Three Mile Island: The Rest of the Story... The following is courtesy of the United States Disaster Preparedness Institute. Comments or questions should be directed to the author, Kevin Briggs. Nuclear Power Plant Hazard Issues Are you prepared for a nuclear power plant disaster? 3 March 2001, V3    by Kevin Briggs, Director, USDPI Observations about the Three Mile Island Nuclear Disaster  Did you know that during the Three Mile Island (TMI) nuclear power plant emergency of Wednesday, 28 March through early April of 1979, government and TMI officials did not know for days the full extent of the risks to the public and that the government went into emergency production of Potassium Iodide (abbreviated "KI") solution to help protect the public? The following quote from the book "Nuclear War Survival Skills", states:  "When the Three Mile Island nuclear reactor accident was worsening and it appeared that the reactor's containment structure might rupture and release dangerous amounts of radioactive iodines and other radioactive material into the atmosphere, the Government rushed preparation of small bottles of  a saturated solution of potassium iodide. The reactor's containment structure did not rupture. The 237,013 bottles of saturated KI solution that were delivered to Harrisburg, Pennsylvania -- mostly too late to have been effective if the Three Mile Island accident had become an uncontained meltdown -- were stored in secret in a warehouse, and were never used." In the official "Report of the President's Commission on The Accident at Three Mile Island" the following was said about the lack of Potassium Iodide (KI) needed to protect the public:  "Officials of the U.S. Department of Health, Education Welfare (HEW) had become concerned about the possible release of radioactive iodine at Three Mile Island and began Friday to search for potassium iodide -- a drug capable of preventing radioactive iodine from lodging in the thyroid. The thyroid absorbs potassium iodide to a level where the gland can hold no more. Thus, if a person is exposed to radioactive iodine after receiving a sufficient quantity of potassium iodide, the thyroid is saturated and cannot absorb the additional iodine with its potentially damaging radiation. At the time of the TMI-2 accident, however, no pharmaceutical or chemical company was marketing medical-grade potassium iodide in the quantities needed. Saturday morning, shortly after 3:00 a.m., the Mallinckrodt Chemical Company agreed to provide HEW with approximately a quarter million one-ounce bottles of the drug. Mallinckrodt in St. Louis, working with Parke-Davis in Detroit and a bottle-dropper manufacturer in New Jersey, began an around-the-clock effort. The first shipment of potassium iodide reached Harrisburg about 1:30 a.m. Sunday {USDPI comment: over 3 days later than needed if the containment vessel had actually burst within the first day} . By the time the last shipment arrived on Wednesday, April 4, the supply totaled 237,013 bottles." It was not until the third day of the TMI disaster that Pennsylvania's Governor Thornburgh decided to recommend that pregnant women and preschool children leave the region within a 5-mile radius of Three Mile Island and to close all schools within that area.  The official "Report of the President's Commission on The Accident at Three Mile Island" also reported the following about the hazardous evacuation zone planning during this disaster: "Friday, Saturday, and Sunday were hectic days in the emergency preparedness offices of the counties close to Three Mile Island. Officials labored first to prepare 10-mile evacuation plans and then ones covering areas out to 20 miles from the plant. {USDPI comment:  State and local governments, with support from the Federal government and utilities, currently develop plans that include a "plume emergency planning zone" with a radius of only 10 miles from each nuclear power plant. However, government officials recognize that in a catastrophic incident, a 20 mile evacuation radius akin to what was needed with the Chernobyl disaster may be more appropriate.} The Pennsylvania Emergency Management Agency recommended Friday morning that 10-mile plans be readied. The three counties closest to the nuclear plant already had plans to evacuate their residents -- a total of about 25,000 living within 5 miles of the Island. A 10-mile evacuation had never been contemplated. For Kevin Molloy in Dauphin County, extending the evacuation zone meant the involvement of several hospitals -- something he had not confronted earlier. There were no hospitals within 5 miles. Late Friday night, PEMA told county officials to develop 20-mile plans. Suddenly, six counties were involved in planning for the evacuation of 650,000 people, 13 hospitals, and a prison." If the TMI containment vessel had ruptured, as it could have done if corrective actions had been slower, hundreds of thousands to millions of people could have been exposed to dangerous levels of radioactive iodine within the first week or two.   