Over the past few weeks, towns from Harwich to Provincetown have been receiving hundreds of thousands of doses of potassium iodide pills to be taken in the event of a nuclear mishap at the Pilgrim nuclear power plant across Cape Cod Bay in Plymouth.

For years, health activists have been frustrated in their efforts to get the pills. In 2002, a Massachusetts law was passed requiring the state to supply potassium iodide, or KI, pills to all towns that requested them. In subsequent town meetings, most Cape towns voted overwhelmingly for resolutions to request the pills, which help prevent thyroid cancer in the event of a radioactive leak from a nuclear power plant.

"It's certainly taken a huge amount of public pressure to have the state implement this program," said Mary Lampert, director of Pilgrim Watch, a public safety group.

But just having the pills stored at town halls isn't enough, advance distribution is essential. The pills, which work by saturating the thyroid gland so it doesn't absorb radioactive iodide from a radioactive plume, must be taken before or immediately after exposure to a radioactive leak.

All over the Cape, towns are drawing up their plans. Orleans health agent Bob Canning said he is working with fire, school and town officials to develop a distribution plan for the 43,000 pills he recently received.

Brian Carlson, who is the health inspector in Provincetown, confirmed he has received a shipment of more than 120,000 doses which are being stores at the health department. Like many Cape health officials, he's waiting for directions from the state regarding distribution.

Paula Champagne, Harwich's health director, said the distribution plan she's working on for Harwich's 40,000 pills has an added benefit - it will be good practice for the distribution of other medicines in the event of other emergencies.

Some towns may be well-advised look to Duxbury when developing their distribution plans. Duxbury, located less than 10 miles from the Pilgrim nuclear power plant, was one of the first towns in Massachusetts to recognize the importance of having a supply of potassium iodide.

Tired of waiting for the state to provide potassium iodide, the town took matters into its own hands. Based on that experience, Lampert, who also serves as chairman of the town's nuclear advisory committee, offered advice for Cape towns.

She said Cape Cod towns must focus on regular public education so the public understands the issue.

If allergic to salt or seafood, you may be allergic to KI pills and should talk to the doctor. "All it is is a concentrated salt, so if you can eat at McDonald's don't worry," said Lampert.

Stockpiling the pills in schools is considered essential, as children are highly susceptible to thyroid cancer. "Potassium iodide needs to be distributed before or shortly after an accident," said Lampert, who keeps a supply of KI pills in her car, on her cruising sailboat, and in her medicine cabinet.

In the event of a radioactive plume, people are advised to shelter immediately in windowless interior rooms as far as possible from the roof.

"If there's an accident all you people can do is shelter. You can't evacuate." Lampert noted that with Plymouth evacuating, the traffic would be horrendous, and the bridges over the canal nearly impassable. What's more, she said, cars don't provide protection against radioactive plumes.

As part of the distribution plans, schools will probably seek medical releases from parents. In Duxbury's plan, children report to their homerooms where the school nurse distributes the pills according to a list prepared in advance.

Duxbury has even gone a step further. The town has purchased little paper masks for school children. According to Lampert, the simple masks shield out 90 percent of the radiation.

David Agnew, a Chatham resident who is a member of Cape Downwinders, a local group concerned about the risks of a nuclear accident, has cautioned about a false sense of security from KI pills. In a 2005 interview, he explained that KI pills are not a panacea. In the event of a nuclear melt down, "a whole host of radio nuclides or radioactive isotopes" would be released into the air. But the largest component in that cloud would be radioative iodine.

© The Cape Codder