chernobyl also released other radioactive by-products, these had little or no significant effect on the public’s health, with the NRC reporting the World Health Organization’s conclusion that, 10 years after the accident:

except for thyroid cancer, there has been no confirmed increase in the rates of other cancers, including leukemia, among…the public that have been attributed to releases from the accident.” 9

The Importance of Thyroid Protection

Thousands of cases of thyroid cancer have demonstrated that the most important step in a radiological emergency is protection of the thyroid from RAI—a step which can be assured by the prompt use of a safe, virtually 100% effective, thyroid-blocking, pharmaceutical—potassium iodide (KI).  But KI has to be taken prior to exposure, so its distribution has to happen before a radiation release occurs.

Unfortunately, thousands of children had to develop radiation-induced cancer before this lesson was learned.  But, astonishingly, US planners have chosen to ignore it.

KI is not a new drug.  Its ability to protect the thyroid from radiation has long been known and its use has been urged by groups such as the American Thyroid Association, who called it “essential that enough KI be available to protect the public, especially children, in the event of a nuclear accident or radiological terrorism.”10  The American Academy of Pediatrics found that “KI can be 100% effective in preventing radiation-induced effects, including thyroid cancer…[which] is the reason it should be kept in homes, schools, and day care centers,”11 and it is supported by the World Health Organization and numerous other groups.  The U.S. FDA concurred, with the unequivocal statement that:

The FDA recommends potassium iodide …for thyroid blocking in radiation emergencies” and “The data clearly demonstrate…[that] KI can be used to provide safe and effective protection against thyroid cancer caused by irradiation”12


So if the FDA has found KI to be safe and effective, and capable of protecting the public from radiation that might be released by a nuclear weapon, or a damaged nuclear power plant, why hasn’t the government acted to assure we have it?  Isn’t that what homeland security is all about?

Congress Mandates Stockpiling of KI in 2002, But Fails To Follow Through

Actually, the government has acted.  But despite an Act of Congress, nuclear industry groups have successfully retarded stockpiling efforts, and kept the issue out of the public’s eye.

Specifically, at the urgings of the country’s leading endocrinologists, Section 127 of the Federal Bioterrorism Preparedness and Response Act of 2002 directed President Bush to expand the program for stockpiling and distribution of KI tablets.  To assure proper implementation of this directive, the President was authorized to request the National Academy of Sciences (NAS) to study the KI issue and to propose the most effective and safe way to distribute the tablets.  Many hoped this would definitively resolve any question about potassium iodide, and assure its availability if ever needed.

The NAS report was completed and issued in December, 2004.  Its scientific review was comprehensive and the panel made two specific recommendations to further public safety.13

Recommendation 1:  “potassium iodide (KI) should be available to everyone at risk of significant health consequences from accumulation of radioiodine in the thyroid in the event of a radiological incident.”

Recommendation 2:  “KI distribution should be included in the planning for comprehensive radiological incident response programs for nuclear power plants.  KI distribution programs should consider predistribution, local stockpiling outside the emergency planning zones (EPZ), and national stockpiles and distribution capacity.”

But despite these recommendations, there is little KI available today.  Rather than follow the NAS recommendations, the nuclear power industry has continued to seek ways to avoid taking the necessary steps to assure that the country has this vital protection.

The Strange Arguments “Against” KI

Over the years, the arguments against KI have ranged from foolish to irresponsible.  Initially, the industry claimed there was no need for KI because nuclear accidents were impossible—but the incident at Three Mile Island (and other US “near misses”) refuted that contention.  Then the industry claimed that KI would offer no more than a “false sense of security” in case of an accident, but was unable to provide either evidence or precedent for this claim.  Next, questions were raised about the value and safety of KI, but these vanished in the face of the Chernobyl experience (where millions of people received the drug and were protected, and not a single serious side effect was seen among the general population).  Then it was argued that KI had limited value since “it only protects the thyroid,” but the rationale behind this argument disappeared as evidence mounted that thyroid protection was, by far, the most important step in dealing with a nuclear event.  Failing here, the NRC stepped in, and agreed to distribute KI to anyone living within 10 miles of nuclear reactors.  However, it was decided that efforts to protect everyone else should be put behind programs emphasizing “evacuation”—until the events in New Orleans and Houston demonstrated the shortcomings of this strategy.

Strangest, perhaps, was the contention of the Director of the Illinois Department of Nuclear Safety, who saw no need for KI since ”hundreds of thousands of people live normal, healthy lives without functioning thyroid glands”14 or the statement of the Georgia official who felt it would be better to depend on massive efforts to evacuate people, “rather than trust them to be able to search though the backs of their medicine cabinets to find some magic pill that they’re supposed to take to make it all better.”15

Recently, a new argument has been introduced as to why the country should avoid stockpiling KI tablets.  Despite the recommendations of the National Academy of Sciences (as noted above), a senior government official for Preparedness Programs for nuclear matters wrote to the Department of Health and Human Services in order to argue that rather than stockpile KI, “other, more effective, protective measures are in place to protect the thyroid…and that expanded distribution of KI is unnecessary.”16  These “other, more effective, measures” he referred to would be to intercept food, water, and milk shipments from contaminated areas in order to prevent ingestion of radioactive iodine.