If the Three Mile Island plant (or other nuclear plant) today experienced a catastrophic meltdown and containment vessel rupture, people who live within about a 20 mile region of the plant (who are exposed to the radioactive plume) may be subject to the dangers of acute radiation poisoning (with symptoms appearing relatively rapidly) as well as long-term health effects like thyroid cancer. If people are not adequately sheltered or evacuated in a timely fashion from this region and are exposed to high levels of radiation, they could experience severe sickness and possible death within a few days to months. Those within the 20 mile region who are exposed to radiation and do not have the protection afforded by Potassium Iodide or Potassium Iodate (especially children) would likely begin to have long-term thyroid problems and possible cancer starting  typically around 5 to 15 years after their exposure (as occurred with the Chernobyl disaster -- see below -- and with the Marshall Islanders from the aftermath of the Bikini atomic test). A range of Nuclear Regulatory Commission (NRC) scenarios show that at 20 miles from a moderate to major U.S. nuclear power plant emergency, the population could be exposed to levels of radioactive iodine from 3 to 1,000+ rems mean thyroid dose (which is roughly 3 to 1,000+ times beyond the level of radiation where Potassium Iodide intervention is recommended by the World Health Organization (WHO) for children and for those pregnant).  Depending on the severity of the accident, people in this region may need to be sheltered or evacuated and if these people did not take Potassium Iodide pills before ingesting any radioactive iodide, they could face serious and life threatening long-term health problems (like thyroid cancer). Also people in the less radiated portions of this region may be able to stay at home rather than evacuate if they have Potassium Iodide pills to minimize their risk of long-term health problems. Hence, for these people, KI pills could greatly reduce the logistical problems associated with evacuating.        The Three Mile Island Power Plant Today   People who are outside of what is typically called the 10-mile "Inhalation Emergency Planning Zone" (EPZ) may still face very dangerous levels of radiation. The government typically calls the regions beyond the 10-mile EPZ the "Ingestion" EPZ because radioactive materials can also be ingested through eating contaminated food. But in a major disaster, inhalation of very dangerous nuclear materials can also continue to occur out to over 300 miles (reference the NRC's NUREG/CR 1433 and the meeting minutes from the "Public Meeting to Substantially Revise   NUREG-1633, "ASSESSMENT OF THE USE OF POTASSIUM IODIDE AS A PUBLIC PROTECTIVE ACTION DURING SEVERE REACTOR ACCIDENTS" - Dec 98). The NRC's NUREG/CR 1433 shows that for children, the following dangers may occur from the inhalation of nuclear materials after a massive core-melt atmospheric accident (like Chernobyl): Approximate Dangers of a Core-Melt Atmospheric Accident for Children Distance in Miles Mean Thyroid Dose (rem) for Exposed Children Outdoors* Probability of Thyroid Damage to Exposed Children Located Outdoors if not Protected by Stable Iodine (like KI) 1 26,000 100% 5 11,600 100% 10 6,400 100% 25 2,200 80% 50 760 26% 100 200 7% 150 72 2% 200 32 1% * Note:  The World Health Organization recommends stable iodine administration to children and pregnant women at the level of 1 rem accumulated thyroid dose and the FDA has published some revised draft guidelines (Dec. 2000) that recommends giving Potassium Iodide pills to these groups at levels of greater than or equal to 5 cGy (or 5 rem).  Some typical ways that ingestion of dangerous nuclear materials can occur is (1)  from eating food (like garden vegetables or fruit) or water, etc., that contains nuclear fallout and (2) by drinking milk from cows or goats -- or for nursing infants, from moms -- who have ingested radioactive materials from their food or water which then passes into the milk they produce. People living in this zone can minimize their risk of dangerous radiation exposure by avoiding milk, vegetables, fruit, etc., that may be carrying radioactive materials and by taking Potassium Iodide pills (if living in an area exposed to dangerous radiation). Unfortunately, adequately tracking where and how radioactive materials have been deposited in near-real-time throughout large regions of the country and within the food supply system may be quite difficult, if not impossible. The trained people, computer models of the weather and food systems, sensors, etc. required to accurately assess the millions of radiation path vectors in a near-real-time fashion do not currently exist (although limited macro-scale predictions can be made, but may prove to fall far short of the needs of thousands to millions of people who are exposed to radiation risks). Hence, relying solely on limiting questionable food or drink intake in areas predicted to be radioactive may be dangerous for both those living in the affected areas and those outside of these areas who unknowingly receive food or drink poisoned by fallout.   