Prescription for Disaster

Twenty years ago, on the morning of March 28, 1979, an explosion as powerful as several 1,000-pound bombs shook the Pennsylvania countryside. A hydrogen bubble inside a Three Mile Island nuclear-power-plant reactor had almost blown through the containment wall. Hours earlier, plant engineers had identified the first warning signs of a total meltdown; before long, alarms all over Three Mile Island marked the passing minutes with a terrifying, high-pitched whine. Most nearby residents didn't wait for an official evacuation order. TV crews captured the mayhem as roads and freeways leading out of the towns of Goldsboro and Harrisburg became slow-motion, honking rivers of station wagons and town cars.

By Day Two of the worst nuclear disaster in American history, no general evacuation of the public had been ordered. After a lengthy argument with Joseph Hendrie, chairman of the Nuclear Regulatory Commission (NRC), Pennsylvania Governor Richard Thornburgh reluctantly ordered everyone within 10 miles of Three Mile Island to stay indoors-for 30 minutes. The following afternoon, Thornburgh-who kept close counsel with both the NRC and optimistic plant officials throughout the disaster-finally ordered nearby elementary schools shut down indefinitely. For those still listening, Thornburgh called for a limited evacuation of all pregnant women and children within a 5-mile radius downwind of the plant.

Thornburgh's decision not to order a general evacuation would not be soon forgotten by survivors of the disaster or by anti-nuclear activists. Nor would another aspect of the catastrophe: the fact that state and local officials had failed to stockpile potassium iodide (KI).

Administered early in a nuclear accident like the one at Three Mile Island, KI can prevent radioactive-iodine poisoning, which causes thyroid cancer in humans, especially children. The nuclear industry takes KI seriously: emergency workers at Three Mile Island, for example, had been equipped with KI tablets.

But not nearly enough of the pills were available for nearby residents. Officials ordered an emergency shipment of the tablets from a St. Louis company. A full week later, on April 4, 1979, 237,013 of the yellow pills arrived in the communities near Three Mile Island. It's still unclear exactly how much radioactive iodine was released at Three Mile Island. What's clear is that the pills arrived too late to help anyone who might have been exposed.

Today, nuclear-energy spokespeople and government officials say a disaster like the one at Three Mile Island is virtually impossible, even unimaginable given advances in nuclear engineering and emergency planning that have taken place since 1979. "The odds are millions and millions to one," said a Southern California Edison spokesman who has worked at four U.S. nuclear-power plants.

So why, two decades after Three Mile Island, is the U.S. government now urging states that operate nuclear-power plants to distribute anti-radiation pills to the public?

KI, the symbols attached to potassium iodide by the periodic table, has exactly one medical benefit for human beings: if swallowed within a few hours of exposure to radiation, a 130-milligram tablet will block the thyroid's absorption of a radioactive isotope called iodine 131. Iodine 131 is one of the many radioactive isotopes produced during nuclear fission, the process by which nuclear energy is created in U.S. reactors. Nuclear-plant officials and government health experts point out that not everyone can take the pill. Some people, such as those who can't eat shellfish, are allergic to all forms of iodide. The pill is much less effective if taken more than a few hours after exposure.

Whether KI's benefits are at all substantial is still a matter of much debate among scientists and environmentalists. One of KI's leading proponents in California is Dr. Willard Osibin, a longtime member of the environmental group Physicians for Social Responsibility. Osibin lives 22 miles upwind of the Pacific Gas & Electric plant at Diablo Canyon near San Luis Obispo, where, throughout the 1970s, the government stockpiled KI at every firehouse within 5 miles of the plant. One day in 1977, Osibin said, local authorities told the public that the tablets had to go. The officials claimed KI had at least two shortcomings: deteriorating stockpiles needed to be replenished every few years, and there was no more funding. As quietly as they had come to San Luis Obispo-and with little public protest-the pills disappeared.

Osibin says he spent years badgering local authorities to bring back the tablets, but to no avail. "We couldn't move a button on this issue," he complained.

The disaster two years later at Three Mile Island didn't change KI's status around Diablo Canyon. It would take another, even greater nuclear disaster for the U.S. government to re-examine the radiation pill. In 1986, an aging, outdated nuclear reactor in Chernobyl, Ukraine, went up in a cloud of radioactive smoke. At first, the official death count was just 22 people, all of whom had died when the reactor's containment structure exploded. Yet in the years following the world's worst nuclear accident, the first long-term effects of radiation exposure from Chernobyl began to surface with horrifying results. Between 1991 and 1992, Russian scientists in Belarus discovered 131 new cases of thyroid cancer-precisely the disease that KI is manufactured to prevent. The victims were almost entirely young children who had been exposed to radioactive iodine in their food; many others were still in their mothers' wombs when the accident occurred.


