STABLE IODINE DISTRIBUTION IN ADVANCE BRIEFING SESSION

Transcription

1 Prepared by the Medical Services Division, Medical Office, Department of Public Health and Welfare, Ibaraki Prefectural Government (FY2018) STABLE IODINE DISTRIBUTION IN ADVANCE BRIEFING SESSION Nuclear Disaster Countermeasures Effects and Precautions of Stable Iodine Cautions after Receiving Stable Iodine

2 Countermeasures for Prevention of Severe Accidents and Nuclear Disaster Countermeasures (Nuclear Regulation Authority) Countermeasures for Prevention of Severe Accidents (Prevention of Accidents) Enhancement of safety regulations for nuclear facilities (New regulatory requirements) Nuclear disaster countermeasures (Preparation for the event of an accident) Enhancement of disaster countermeasures (Nuclear disaster countermeasures guidelines) Nuclear Disaster Countermeasures Through the measures noted below, the possibility of the occurrence of a severe accident on the same scale as the Fukushima Daiichi Nuclear Power Station accident is limited to a very low level. Strengthening criteria for the prevention of severe accidents Establishing criteria for addressing a case in which a severe accident or terrorism occurs In preparation for a nuclear disaster, emergency preparedness is predetermined assuming the occurrence of a severe accident on the same scale as the Fukushima Daiichi Nuclear Power Station accident.

3 Nuclear Disaster Countermeasures Concept of Nuclear Disaster Countermeasures Guidelines It is assumed that prevention actions will be taken according to the status of a facility or the ambient dose rate. Within a 5-km zone from a nuclear power station (PAZ): Evacuation Occurrence of an accident or other event Within a 30-km zone from a nuclear power station (UPZ): Sheltering indoors Alert An incident occurs Site emergency There is the potential to lead to a severe accident Progress of accident General emergency A severe accident occurs, and there is a high possibility of releasing radioactive materials. After the release of radioactive materials Prevention actions PAZ UPZ Prepare for evacuation of evacuees required by a site emergency Evacuation of evacuees required due to site emergency Preparation for evacuation of residents and other people Preparation for sheltering indoors of persons requiring special assistance Preparation for sheltering indoors of residents and other people Evacuation of residents and other people Preparation for sheltering indoors or evacuation of persons requiring special assistance Sheltering indoors of residents and other people Actions based on the results of measurement of the ambient dose rate Evacuation within one day in zones with more than 500 msv/hour, etc. Temporary transfer within a week in zones with 20 msv/hour, etc. Occurrence of a lower- 6 intensity earthquake in a municipality with a nuclear power station, etc. In the case of leaked reactor coolant, failure of immediate high-pressure or low-pressure water injection, etc. Failure of water injection in all emergency core cooling systems, etc.

4 Nuclear Disaster Countermeasures The views on the nuclear disaster countermeasures guidelines UPZ (30 km) Evacuation Within a 5-km zone; prepare for evacuation PAZ (5 km) Sheltering indoors Within a 5-km zone; evacuation Within a 5-km zone; prepare for evacuation Within a 5-km zone; Evacuation for all Within a 30-km zone; Sheltering indoors

5 Nuclear Disaster Countermeasures Q: Why is stable iodine distributed in advance? Stable iodine is a medicinal drug that has the effect of preventing or reducing internal exposure to the thyroid gland by limiting the ingestion of radioactive iodine, one of the radioactive materials released during a major accident at a nuclear facility. If a nuclear disaster that necessitates an evacuation occurs, everyone who is within about 5 km of the nuclear facility will have to evacuate before the release of radioactive materials. The stable iodine is distributed in advance to the relevant residents so that they can take it without any delay if such an emergency occurs.

6 Stable Iodine Distribution in Advance Briefing Session Nuclear Disaster Countermeasures Q: When should I take the stable iodine? The national government, the prefectural government, or the municipalities will issue administration instructions if taking stable iodine is necessary. Instructions will be transmitted via such means as the emergency broadcast system, TV, radio, and Internet. Do not, by any means, use your own judgment and take stable iodine. [Take according to instructions] If side effects occur upon taking stable iodine based on instructions, the national government will compensate.