But there is little confidence that this program could work.  While removing radioactive food would obviously prevent it from being eaten, the practical difficulties in intercepting all food supplies for, say, 100 miles around a radiation release (about 30,000 sq. miles) would be enormous.  It would have to take place under the confusion that would accompany a reactor accident or nuclear bomb attack, and reach everyone from large farming/food processing operations, to those who grow tomatoes in their back yards.  Further, how replacement food and water could be found and trucked-in for the millions who might be affected has not been explained.  And these efforts would have to be completed in just a matter of days.

Worse, though, is that merely blocking contaminated food and water is far from an effective solution.  NRC research on the dispersion and effects of radiation had previously led to findings that “the thyroid dose [of radiation] is dominated by the inhalation of radioiodine” and ”protective measure[s] must reduce the inhalation dose.”17  Clearly, efforts to prevent ingestion of contaminated food (even if possible) would have no impact on inhalation, which is the major source of irradiation.  Why, then, would the nuclear industry prefer to see a cumbersome, unworkable program to block food and water which, at best, would be only partially effective, as opposed to KI which is easy, simple, low cost and virtually 100% effective?

Why does the industry pursue a course that their own science advisors tell them is wrong and which could lead to unnecessary injury and disease in the event of a nuclear emergency?  And why, through efforts to block implementation of an Act of Congress and to ignore the NAS recommendations, has the industry been allowed to take steps that reduce, rather than enhance, the state of preparation in the US?

But things might be changing.  In an August, 2006 letter from the US Secretary of Health and Human Services, Michel Leavitt, to Congressman Edward Markey, the industry argument that “other, more effective, measures to protect the thyroid” though blocking shipments of food, water and milk, was rejected.  In a strong statement of support for expanded KI distribution, the Secretary wrote “We are not aware of any ‘alternative and more effective prophylaxis or preventative measures’ that could be offered in place of potassium iodide” and concluding that “HHS has therefore proceeded with finalizing the KI distribution guidelines.”  However, despite this encouraging letter, the promised guidelines have still not been issued.

KI works.  It’s safe, effective, and inexpensive.  Surely in an environment where responsible concerns exist regarding nuclear power safety, where all of the country’s major political leaders, including the President, have called nuclear terrorism the greatest threat to our security, where diagrams of US nuclear power plants were found in Al Qaeda camps in Afghanistan, where Osama bin Laden has boasted of his efforts to obtain a nuclear bomb and where the nuclear ambitions of Iran and North Korea cannot be contained, the importance of this matter must not be overlooked.

But, as a result of the failure of officials to assure ample public supplies of potassium iodide tablets, we believe there is a powerful incentive for individuals to acquire their own supplies.  Iosat Potassium Iodide can be obtained at or by calling 866-283-3986.

iosat potassium iodide

1      United Nations, History of the United Nations and Chernobyl, set forth at
2 as reported by The Guardian
3    OCHA, Chernobyl A Continuing Catastrophe, United Nations, New York and Geneva, 2000
4      Examination of the Use of potassium iodide (KI) as an Emergency Protective Measure for Nuclear Reactor Accidents.  Sandia National Labs.  Prepared for US Nuclear Regulatory Commission, Oct., 1980, NUREG/CR-1433
5      Radiation Dose-Response Relationships for Thyroid Nodules and Autoimmune Thyroid Diseases in Hiroshima and Nagasaki Atomic Bomb Survivors. Journal of the American Medical Association, Vol. 295, No. 9, March 1, 2006
6 Conrad, R. A. et al., “A Twenty Year Review of Medical Findings in a Marshallese Population Accidentally Exposed to Radioactive Fallout.” Report BNL-50424. Brookhaven National Laboratory, Upton, NY, 1975.
7      Assessment of the Use of potassium iodide (KI) As a Public Protective Action During Severe Reactor Accidents.  U.S. Nuclear Regulatory Commission, Draft Report for Comment, NUREG-1633
8    Guidelines for Iodine Prophylaxis following Nuclear Accidents.  World Health Organization, (1999 Update)
10   February 13, 1998 letter to USNRC
11   American Academy of Pediatrics, News Release, May 19, 2003.  Also, Pediatrics Magazine, June 2003
12   Federal Register, December 15, 1978,  FDA Talk Paper, December 10, 2001
13   Distribution of potassium iodide in a Nuclear Accident  National Research Council of the National Academies of Science,
December 2004
14   Letter to US Nuclear Regulatory Commission dated January 8, 1998
15   Got Anti-Nuke Pills? Probably Not  Randy Dotinga, Wired News, Nov. 8, 2004
16   Letter to Dr. Robert Claypool, US Dept. of Health and Human Services, November 1, 2005


                        Distance                       Mean Thyroid Dose               Probability of Thyroid
From Reactor                   (REM) for Exposed           Damage to Exposed Adult
In Miles                            Adult Outdoors                      Located Outdoors
1                                       13,800                                        60%
5                                        6,800                                         70%
10                                       3,200                                         70%
25                                       1,100                                         40%
50                                         380                                          13%
100                                        100                                           3%
150                                         36                                            1%
200                                         16                                           .05%

SOURCE:  US Nuclear Regulatory Commission, as reported in Examination of the Use of potassium iodide (KI) as an Emergency Protective Measure for Nuclear Reactor Accidents.  Sandia National Labs.  Prepared for US Nuclear Regulatory Commission, Oct., 1980, NUREG/CR-1433.  Data taken from Tables 3 and 4 with following clarifying notes:
–For children, increase dose and probability of damage by an approximate factor of two
–Includes inhalation dose only.  Does not include effects of ingestion of contaminated food or water
–Thyroid damage includes benign pre-cancerous and cancerous thyroid nodules and ablated thyroids.

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