STABLE IODINE DISTRIBUTION BRIEFING SESSION

Transcription

1 Prepared by the Medical Services Division, Department of Public Health and Welfare, Ibaraki Prefectural Government (FY2017) STABLE IODINE DISTRIBUTION BRIEFING SESSION Nuclear Disaster Countermeasures What is? Handling of

2 Nuclear Disaster Countermeasures 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) 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 Nuclear disaster countermeasures (Preparation for the event of an accident) Enhancement of disaster countermeasures (Nuclear disaster countermeasures guidelines) 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 Nuclear Disasters and Radioactive Materials I-131 Iodine Cs-134 Cesium Cs-137 Cesium Sr-90 Strontium Pu-239 Plutonium Physical halflife 8 days 2.1 years 30 years 29 years 24,000 * years Tissue accumulation Thyroid gland Whole body Whole body Bones Bones and liver *Period during which a radiation dose reduces by half with the passage of time Various kinds of radioactive materials are released to the environment after an accident at a nuclear facility. There are four types of radioactive materials that are main concerns in terms of health and the environment: iodine 131, cesium 134, cesium 137, and strontium 90.

5 Nuclear Disaster Countermeasures Exposure Types Receiving radiation from a radioactive material is called radiation exposure. External exposure Radioactive material Radioactive material Internal exposure Inhalation Drinking/ eating Wound Receiving radiation from external radioactive materials is called external exposure. If a radioactive material that has been dispersed in the atmosphere is inhaled with air, or if contaminated food and drink are ingested, radiation will be internally received. Furthermore, a radioactive material may enter the body through a wound. This situation is called internal exposure.

6 Prevention of Exposure In the event of a nuclear disaster, it is important to prevent both external and internal exposure. External exposure (Receiving radiation from external radioactive materials) Get further away Shield the radiation Get away quickly Internal exposure (Receiving internal radiation after radioactive materials enter into the body) Restrict the intake of foods Gargling and hand-washing Taking stable iodine In the event of a nuclear disaster, stable iodine may be taken in order to reduce internal exposure that results from radioactive iodine.

7 Target Group for Stable iodine pills are distributed to all residents who live within 5 km from a nuclear facility. If a nuclear disaster occurs, all residents who live within about 5 km from the nuclear facility are supposed to immediately 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.

8 Functions and Effects of 1 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.) The effect continues for about 24 hours after taking it. Stable iodine is only effective for internal exposure to the thyroid gland that results from radioactive iodine, but it cannot reduce exposure that results from other radioactive materials.

9 Functions and Effects of 2 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 Dose of [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] From age 1 month up to age 3: One 32.5-mg pack [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

11 Side Effects 1 There have been 4 cases in the past 10 years in which a side effect was reported by law after the use of stable iodine for treatment. All of these cases resulted from long-term use, but did not produce any serious side effects. It is unknown whether the following symptoms result from the side effects of stable iodine, but they have been reported. Hypersensitivity: Rash etc. Digestive symptoms: Nausea/vomiting, stomachache, diarrhea, etc. Other: Hypothyroidism, headache, shortness of breath, etc. Mainly digestive symptoms occur as side effects on first use.

12 Side Effects 2 [The case of Poland after the accident at the Chernobyl Nuclear Power Station] Stable iodine tablets were distributed to 10 million children and 7 million adults. The results for 34,491 people were analyzed. There were no persistent side effects due to the lingering effects of stable iodine. 0.37% of newborns suffered from hypothyroidism. 4.6% of children developed vomiting, skin rash, stomachache, diarrhea, headache or other symptoms, but it is unknown whether these symptoms were the results of side effects of stable iodine. [The case of the accident at TEPCO Fukushima Daiichi Nuclear Power Station] About 2,000 workers took stable iodine pills (from March 13 to October 12, 2011). Hypersensitivity has not been reported. Among 229 workers who took the pills for 14 days or more, or who took 20 pills or more, 3 (1.3%) developed temporary hypothyroidism.

