From: "Peter G. Crane" <pgcrane@erols.com>
Date: Sat, 06 May 2000 09:39:00 -0400
Reply-To: westcan@egroups.com Subject: [westcan]
Potassium iodide (KI) stockpiling -- op-ed article
From the Cape Cod Times, Hyannis, Massachusetts, April 27, 2000:"A Plea to the Public Health Commissioner"
By Peter Crane
Dr. Howard Koh, the Massachusetts commissioner of public health and a cancer specialist, has championed education and prevention in the fight against cancer.
He has made it his mission to inform the public about ways to avoid certain types of cancer: explaining that sunblock and protective clothing can prevent melanoma, for example, and stressing the link between lung cancer and smoking.
Koh now has an opportunity to help protect Massachusetts children against another highly preventable kind of malignancy: childhood thyroid cancer. He must decide whether Massachusetts should begin stockpiling a cheap and effective antidote, potassium iodide (KI), in case a nuclear accident or act of terrorism ever occurs.
Today, governments throughout the developed world routinely keep supplies of the drug near nuclear plants. In the U.S., however, the nuclear industry has so far derailed all federal efforts to follow suit.
In 1997, the Nuclear Regulatory Commission promised to buy KI for any state that wanted it. Two years later it reneged, saying it didn't have the money.
What happens when children don't get KI in time? A recent article in "Cancer," published by the American Cancer Society, reports on childhood thyroid cancer resulting from the 1986 Chernobyl accident. Doctors in Germany who studied 493 Belarussian children found that the greatest danger is to those under 2. Infants are more likely than older children to get the disease, and in almost two-thirds of them, the cancer will have spread by the time it is detected.
New England states have wrestled with the KI question since 1996, when Maine decided to join Tennessee, Alabama, and Arizona in establishing state stockpiles.
New Hampshire, on the other hand, decided in 1999 to leave it up to individuals to decide whether to buy supplies of the drug and keep them in the home. That approach is sure to save money but unlikely to save children, especially if an accident occurs during school hours.
The Massachusetts Advisory Council on Radiation Protection recently came down in favor of the New Hampshire solution. In February, it sent its recommendations to Koh: no stockpiling of KI for the general public, but better information on KI, to allow individuals to decide whether to buy it for themselves.
One problem with the Advisory Council's recommendation is that it relied on flawed information. The commonwealth nuclear engineer, who represents the Massachusetts Emergency Management Agency on the Council, informed the group that "thyroid cancer is readily and commonly treatable, without long term consequences other than taking [medication]." The few deaths from Chernobyl-related thyroid cancer were, he wrote, "caused by failing to provide adequate medical care," and the rate of childhood thyroid cancer had only increased "by a factor of 3 to 4."
True, the disease is normally treatable, as I know from experience. As a two-year-old, I was given x-ray treatments for enlarged tonsils, and 24 years later I developed thyroid cancer. I had surgery in 1973, and when the disease recurred 15 years later, it took five courses of radiation over three years to wipe it out.
"No long term consequences"? The relatives of the more than 1,000 Americans who died of the disease last year would have a different story to tell. Even for those who survive it -- and the vast majority of us do -- there are often extensive consequences, physical and psychological, as well as the cost of a lifetime spent on medication. And the disease is much harder on children than on adults.
What about the commonwealth nuclear engineer's claim of only a three-fold to four-fold increase in childhood thyroid cancers in the wake of Chernobyl?
Dr. Jacob Robbins, scientist emeritus at the National Institutes of Health and a world-renowned expert on the disease, disagrees. Writing in a medical journal, he and other specialists reported a more than 50-fold increase in the most affected parts of Belarus.
Though the Department of Public Health has doctors on its staff, the MDPH representative to the Advisory Council was a non-physician. Earlier this year, he sent out a document purporting to state "MDPH's position" on a variety of KI issues. It included the statement, "The thyroid is relatively insensitive to radiation induced adverse health effects."
No doctor would ever have made such a claim, which flies in the face of everything known about the thyroid. (Koh's deputy has since confirmed that the document was issued without the Commissioner's approval or knowledge.) With such input, it is small wonder that the Advisory Council recommended against stockpiling.
Why such opposition to so sensible a measure? Lobbyists for the nuclear industry have candidly admitted their concern that to improve emergency preparedness with KI could lessen public confidence in the safety of nuclear plants. Even if that were true, it would not justify short-changing our children's health.
Just weeks ago, the town of Duxbury, Massachusetts, voted to stockpile KI. The cost is low, and in an emergency, the benefit to children could be enormous. Is there any doubt that this extra insurance policy is worth having?
Koh must now decide whether the children of Massachusetts will be protected against this extremely preventable cancer. If he takes his medical advice from nuclear engineers rather than doctors, the Commonwealth's youngest citizens could someday be in trouble.
Peter Crane, a retired Nuclear Regulatory Commission lawyer, lives in Chevy Chase, Maryland.
pgcrane@erols.com
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