It may be worth a look around the world before wholeheartedly investing in Taiwan's Fourth Nuclear Power Plant.
Safety, particularly in the area of accident preparedness, has been overlooked in Taiwan's quest for nuclear energy. According to the International Atomic Energy Agency, an organization of which Taiwan is not a member, it is standard practice for local authorities near nuclear power plants to play a major role in organizing emergency preparedness plans for nuclear accidents. In fact, local governments in many countries will not issue an operating permit to the plant until an emergency plan is already established.
Such a plan entails that police, fire fighters, mayors, teachers and other public roles are fully aware of and instructed in emergency procedures and plans in the case of the release of radiation outside of nuclear power plants. It is also standard that these plans are rehearsed and exercised at least every two years so that emergency alert systems, personnel, evacuation reception stations, radiation monitoring teams and equipment are all kept up to date. In most countries, it is also crucial that there are trained medical emergency response teams and facilities capable of handling an off-site radiological event.
This past September's earthquake woke us up to the fact that Taiwan has little medical emergency planning for disasters, and especially not in such a specialized area as radiation accidents. There is neither a radiation medical response team in Taiwan, nor are there suitable facilities equipped to handle even minor radiological emergencies. Another safety concern is the area around nuclear facilities that is included in emergency preparedness plans. Taipower (台電) loosely plans for an area in a 5km radius around nuclear power plants.
Although there is no international regulation determining the radius of this zone, usually called the Emergency Planning Zone (EPZ), looking at plans from other countries where accidents have already happened could be useful. In the US, the EPZ radius is 18km for immediate protective action plans such as evacuation, and 90km for secondary protective actions. In Lithuania, the EPZ is 30km, in which all members of the public would be administered potassium iodide pills to prevent thyroid cancer. In Japan, the suggested EPZ was 8-10km, though this may soon be raised.
Moreover, many are unaware that in the short time that it takes for a radioactive plume to pass overhead, there is a simple preventive measure to prevent thyroid cancer -- taking stable iodine prophylaxis -- yet it must be taken within 30-40 minutes of the accident to be fully effective.
Last year, the WHO published a document on guidelines for stable iodine administration after radiation accidents, reminding states to seriously consider pre-distribution to households or at least stocking this preventive drug at points such as schools, hospitals, pharmacies, fire and police stations near nuclear power plants.
Stable iodine (either KI, potassium iodide or KIO3, potassium iodate) is useful in blocking the thyroid gland, especially in the first 30 minutes of exposure or risk of inhalation of radioactive iodine, a standard ingredient in a radioactive plume. It is still debated how many hundreds or thousands of people averted thyroid cancer due to this protective action in the Chernobyl accident.
Just after Chernobyl exploded, people within 30km of the accident were instructed to take potassium iodide, while 18 million people in Poland also took this preventive measure. It takes substantial planning to prepare a drug in this quantity, not to mention distribution strategies, yet many countries have decided that this planning is worth the hassle. France's Ministry of Health has distributed iodine prophylaxis to 600,000 people within 10km of 24 nuclear power plants.
Local authorities in the UK are required to prepare for the distribution of stable iodine pills to all members of the public near nuclear power plants. In the US, the Nuclear Regulatory Commission stated that it would foot the bill for those states wishing to include stable iodine pills in their plans.
Why many localities do not implement such measures is due to either lack of organization or fear of the public becoming aware that there is a potential danger near their homes. Countries with land to spare can usually locate nuclear power plants in sparsely populated areas, but most public health officials in the world would groan at the densely inhabited areas where Taiwan's plants are located. How would Taipower explain to the millions of people within 30, 20 or even 10km of its plants that they must be prepared to evacuate or take iodine prophylaxis the next time an earthquake, terrorist attack, or malfunction jeopardizes a nuclear facility's safety?
It is worthwhile to consider that many countries which had concrete plans for nuclear power are canceling construction or even phasing out nuclear energy due to economic or safety reasons. Planning the medical response to nuclear emergencies requires complex organization as well as local support.
Peter Morehead is with the Taiwan Radiation Emergency Medical Preparedness Project.
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