13 People Who Cannot Take 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 hives, respiratory difficulty, a drop in blood pressure, or another allergic reaction after using a povidone iodine liquid (contained in mouthwash), Isodine, or 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. In the event of an emergency, you should evacuate earlier than the general public.

14 People Requiring Caution in Taking If you suffer from a particular disease, put a checkmark in the Yes box in the relevant disease column for the following items on the check sheet, and consult us at the time of distribution. If you suffer from one of the following diseases, a stable iodine pill may worsen your symptoms, but taking it once will not provide a dose that adversely affects your health, so it is considered to be appropriate to provide stable iodine to you. [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

15 People Taking Medicine that Requires Caution in Use with If you are taking any of the following medicines, there may be a concern that the concurrent use of the medicine and stable iodine will affect your health, but taking it once will not provide a dose that adversely affects your health, so it is considered to be appropriate to provide the pills to you. [Medicines requiring caution in concurrent use] Potassium-containing formulations (potassium replacement)* 1 Angiotensin II receptor blockers, potassium retention diuretics, antihypertensive drugs (combination drugs), ACE inhibitors (hypertensive therapy) * 1 Lithium formulations (bipolar disorder (manic depression) therapy) * 2 Antithyroid agents (hyperthyroidism therapy) *2 If you are worried about concurrent use, bring your prescription record and consult a doctor or pharmacist at the briefing session. *1 The level of potassium in the blood may increase. *2 Decreased thyroid activity may develop. The effect of taking it once is minor.

16 Pregnant or Lactating Women In principle, pregnant women can take stable iodine. If a pregnant woman takes stable iodine pills, it has the potential to affect the fetus, so you should avoid taking it multiple times. If you have any concerns, please consult the staff at a counseling counter after taking it. Lactating women need to avoid breastfeeding (breast milk) while taking stable iodine and for about three days after taking it. Babies/infants less than 3 years of age and pregnant women are supposed to evacuate earlier than the general public.

17 Intake of Iodine Because Japanese people usually eat iodine-rich kelp and other marine products, their thyroid glands are packed with iodine. However, iodine excess has not been reported. Taking stable iodine may cause an iodine excess state and reduce thyroid functions, but this symptom is temporary, and will soon recover after taking it once.

18 Increased Level of Potassium with (Comparison of potassium content per 100 g of food) Potassium iodine pills: 24 mg potassium in two pills 30% apple juice: 24 mg (half a glass) Banana: 360 mg (edible part of 1 banana) Baked sweet potato: 540 mg (half to a third of a potato) Slice of bread: 97 mg (about 2 slices of a 6- slice loaf of bread) Tuna (lean): 380 mg (about 10 slices) Avocado: 720 mg (edible part of 1 avocado) The amount in brackets equals the reference quantity per 100 g of each food. In principle, stable iodine can be taken because it has a much lower potassium content than food.

19 Instructions for Taking For stable iodine to be most effective in the event of a nuclear disaster, it is important to take it in a timely manner. Without deciding on your own, take it under the instructions of the central government, prefectural government or [Follow instructions to take it] municipality. The instructions are given via the community PA system, TV, radio, Internet, area mail and so on. *If you take it under the instructions of the central government, prefectural government or municipality and experience any side effects, the central government will compensate you for any damage.

20 Handling of How to Store Store stable iodine in a dry place, avoiding direct sunlight. Store it in a medicine cabinet or other conspicuous place, or put it in an emergency bag. Be prepared to take it immediately when necessary. The stable iodine have an expiration date. If their expiration date is approaching, we will replace them with new ones. Do not give the stable iodine to someone else.

21 Handling of To People Who Received If you fall under one of the items on the check sheet after receiving stable iodine, consult a doctor again. If the stable iodine become unnecessary because you will move or for other reasons, return them to the city office or village office immediately. Be sure to explain the precautions, etc., to your family members who did not participate in today s distribution session.

22 Handling of 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.)