Throughout Eastern Europe, thyroid cancer was notable for its absence only in Poland, where the landscape was dotted with Soviet nuclear-production facilities-and their healthy stockpiles of KI. By administering more than 17 million does of the drug, Polish officials were able to prevent any unusual increase in thyroid cancer.

Despite the Chernobyl experience, however, only three U.S. states operating nuclear plants have so far made KI available to the public: Tennessee, Maine and Alabama. The rest, most notably California, have refused to stockpile the drug at shelters-much less distribute it to residents around the state's two nuclear-power plants, Diablo Canyon and the San Onofre Nuclear Generating Station (SONGS). Not even Camp Pendleton-which is less than a quarter of a mile uphill from SONGS-has stockpiled KI.

That may soon change. "Right now as we speak, the Nuclear Regulatory Commission is voting on what the ultimate language of the proposed rulemaking on potassium iodide will be," said NRC spokesman Aby Mohnesni. The phrase "ultimate language" is significant. Last year, the NRC strongly encouraged states to distribute KI to everyone within 10 miles of a nuclear-power plant. That caused an uproar, mostly among the nuclear industry and state, county and local officials who claimed variously that the drug is ineffective and difficult to manage and could interfere with what officials regard as the preferred response to a nuclear disaster: evacuation.

In response, the NRC created a pill-review committee made up of representatives from the Federal Drug Administration (FDA), the Environmental Protection Agency (EPA), and the Federal Emergency Management Agency (FEMA), as well as the three states that already use the anti-radiation pills.

"The experiences of those three states," Mohnesni said, "was that predistribution of KI was not the best way to go." According to case studies gathered by the NRC, some residents in the three states immediately ate the KI pills they'd been given-and then called emergency officials to ask for more. In Tennessee, the NRC found, only 15 percent of the public showed up to claim their supply of the emergency pills, even after they had been advertised on local television and radio. Understandably gun-shy, Mohnesni says the NRC will simply recommend that states make KI available to the public without telling them exactly how to do it. "That's the kind of language that comes out of here," he said. "We're not going to say, 'You should have potassium iodide.' It's going to be up to the states to decide."

But state officials say it's not their decision. "The folks who really get to decide if KI is going to be implemented are at the local level," said Steve Woods, a senior health physicist with the California Department of Health Services (DHS).

Underlying the complex discussion about KI's utility is one simple point: its critics say KI doesn't work-or doesn't work frequently enough-and that dispensing it broadly before an accident would lull a power plant's neighbors into a false sense of security. "KI is not a panacea," Woods said. "It is only useful against one isotope. If you have a leak that isn't iodine, KI won't help you. Nor will it if you take it an hour or so after you've been exposed."

"The thing to remember about KI is that it only protects against inhaled radiation, not external radiation," added Dr. Deborah Gillis, an official with the DHS' environmental-health investigations branch. In the Chernobyl incident, Gillis said, most thyroid-cancer victims were contaminated after eating radioactive food-not because they inhaled particles of radioactive iodine. "The KI would only protect against what you inhale, not what touches your skin. It's estimated that the risk of getting cancer from external exposure to radioactive iodine would be greater than inhalation."

"That's why it's best not to be in the [radiation] plume at all," Gillis concluded. "KI only has a very small potential to prevent cancer. Getting people out of the path of the plume is much more important."

Officials argue against KI's effectiveness as a precursor to their preferred option: total evacuation of everyone in the path of "the plume." To that end, Gillis argued, distributing KI to individual households may only confuse an already hectic situation. "What if people aren't at home when the emergency happens?" she asked. "Will they go back home to get their pills instead of evacuate? What about the people who are allergic to KI? Do you try to segregate evacuees into allergic and non-allergic groups in the middle of an evacuation?"


As another official described the dilemma, "Handing out medication during a nuclear emergency is not a normal procedure."

"That's nonsense," says Osibin. "The state of California says it doesn't recommend that KI be made available to residents because it would interfere with an evacuation, which is nonsense in our case. There are only two evacuation routes out of here." Osibin points out that a general evacuation of the Diablo Canyon area would take between 18 and 24 hours. From Osibin's perspective, anything that could be done to protect residents during that crucial period ought to be done. As he puts it: "How would providing us with KI interfere with an evacuation that slow?"

