Nuclear Risk: France Extends Iodine Distribution Area

Aude Lecrubier

September 23, 2019

Paris - France has extended the areas for stable iodine tablet distribution to 20km around 19 nuclear power plants.

The news came in a statement issued on September 17th from the French Nuclear Safety Agency (ASN). People and public buildings, such as hospitals, schools, restaurants, and train stations, in a radius of up to 20 km around 19 nuclear power plants, will receive a letter from the public authorities allowing them to claim supplies of iodine tablets free of charge from pharmacies.

The announcement came as part of an awareness campaign, and reminds the public that the possibility of a nuclear accident can never be completely ruled out, especially as nuclear reactors get older.

If inhaled or swallowed, radioactive iodine attaches itself to the thyroid gland, where it may cause thyroid cancer. Taking stable (non-radioactive) iodine blocks this uptake and so protects the gland from the effects of nuclear radiation.

The thyroid gland is especially sensitive to radiation in children, pregnant women and foetuses.

Iodine Distribution Over an Extended Area

Since 1997, the French government organised iodine tablet distribution for the populations living around the nuclear installations. The iodine distribution plans were renewed in 2000, 2005, 2009, and 2016.

Until now, the distribution area was up to 10 km around nuclear plants. The extension from a 10 km to a 20 km radius was announced by Ségolène Royal, then Minister of Environment, on 26th April 2016, the 30th anniversary of the Chernobyl disaster.

The move complies with the recommendations of the European Nuclear Safety Authorities but took 3 years to be implemented. It now covers 2.2 million people and more than 200,000 public buildings.

Is this extension sufficient? There are some doubts. Pierre-Franck Chevet, former president of the ASN told the Libération newspaper in 2016 that Fukushima had had "diverse consequences for the populations up to 100 km around the plant" and that the scope needed to be extended to cover this wider area.

The French authorities have made stocks of iodine that can be distributed countrywide if needed, according to the ASN.

In the UK, local authorities are responsible for the storage and emergency distribution of potassium iodate tablets.

The NHS had previously warned that iodine tablets can cause serious adverse effects if taken unnecessarily or when not instructed to do so.

Personal Nuclear Emergency Plans

As well as the preventive distribution of iodine, the ASN has reminded the public of the six emergency steps to be taken in the event of a nuclear alert:

  1. Quickly find shelter in a permanent structure

  2. Follow the news for updates

  3. Do not fetch children from school

  4. Limit telephone calls to avoid network congestion

  5. Take the stable iodine tablets when instructed by local commissioners

  6. Prepare for a possible evacuation

A Role for Health Professionals

The ASN said health professionals played "an essential role in this campaign with 646 pharmacists dispensing tablets and 3077 doctors able to provide information and advice to their patients in the areas concerned".

"During the last iodine distribution operation in 2016, only 49% of people made an effort to fetch their tablets from the pharmacy," according to a recent comment on nuclear activities in LesEchos by Jean-Claude Delalonde, president of the National Association of Local Information Committees and Commissions (Anccli).

"People who live right next to power plants follow certain habits. We need to develop our risk culture globally, because an accident can always occur and the consequences are not generally limited to an area of 20 km," he said.

Health Impact of the Fukushima Daiichi Nuclear Accident

What do we know about the health consequences of the Fukushima Daiichi nuclear accident? In 2018, the French Institute for Radiation Protection and Nuclear Safety published a report on the Japanese experience from 2011 to 30th June 2017.

It documented how the Japanese health authorities set up a programme of epidemiological studies and evaluations to assess and monitor the health status of people who were exposed to radioactive releases from the accident at the Fukushima Daiichi nuclear power plant. According to the latest results of 30th June 2017, 566,773 people from the 2,055,258 residents of Fukushima Prefecture had responded to the questionnaire.

Between 2011 and 2018, ultrasound monitoring of thyroid function in 360,000 children in Fukushima Prefecture present at the time of the accident reported confirmed papillary thyroid carcinoma in 155 children as well as a few other thyroid cancers of an unspecified type.

At the same time, monitoring the 210,000 evacuees in the weeks following the accident showed an overall trend towards improving physical health status, though no further details were given.

On a psychological level, 4386 people (473 children and 3913 adults) received telephone support. For children, problems were mainly: heightened emotions (38%), irritability (34%), relationship problems with their friends (33%) and rebellious behaviour (31%). In adults, 35% of people contacted by telephone were affected by a depressive syndrome, 15% reported a decrease in their physical condition and 13% were taking psychotropic drugs.

As far as pregnancies were concerned, according to a survey published in February 2015, after a slight increase in the rate of abortions between 2011 and 2012, this rate (0.04%) went down in 2013. There was no significant rise in miscarriage rates over the August 2010 - July 2013 period and the birth defect rate remained comparable to the Japanese national average over time. The rate of premature births remained close to the rate observed for Japan as a whole.

Translated and adapted from Medscape's French Edition .

References:

ANS press release. Kick-off of the additional stable iodine tablet campaign around nuclear power plants: 2.2 million people and 200,000 institutions involved. 17th September 2019

Coralie Schaub. " We have to imagine that an accident like Fukushima can happen in Europe". Libération. 3rd March 2016.

Sharon Wajsbrot. Nuclear risk : eight years after Fukushima, France extends its safety perimeters. Les échos. 17th September 2019.

IRSN. Impact on health in 2018 of the Fukushima Daiichi accident.

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