Health agents sit on hoards of potassium iodide

No firm plan on how to get the critical prophylactic to Islanders ahead of nuclear fallout.

Tisbury health agent Maura Valley has a stockpile of KI in the event of a radiation leak at Pilgrim Nuclear Power Station. — Stacey Rupolo

Pilgrim Nuclear Power Station is slated to shut down in 2019. Yet its potential for a radiological accident will endure beyond its decommissioning, because the nuclear waste the plant has generated will remain onsite in Plymouth for the foreseeable future.

Should a calamity occur at the station that causes fallout to drift onto the Vineyard, Island health agents will be among the people Vineyarders turn to for aid. Via the state, they are in possession of large quantities of potassium iodide tablets, also known as KI, a prophylactic used to keep radioactive iodine from permeating the thyroid gland, where it can cause cancer. Exactly how the 130-milligram tablets would be dispersed to the Island population is not clear.

A report from the U.N. Scientific Committee on the Effects of Atomic Radiation states that iodine-131 or I-131, the radioisotope KI is designed to hedge against, “can be transferred to humans relatively rapidly from the air, and through consumption of contaminated milk and leafy vegetables.”

According to the Centers for Disease Control, I-131 can also be ingested in water.

Tisbury health agent Maura Valley has at least 20,000 doses of KI stashed in her office closet. In an effort to disperse the tablets among Tisbury residents, she held a dispensary day a year ago in May, and advertised it in the Island’s newspapers. Only 40 takers surfaced. She also said the Massachusetts Department of Public Health, the entity that distributes KI to cities and towns, and is likely to play an advisory role in any sort of radiation event, is not frequently in touch with her office about KI.

“I can’t recall the last communication on the issue,” she said. As to Martha’s Vineyard Hospital, Ms. Valley said that “to date, we have not had interactions with the hospital regarding KI or radiological planning, although I’m sure we could work together in the event of an emergency.”

Edgartown health agent Matt Poole also held a dispensary day in May 2016 out of Edgartown town hall. He said the turnout was “minuscule” Prior to that, in February 2009, as part of an effort by all six towns plus the Wampanoag tribe, each of which distributed KI from different locations, he held what he termed a “scheduled predistribution.” He advertised and set up shop in the Edgartown School. Fifty people showed up. Mr. Poole’s cache of KI, also 20,000 doses, rests under his desk. He told The Times that all Island flu clinics once held at the high school served as good training exercises for the distribution of KI. One of those clinics was a drive-through type, where folks received the flu vaccine without exiting their cars. The aim was to keep people from mingling in inoculation queues so they wouldn’t infect each other during an outbreak. Mr. Poole said the model also would work for KI dispensing, because the cars would help to shelter Islanders from a contaminated environment. He emphasized that in an emergency situation, whether health agents need to distribute KI, an inoculation, or even bottled water, a single distribution site with security for both the health staff and the public is essential to serve a large population in a short span of time. “The last thing you want is a dispensary being overrun,” he said.

According to Mr. Poole, at present there is no absolute plan as to how KI would be distributed on the Island. The Massachusetts Department of Public Health will notify the Island’s health agents when a situation warrants the distribution of KI. West Tisbury emergency management director John Christensen told The Times that he has a trailer full of signage left over from the defunct all-Island flu clinics that could be readily employed to facilitate a KI dispensary.

Mr. Poole hopes KI distribution would play out like those orderly flu clinics, but he points out that like the Island’s health departments, the Island’s emergency management directors do not have a chief executive to unify and direct Island resources. This makes the prospect of organizing an all-Island emergency dispensary more complicated.

Department of Public Health spokeswoman Ann Scales told The Times that the state has stockpiled KI for the Vineyard, Nantucket, Cape Cod, Cape Ann, and any city or town within 10 miles of a nuclear power plant.

“For those who have elected to participate, KI supplies (based on summer populations) have been predistributed,” she said.

Ms. Scales also said the Department of Public Health would play an active role in monitoring any radiation incident. “In the event of a radiological event, the DPH/Radiation Control Program would perform in-field radiation monitoring as part of a team, providing ‘real-time’ data to state senior staff, who would act as technical advisors to local, state, and federal agencies,” she said.

A stockpile of of KI at the Tisbury town hall annex. — Stacey Rupolo

I-131 was released in both the Chernobyl and Fukushima disasters. It’s a regular byproduct of nuclear fission, with a half-life of eight days. It would be a likely component of fallout from a disaster at Pilgrim Station.

Disasters like those at Fukushima and Chernobyl produced other perilous isotopes, like cesium-137 and strontium-90. Strontium-90 attacks bones and bone marrow by mimicking calcium. There isn’t a prophylactic or antidote for it. If ingested, cesium-137, a muscle attacker, can be mitigated through the use of Prussian blue, according to the Nuclear Regulatory Commission. However, Prussian blue isn’t a substance that the commonwealth has furnished Island health agents with.

The Bureau of Environmental Health, a section of the state health department, oversees the radiation control program, but does not stockpile other medicines. “DPH does not stockpile or facilitate the distribution or administering of Prussian blue for radiological incidents,” Ms. Scales said.

Mary Lambert, director of the Cape Cod watchdog group Pilgrim Watch, told The Times that the threat of I-131 de-escalates once a reactor like Pilgrim’s shuts down. She said that 80 days after shutdown, KI is no longer necessary to have on hand. But she also said that it would be unwise for the Vineyard to discard its stocks of KI, because the Island is downwind of Connecticut’s Millstone Power Station, which possess a viable license until 2045.