Unfortunately, much of the current U.S. policy, as opposed to other countries in Europe (like Poland), assumes that the national, state, and local health officials will adequately warn U.S. citizens of any radiation danger and shipments of any necessary non-radioactive food will be accomplished in a timely and effective manner into contaminated areas. This assumption of adequate warning and alternative food distribution is used to explain the current U.S. policy of not having a stockpile of Potassium Iodide sufficient to administer to people who live in dangerously radiated regions within a 320 mile zone from a nuclear power plant (this does not mean that everyone within the zone needs stable KI -- just those who are downwind of the accident). What this policy does not explain is how the government plans to handle the major problem of inhalation of radioactive iodine within these areas (see Table above).   Some have said that for the extended inhalation hazard zone (which can go up to roughly 320 miles), we would be able to track/predict the radioactive cloud flows and evacuate as necessary. As mentioned above for the food contamination predictions, predicting where radioactive iodine gas is on a near-real-time basis is extremely difficult, if not impossible, with the precision necessary to protect all of the exposed public.   And while numerous other countries see the benefit of stockpiling stable iodine to protect people up to hundreds of miles from a major accident, it is not felt to be cost-effective by many U.S. policy-makers who have read or heard generalized studies (with very questionable assumptions and little public mention of the risks) that do not factor in the cost of things like: (1) human suffering associated with sickness (like cancer and hypothyroidism) and deaths caused by preventable thyroid irradiation, (2) lawsuits against the utilities and the government should thousands to millions of people have their health needlessly damaged, especially after studies have shown that KI could greatly diminish people's risks and have recommended KI's stockpiling/distribution, and (3) having to evacuate much larger portions of the U.S. population around a nuclear power plant than would have been needed if KI pills were available to make in-place sheltering a more viable option in large outlying areas.  If TMI's containment vessel had burst and an immediate mass evacuation had been required during the first few days of the disaster, tens to hundreds of thousands of people would have had to do so without the protection afforded by Potassium Iodide pills. This is still the case today. If a moderate to major nuclear power plant disaster occurred today at Three Mile Island (or another U.S. nuclear power plant), officials would have to weigh the risks of ordering an immediate evacuation without KI tablet protection where evacuees may face greater risks in their cars of dangerous radiation exposure -- especially with traffic jams -- (as well as the dangers associated with panicked people) than if people stayed in their homes with the windows and doors shut and with their ventilation system turned off . People who stay inside in a closed environment will receive roughly one-half the inhalation radiation dose of those who venture outside of the home (see NUREG/CR-1433). (Note: In very high levels of radiation, people must heed the recommendation of public health officials to immediately evacuate and not rely on just indoor sheltering and KI tablets -- unless you have a well-built fallout or blast shelter with air-protection system as is common in regions of many other countries, like Switzerland).   One can only imagine the difficulty of rapidly evacuating 10s to 100s of thousands of people -- and possibly millions of people --  within a few hours in a 10 to 20 mile radius, especially if there is little prior warning and if the incident occurs at night or during extreme weather conditions.     The map below shows the 5, 10, and 20 mile evacuation zones around the Three Mile Island Nuclear Power Plant. During the Three Mile Island nuclear materials release, pre-school and pregnant or nursing moms were evacuated within 5 miles of the plant and people were cautioned to stay indoors within a 10 mile radius. During the major Chernobyl nuclear plant disaster, people were evacuated (many permanently) from a zone of roughly 20 miles. 20 miles is the expected maximum evacuation zone in a radiation emergency if the public has Potassium Iodide (KI) or KIO3 pills. Map:  Copyright © 2000 United States Disaster Preparedness Institute (USDPI) The map below shows the maximum expected radioactive iodine hazard regions around the Three Mile Island Nuclear Power Plant, if TMI's containment vessel were ever to catastrophically rupture.  