7 Receiving radiation is called radiation exposure. Nuclear Disaster Countermeasures Q: What is important as to preventing exposure if a nuclear disaster occurs? Radioactive material External exposure Radioactive material Internal exposure Inhalation Drinking/ eating Wound Receiving radiation from outside the body is called "external exposure." If radioactive materials that have been dispersed in the atmosphere are inhaled or if contaminated food and drinks are ingested, radiation will be received from within the body. Furthermore, radioactive materials may enter the body through a wound. These are called "internal exposure."

8 Nuclear Disaster Countermeasures Q: What is important as to preventing exposure if a nuclear disaster occurs? In the event of a nuclear disaster, it necessary to prevent both external and internal exposure. Prevent external exposure Get further away Shield the radiation Get away quickly Evacuate or shelter indoors Prevent internal exposure Restrict the intake of foods Gargle and wash hands Take stable iodine

9 Effects and Precautions of Stable Iodine Functions and Effects of Stable Iodine Not taken Radioactive iodine Stable iodine Taken in advance Thyroid gland If radioactive iodine is taken into the body, and at least a certain amount accumulates in the thyroid gland, the potential for developing thyroid cancer is undeniable. If the thyroid gland is initially filled with stable iodine, it will be possible to reduce the accumulation of radioactive iodine. The major role of the thyroid gland is to use iodine to produce thyroid hormones. The thyroid hormones have functions including promoting metabolism.

10 Effects and Precautions of Stable Iodine Functions and Effects of Stable Iodine Before radioactive iodine is taken into the body, it is possible to reduce the amount of radioactive iodine that accumulates in the thyroid gland by taking stable iodine. (This is also expected to be effective after iodine inhalation.) Reduces internal exposure to the thyroid gland Stable iodine is only effective at preventing and reducing internal exposure to the thyroid gland that results from radioactive iodine and cannot reduce exposure that results from other radioactive materials besides radioactive iodine.

11 Effects and Precautions of Stable Iodine Dose of Stable Iodine [Potassium iodine pills (50 mg)] Age 13 or over : 2 pills From age 3 up to age 13 : 1 pill [Potassium iodine jelly for internal use] Up to age 3 : 1 pack (according to age) [Potassium iodine pill] *For the quantity distributed, confirm the back side of the check sheet. [Potassium iodine jelly for internal use] (Illustrative image) Photo courtesy of Nichi-Iko

12 Effects and Precautions of Stable Iodine Side effects of Stable Iodine (1) The following like symptoms have been reported thus far. Hypersensitivity: Rash etc. Digestive symptoms: Nausea/vomiting, stomachache, diarrhea, etc. Other: Hypothyroidism, headache, shortness of breath, etc. Pay attention to any unusual changes in your physical condition..

13 Effects and Precautions of Stable Iodine Side effects of Stable Iodine (2) [The case of Poland after the accident at the Chernobyl Nuclear Power Station] Results of a follow-up survey of people who took stable iodine. 4.6% of children are said to have had symptoms of vomiting, skin rashes, etc. It is not clear that these were the side effects of stable iodine and it has been reported that there were no side effects that lasted. [The case of the accident at TEPCO Fukushima Daiichi Nuclear Power Station] About 2000 workers took stable iodine for about 7 months after the accident. A portion of the people who took stable iodine multiple times has been recognized to experience temporary hypothyroidism.

14 Effects and Precautions of Stable Iodine People Who Cannot Take Stable Iodine People who have a previous history of hypersensitivity to a component of a stable iodine pill or iodine cannot take these pills, and the stable iodine will not be delivered to them. Do you fall under one of the following items in the check sheet? [Items contraindicating use] Have you ever been told that you have a hypersensitivity to a component of a stable iodine pill or iodine? Did you experience allergic reactions such as hives, respiratory difficulty, or a drop in blood pressure after using a povidone iodine liquid, Isodine, Lugol s solution, or after taking a potassium iodide pill? If you fall under one of these items, put a checkmark in the Yes box on the check sheet.

