Distribution of stable iodine in a nuclear emergency--are we prepared?

In the event of a nuclear accident health authorities are responsible for the provision of stable iodine to an affected population. Following an emergency exercise deficiencies in local arrangements were apparent, and a survey of other districts with nuclear reactors was carried out to examine alternative solutions to some of the practical problems created.

Health districts in England and Wales and health boards in Scotland with nuclear sites within their boundaries were identified from literature supplied by the Health and Safety Executive, and a copy of their current nuclear emergency plans together with any field experience of their use requested. Information from the plans was extracted and categorized according to a pre-defined list of criteria.

Sixteen districts with 18 nuclear sites had plans for distribution of stable iodine. Plans concentrated on the population within a small area around the site; more remote populations and special groups such as those in the emergency services were rarely mentioned. The most common arrangement was predistribution of tablets to local centres for onward distribution by community nurses, police or the public. Predistribution to households was unusual, although two districts were in the process of redrafting plans to accommodate this. Two districts with operating reactors did not have any agreed plans. No district had any experience of use in a real situation and only two with operating reactors had attempted field testing.

There is considerable uncertainty and confusion about the best method of distribution, with significant omissions from the majority of current plans. This is exacerbated by a lack of practical experience and a failure to share exercise experiences.