320 miles (the outer ring) is the expected maximum zone of where a high cancer risk could occur in a radiation emergency and where Potassium Iodide (KI) pills may be needed downwind of the plant to reduce this risk. The government generally uses an "ingestion emergency planning zone" with a radius of 50 miles around each nuclear plant, although as with the inhalation EPZs, government officials acknowledge that the "ingestion EPZ" may actually extend to hundreds of miles as happened with Chernobyl (note: the NRC also states that the inhalation hazard zone can also extend out this far). It is likely that people within regions of the 320 mile zone will be required to carefully watch their food intake and eliminate certain food from their diet for up to weeks. People living in regions of known fallout deposition will likely be requested to stay indoors and keep their windows and doors shut as much as possible as well as to shut down their homes' ventilation systems and to take Potassium Iodide pills if available. Evacuations in the portions of the "ingestion" zone with the greatest radioactive fallout (mainly for people under 40 – especially children and infants – and for pregnant and nursing moms) may be recommended if there are no Potassium Iodide pills available for the public and food supplies are disrupted.  During the Chernobyl nuclear plant disaster, millions of people received KI pills in this zone and a major cancer hazard zone extended out to about 320 miles (note: only limited regions within this zone actually received dangerous levels of radiation based on wind and weather effects on the fallout cloud, such as rain induced fallout deposition).  Map:  Copyright © 2000 United States Disaster Preparedness Institute (USDPI) [Note: see www.delorme.com for the products required to produce maps like the ones above]   Lessons from the Chernobyl Nuclear Power Plant Disaster  On April 26, 1986, the number 4 nuclear reactor at Chernobyl was torn apart by a steam explosion that resulted both because of serious human error and poor reactor design. As a result, about 30 people died within the first few months of acute radiation exposure and thousands of others received dangerous levels of radiation that would seriously impact their long-term health. For example, over two thousand children have developed an aggressive form of thyroid cancer associated with the Chernobyl radiation exposure (see www.thyroid.org/annonc/nuclear.htm for some of the details on this). While this cancer is treatable if detected early enough (only a few have died from this cancer), the treatments involve prolonged, invasive, and expensive procedures and dramatically impact the lives of all those involved. Thankfully, millions of doses of Potassium Iodide (KI) pills (that successfully block the uptake of radioactive iodine) were administered to many of the children and adults in dangerously radiated regions that extended up to over 300 miles from the Chernobyl site. This extensive administration of KI tablets to children and adults is likely to have prevented hundreds, if not thousands, from contracting thyroid cancer. Unfortunately, numerous children and adults did not receive a timely dosing with KI pills, and have subsequently developed thyroid cancer. The following quote from "Guidelines for Iodine Prophylaxis following Nuclear Accidents -- 1999 update" by the World Health Organization (WHO) explains both the extent of the hazard zones surrounding the Chernobyl plant and the levels a radiation that caused significant problems in children.   "Following the Chernobyl accident there were several thousands of children who accumulated a dose to the thyroid of several Gy. {USDPI comment:  1 Rad = .01 Gray (Gy) or 1 cGy, so these children received over 100 Rads or 100 cGy}   Nevertheless, most of the children that have developed thyroid cancer were exposed to an estimated dose to the thyroid of less than 300 mGy. There has been an excess thyroid cancer incidence even in areas where the mean dose to the thyroid in children was estimated at 50 – 100 mGy  {USDPI comment: 50 - 100 mGy = 5 - 10 Rads or cGy}. The increase in incidence has been documented up to 500 km from the accident site. This is understandable in terms of the wide area affected by radioiodine and therefore the large number of children exposed. The Chernobyl accident has thus demonstrated that significant doses from radioactive iodine can occur hundreds of kilometres from the site, beyond emergency planning zones. Many U.S. government studies have documented similar results from possible accidents at U.S. nuclear reactors. A sharp distinction in the requirements for stable iodine prophylaxis based on distance from the accident site cannot be made. For example, few regions in Europe are situated so far from a nuclear reactor as to preclude any potential need for stable iodine prophylaxis against inhaled or ingested radioactive