15 Effects and Precautions of Stable Iodine People Requiring Caution in Taking Stable Iodine If you suffer from a particular disease, put a checkmark in the Yes box in the relevant disease column on the check sheet, and consult us at the time of distribution. [Items indicating caution in taking stable iodine] (1) A previous history of hypersensitivity to an iodine-containing contrast agent (2) Thyroid gland disease (hyperthyroidism or hypothyroidism) (3) Kidney disease or impaired kidney function (4) Congenital myotonia (5) Hyperkalemia (6) Hypocomplementemic urticarial vasculitis, or a previous history of the disease (7) Pulmonary tuberculosis (including caries and pleural inflammation) (8) Duhring dermatitis herpetiformis or a previous history of the disease

16 In principle, stable iodine is taken once; therefore, there is little concern for major health effects with combined use. People taking medicine in which caution should be taken with combined use Consult us when the stable iodine pills are being distributed if you are taking the following medicines. Potassium supplementation Possibility of an Pharmaceuticals that have potassium increase in the level of potassium High-blood pressure in the blood Angiotensin II inhibitor Depressor drug (combination drug) ACE inhibitor Potassium retention diuretics Bipolar disorder (manic depressive illness) Lithium preparation Treatment for hyperthyroidism Antithyroid drug Effects and Precautions of Stable Iodine Possibility of a decrease in thyroid activity

17 Effects and Precautions of Stable Iodine Increased Level of Potassium with Stable Iodine Potassium iodine pills: 24 mg potassium in two pills [Potassium content per 100 gr of the following foodstuffs] 30% apple juice: 24 mg (half a glass) Banana: 360 mg (edible part of 1 banana) Slice of bread: 97 mg (about 2 slices of a 6-slice loaf of bread) Tuna (lean): 380 mg (about 10 slices) Baked sweet potato: 540 mg (half to a third of a potato) Avocado: 720 mg (edible part of 1 avocado) The amount in brackets equals the reference quantity per 100 g of each food. Source: Standard Tables of Food Composition in Japan 2015 edition (7th revision) The amount of potassium in two pills is low compared with the amount in the foodstuffs.

18 Effects and Precautions of Stable Iodine Pregnant or Lactating Women In principle, pregnant women can take stable iodine. The fetus may be affected if a pregnant woman takes a stable iodine; therefore, contact an inquiry counter or consult a doctor or a pharmacist and avoid taking the pill multiple times. It takes about 3 days for the stable iodine to get discharged from the body; therefore, refraining from breastfeeding (breast milk) until then would be required.

19 Cautions after Receiving Stable Iodine Cautions after Receiving Stable Iodine (1) Consult your family doctor if you experience the kinds of conditions listed in the checklist or if you will be taking the kinds of medicine listed in this document after receiving stable iodine.

20 Cautions after Receiving Stable Iodine Cautions after Receiving Stable Iodine (2) The amount of stable iodine that will be distributed today will vary according to age. (Check the writing on the backside of the checklist) The stable iodine should be stored in a place out of direct sunlight and with little moisture. The, etc., you will be taking out in the cmedicine chest, disaster bagase of an emergency should be stored in plain sight and easily accessible should they become necessary.

21 Cautions after Receiving Stable Iodine Cautions after Receiving Stable Iodine (3) The stable iodine has an expiration date. (The date is written on the prescription bag given with the pills.) Replace with new pills when the expiration date nears. The stable iodine should not by any means be given to anyone. If the pills become unnecessary due to you moving, etc., please return them to your city office. Please also make sure you tell your family about the cautions.

22 Cautions after Receiving Stable Iodine Phone Consultation Contact for Stable Iodine If you have questions or concerns about taking stable iodine, you can consult a nurse or another medical expert by phone. (Dial Service Co., Ltd., and the National Institutes for Quantum and Radiological Science and Technology (QST) jointly conduct telephone consultations under contract from the national or local government.) Reception hours: Weekdays 9:00 to 17:00 Free consultation *Call charges apply Note: If you call from an ordinary fixed-line phone, you can access the service for the price of a local phone call. If you call from a phone other than a fixed-line phone (a mobile phone, etc.), you will be charged the normal calling rate. Note: You cannot use a navigation dial system with an IP phone, prepaid mobile phone, or satellite phone, or from another prefecture. Call (Tokyo). (You will be charged the normal calling rate.)