With updates from disaster-stricken Japan continuing to dominate news headlines and broadcasts, family physicians likely will be hearing questions from patients about radiation, potassium iodide and food safety.
A fishing boat is among debris strewn throughout Ofunato, Japan, following a massive earthquake and subsequent tsunami. U.S. federal agencies have detected radiation in domestic air, milk and water samples since the disaster in Japan damaged a nuclear facility there, but the agencies say that the radiation is at levels that do not pose a public health threat.
Several federal agencies are addressing those issues, and resources and information are available to help answer patients' questions. The CDC said in a March 27 health advisory(emergency.cdc.gov) that, based on Environmental Protection Agency, or EPA, monitoring of air and rainwater, there is no indication for anyone in the United States to take potassium iodide -- which is used to protect thyroid glands from radioactive iodine in the event of a nuclear accident -- or to switch to bottled water because of the situation in Japan.
The CDC also said on its website that there are risks and side effects(emergency.cdc.gov) associated with potassium iodide, and the medication should be taken only on the advice of emergency management officials, public health officials or a physician.
Nonetheless, the FDA acknowledged in its (then) continually updated public health focus(www.fda.gov) on the Japan situation that domestic demand for potassium iodide has increased. The agency also said consumers should be wary of Internet and retail outlets promoting products that make false claims about preventing or treating effects of radiation poisoning.
The EPA said in March 28 news release(yosemite.epa.gov) that air monitoring locations across the nation had identified trace amounts of radioactive isotopes at levels slightly higher than those found in the previous two weeks. However, the agency said the findings were "far below levels of public health concern."
The EPA, which also is monitoring radiation levels in domestic milk, said in a March 30 joint news release(www.fda.gov) with the FDA, that radiation was detected in a sample taken March 25 in Spokane, Wash., but the radiation level in that sample was 5,000 times lower than the intervention level set by the FDA.
"Radiation is all around us in our daily lives, and these findings are a miniscule amount compared to what people experience every day," said FDA senior scientist Patricia Hansen, Ph.D., in the release. "For example, a person would be exposed to low levels of radiation on a round-trip, cross-country flight, watching television and even from construction materials."
Nevertheless, the FDA has issued an import alert(www.accessdata.fda.gov) that will prevent produce, milk and milk products from areas of Japan near the damaged Fukushima Daiichi nuclear plant from entering the country unless the products are shown to be free of contamination. Although seafood is not subject to the alert, it will be diverted for testing, the agency said.
FDA staff will be monitoring and testing food products from other areas of Japan, as well. However, the agency said that because of damage to Japan's infrastructure caused by the March 11 earthquake and tsunami, few Japanese food imports were reaching U.S. ports.
The U.S. Department of Agriculture said Japan has not exported beef products to the United States in nearly a year and is not eligible to export poultry or processed egg products here.
Finally, the CDC said in its safety alert that rainwater in several states has shown elevated levels of radiation, but the agency said the amount of radiation was "25 times below the level that would be of concern."
Physicians can prepare for an incident that would meet the agency's level of concern. The CDC has a Web page devoted to clinician resources(emergency.cdc.gov) for radiation emergencies, including training opportunities, patient management guidance, and clinical guidelines and recommendations. In addition, the journal Disaster Medicine and Public Health Preparedness recently published a supplement on preparedness for nuclear and other radiological events(journals.cambridge.org). According to a survey by the journal, 45 percent of states do not have a radiation plan, and more than 80 percent of states reported an insufficient ability to respond to a radiation incident.