iodine. Another important insight gained from the Chernobyl accident concerns the side effects from stable iodine. In Poland stable iodine, as single doses, was given to 10 million children. No serious side effects were seen, though gastrointestinal effects and minor skin rash were reported. Of newborn infants receiving 30 mg potassium iodide in their first two days of life, 0.37% (12 infants) showed a transient increase in serum thyroid stimulating hormone (TSH), combined with a decrease in serum free thyroxine (T4). This transient thyroid inhibition has had no known consequences to date. Seven million adults took stable iodine although it had not been recommended. Among these, only two severe adverse reactions were seen, both in persons with known iodine allergy. In summary, the incidence of severe side effects from a single dose of iodine was less than 1 in 10 million in children and less than 1 in a million in adults." The Current Situation:  Many Lessons from History Seem to be Ignored Unfortunately, even though recommended by the President's commission after the Three Mile Island  nuclear disaster and by the Nuclear Regulatory Commission (NRC) and by the American Thyroid Association (see www.thyroid.org/annonc/nuclear.htm for details), and many other research groups, Potassium Iodide (KI) tablets are still not stockpiled and available for use by most of the endangered U.S. public in the case of a future radiation disaster (whether from an accident, terrorism, or war).   The U.S. public should wonder why other countries, like Britain, France, Germany, Switzerland, Sweden, Norway, Austria, Poland, Russia, Slovakia, Japan, Canada, and many others stockpile stable iodine pills (like Potassium Iodide tablets) to protect their public from radiation emergencies. And while a few states have some very limited KI stockpiles for use by the public in a nuclear emergency  (Maine, Tennessee, Arizona, and Alabama), most of the nation's public is unprotected. Only Tennessee reportedly allows a few thousand people to stockpile KI in their homes that are adjacent to a nuclear power plant (see www.ki4u.com/#7 ).  This is a small step in the right direction, in that to be most effective, people should be able to take KI pills as soon as a radiation health emergency exists and as soon as recommended by public health officials and/or physicians. Indeed, because of the problems associated with mass evacuations during nuclear emergencies,  people in many radiated regions may be instructed to stay in their homes and close their windows and seal their house from outside air as much as possible. This was the case during the radioactive iodine release from a uranium processing plant around Tokaimura, Japan, on September 29, 1999, where several hundred thousand people were asked to stay in their homes with the windows shut. If KI pills are available in homes, then vast numbers of the public could safely stay in their houses rather than risk an evacuation or risk staying in place without the radiation blocking protection of KI pills.  One particular note of concern is that many in the government are recommending stockpiling KI tablets only in regional centers. The problem with this suggestion is that in a true emergency, you need to rapidly get the pills into the hands of the public and this is essentially impossible in many likely scenarios if the KI pills are only stored in a regional stockpile and you are trying to conduct an evacuation at the same time. Many experts have recommended stockpiling KI in homes and local urban centers, such as in schools, libraries, hospitals, fire stations, police stations, etc.  As mentioned above in the example of Tennessee (where KI pills are available for free to the public that lives within 5 miles of their nuclear power plant -- if people take the time in advance to go pick it up at a Health Center), for those who live closest to the nuclear power plants (that is, especially within about 20 miles of the plant), there is a need for in-home supplies of KI pills to ensure timely administration of this drug. Without home storage of KI, people may impede required evacuation activities by their need to proceed to KI distribution centers. People may also be faced with the quandary of whether to stay in place with the doors and windows shut or try to venture forth to obtain KI supplies. In addition, local stockpiling of KI in homes and urban centers would allow the public to more readily look over the suggested use and contraindications for use (such as a known allergy to iodine as is the case with some who have allergic reactions to eating fish). Experience from Poland and other countries show that the risks are exceedingly small for taking radiation blocking KI pills -- at the recommended dosage levels that are far below the risk range of the vast majority of people -- compared to the risk of long-term cancer and thyroid abnormalities in children and young adults (less than 40 years of age) who have been exposed to radioactive iodine.  