SONGS' neighbors won't be seeing any KI pills until-at the earliest-sometime next year. The federal and state agencies responsible for advising San Onofre's off-site emergency-planning team won't be finished with their KI reports until September. In the meantime, Orange County has yet to stockpile KI for residents around San Onofre because officials say they have a better plan. According to Lolita Barrett, who heads the Orange County Sheriff-Coroner's emergency-management division, "If we evacuate people, there's no need for them to be protected with KI."

But an evacuation of San Onofre is likely to be even messier than the one Osibin ridicules at Diablo Canyon. Engineers inside the plant would have 15 minutes to notify local officials that they had declared an emergency. Once they do, 51 sirens in the hills within 10 miles of San Onofre would fire off a chilling, 100-decibel scream. According to the plan, the entire populations of San Clemente, San Juan Capistrano, Camp Pendleton and Dana Point would suspend their natural terror and tune in by radio and television for instructions. Barrett says the message they would hear would go more or less as follows: "There has been a problem at the plant. As a precautionary measure, we've determined that the schoolchildren at Capistrano Unified School District should be moved out of the area."

This news would be followed by the telephone number of an emergency hot line. If a general evacuation has been agreed upon by San Onofre's off-site emergency-planning team, the locations of five emergency-reception centers in San Diego and Orange counties would be announced. If the anticipated radiation leak is both fast-moving and of a short duration, people may be told to stay indoors, close their windows, and shut down their ventilation systems. During a general evacuation, officials envision an orderly flow of evacuees; Barrett insists that no more than 150,000 people would be involved in an evacuation during a worst-case scenario.

But if Three Mile Island is any guide, people who live anywhere within 50 miles of San Onofre can be counted on to self-evacuate. Once the sirens go off, hundreds of thousands of additional automobiles, if not more, will likely hit the interstates in search of safety. "I don't know that we have a specific plan for a panic," said Barrett. "A lot of people are going to panic, but the sensible folks are going to listen. They're the only people we're going to target when an emergency occurs."

Sense may prove the first casualty in a nuclear disaster. While a few thousand "sensible" people gather around their televisions awaiting evacuation instructions, others will pack their prized possessions into cars and jam every road out of town. Depending on the scope of the disaster, it's entirely conceivable that they will fret and fume at the wheels of those cars while a radioactive plume passes slowly through the gnarled traffic.

County officials may have more faith in human nature, but they admit they aren't sure what a nuclear disaster at San Onofre-and its subsequent evacuation-would look like. As Orange County's representative to San Onofre's off-site emergency-planning team, Barrett participates in biannual safety drills at the plant. Utilizing a state-of-the-art, $30 million computer simulator, the team acts out a series of randomly selected hypothetical disasters and responses; their preparedness is monitored by officials from the NRC and FEMA. The 500-person ensemble includes public-safety officials and emergency crews from Camp Pendleton, San Clemente, San Juan Capistrano, San Diego County and Capistrano Unified School District. The drills also include emergency workers from numerous agencies who are trained to penetrate the radiation plume. In a real emergency, each worker would be equipped with a yellow radiation suit. Sewn into the outside of each garment is a radiation-detection badge, and inside each emergency kit is a canister containing an anti-radiation pill.

Despite the fact that its emergency workers have also carried KI tablets since the plant opened in 1968, Southern California Edison, which owns and operates SONGS, says it has no position on whether the public that lives around the plant should be issued the pills. "We will abide by whatever guideline the state and counties decide upon," commented Ray Golden, a Southern California Edison communications manager who works at SONGS. "We've never had an event. We routinely test the procedures three times per year, and we've been proud to say that we haven't had a civil penalty since 1993." (That $50,000 fine, levied by the NRC during an annual inspection five years ago, cited the plant's failure to maintain an operable fire-suppression system in one area of the plant.)


"The likelihood of San Onofre having an event that would be cause for concern is millions and millions to one," Golden claimed.

On a recent tour of SONGS, Golden demonstrated how the plant uses a life-size replica of its own reactor-control room to simulate an emergency. According to an Emergency Classification and Event Code Chart, which hangs on the wall of the real control room, there are about a dozen basic types of accidents that could occur at San Onofre. They range from things like a ruptured cooling-water pipe or an "uncontrolled release of radioactivity" to a "site area emergency" or the worst of all, a much-dreaded "general emergency."





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