The adverse reaction rate was demonstrated to be less than 1 in 10 million children and less than 1 in 1 million adults according to the World Health Organization (see "Guidelines for Iodine Prophylaxis following Nuclear Accidents -- 1999 update"). The WHO went on to say: "In practice, this means that the risk of severe side effects can be ignored when deciding on the intervention level. Minor side effects from stable iodine prophylaxis, such as skin rash or gastrointestinal complaint, constitute no major problem." The WHO also went on to say that, based on recent studies of the Chernobyl data, pregnant women and children should probably be given stable potassium (like KI pills) if they will be exposed to as low as 1 rem of accumulated thyroid dose of radiation, which is about 25 times lower than the intervention rate previously recommended by the U.S. government (which was 25 rem -- this number may change as a result of the U.S. government's review of the Chernobyl data).  In addition, the U.S. Food and Drug Administration (FDA) recommends that Potassium Iodide be taken by the public as a radiation blocking pill in cases where the public could be exposed to dangerous levels of radioactive iodine.  {Note: Even though KI is a non-prescription drug that is generally recognized as safe (GRAS) and recommended for use by the FDA, it is advisable to discuss the risks associated with taking any drug with a physician, especially if you are taking other medications or have a known allergy to iodine. USDPI recommends you talk with your physician before taking any drug, whether prescription or not}. The new WHO and the new draft FDA guidelines provide a much more complete contraindication for use of stable iodine prophylaxis which, if followed, should further reduce the risks of widespread administrations of this GRAS drug. (Note, the old FDA guidelines found in books like Nuclear War Survival Skills and included with many of the bottles of KI sold or distributed in the past, contain too high of dosages of KI for children 12 and under, and especially for neonates and those under three years of age. The FDA has new draft guidelines that lower the recommended dosage for these groups akin to what is recommended by the WHO). Please see the associated RAD BLOCK ™ Information Guide  for more information on recommended dosages and warnings for use of KI.  On a legal note, many in the U.S. government speak of the risks of potential lawsuits if people have some adverse reaction to KI pills if taken based on the recommendation of a government official. On the other hand, if the government does not protect the population from known radioactive iodine risks by providing KI in local and home-based stockpiles as is done in numerous other countries , tens of thousands of lawsuits are likely to result in the aftermath of a major U.S. nuclear materials or power plant disaster due to associated thyroid dysfunction and cancer. This is especially true when considering the recommendations in the Report of the President's Commission on The Accident at Three Mile Island disaster and after the known risks demonstrated by the Chernobyl aftermath data reported by the WHO.  Could a major nuclear power plant disaster occur in the US?  The answer is "Yes"!  Numerous U.S. government studies confirm this as a possibility. With what probability is greatly debated.  This debate rages because of the complexity of scenarios and the politics of the nuclear power and regulatory industry. Perhaps it would suffice to say that many complex factors could lead to a major nuclear power plant disaster in the US or Canada, to include: a major earthquake near a nuclear power plant, human error on the part of nuclear power plant workers or manufacturers or suppliers, a disgruntled or insane nuclear power plant worker, terrorist activities, prolonged power outages combined with other plant problems, etc.  And while the U.S. nuclear power plants are much better engineered for safety than the Chernobyl nuclear power plant, a ruptured containment vessel at a U.S. power plant is quite possible and indeed, governmental and nuclear power industry emergency management specialists plan for it on a regular basis and are planning a new generation of power reactors that will further reduce these risks. It is also well known within the nuclear power industry, that minor accidents occur on a regular basis due to human error or purposeful sabotage.  There are 103 licensed nuclear power plants operating in the United States today and many others that operate in Canada near the northeastern U.S./Canadian border.  In addition, there are numerous other non-power related nuclear reactors in the U.S. and Canada along with nuclear processing and storage facilities. The map below only shows the locations and regions where there is a radioactive iodine risk from nuclear power plants. Many other parts of the country are exposed to nuclear radioactive iodine risks than from what is shown below due to the non-power reactors and nuclear materials processing and storage, such as those in Colorado, New Mexico, Utah, Idaho, and Oregon.      What should you do as a U.S. citizen?   One recommendation is that you consider your radiation risks based on where you (or your loved ones) live. If you live within 320 miles of a nuclear power plant, you should consider the purchase of Potassium Iodide tablets to protect you, your family, and friends. These tablets are now available as a service/product of the US Disaster Preparedness Institute. You can also look at others who offer KI tablets and the rationale for their use, etc.  by consulting the site:  www.ki4u.com (which is generally a great resource for nuclear disaster related information). KI tablets are inexpensive and represent a form of "cheap" insurance for you or for those you care about against not only nuclear power plant emergencies, but also radioactive/nuclear terrorism and nuclear war (whether in the USA or overseas).  If you live very close to a nuclear power plant, you may also want to purchase inexpensive HEPA masks to protect you and your family, etc. from inhaling radioactive particles, especially if you may have to evacuate. Please see the related Federal Emergency Management Agency (FEMA) website for other recommendations on how to prepare for nuclear power plant emergencies.  Another recommendation is that you write or talk with your local, state, and national government officials and let them know that you think they should locally stockpile KI tablets in communities and homes to protect the public in time of nuclear emergencies. As a minimum, citizens should have at least 10 to 14 doses of KI pills readily available (preferably, pre-distributed) within the 10 mile emergency planning zones around each nuclear power plant as well as out to 20 miles from each nuclear power plant. One dose would allow people in the most likely evacuation areas to protect themselves while preparing to evacuate and during the actual evacuation, if needed.  Subsequent doses would allow people more options on how far to evacuate, and if necessary, to take additional doses if the radioactive fallout follows them to the area they evacuated to. Since radioactive iodine disperses and decays relatively rapidly (half-life of 8 days) and stable iodine continues to fill the thyroid for some time, 10 to 14 doses would normally be all that is needed if people evacuate to an area that is generally free from fallout (note: newborns and pregnant women should only take KI pills for 2 days duration according to the WHO, unless otherwise directed to take them for a longer period of time by a physician).  If people do not evacuate to a relatively fallout free zone and continue to be exposed to radioactive iodine in food supplies, then a dose duration of as long as 80 days may be needed {note: a longer duration would likely be needed if there ever was a nuclear war}. A strong case could also be made for pre-distributing at least 10 to 14 doses of KI pills for the 20 to 50 mile regions around nuclear power plants to minimize the need for evacuation in these regions. Outside of these zones, perhaps larger regional stockpiles could be used to provide distribution to the public who are predicted to be exposed to dangerous levels of radioactive iodine (although this requires a lot of planning on how to then distribute the KI during an actual emergency). Your voice can truly make a difference, as was illustrated when a small group of concerned citizens helped to change the KI stockpiling policy in Maine (see www.thyroid.org/annonc/nuclear.htm).  Consider telling your friends about the need for KI tablets to protect them during a radiation emergency.  A book on "U.S. Nuclear Threats, Hazards, and Survival"  is forthcoming from the USDPI, hopefully within the next six months, with much more risk information and options for protection. In the meantime, please consult the links referenced on this page for more information (note: the USDPI does not necessarily endorse all of the information at all of the referenced sites, for example, because some of the information is either incomplete or out of date).  Disclaimer:  The USDPI provides the above information as a public service. While we have worked hard to ensure the accuracy of all of the above information, we are not infallible. We welcome any questions or comments you may have. USDPI and the author are not medical professionals and are not providing specific medical or professional advice or recommendations to any specific individual. For specific medical advice for you or your associates, please consult a physician.  Always consult a physician prior to taking any drug, even if it is a non-prescription drug (like KI) and is recommended by the FDA and the World Health Organization, etc.      Copyright © 2001 United States Disaster Preparedness Institute Last modified: March 03, 2001 Buy KI for your family here!