Officials are concerned about speed of distribution and allergic reactions.

It's a scenario everyone hopes stays forever tucked away in the "what if" drawer - a radiation release at the Perry Nuclear Power Plant.

The first line of defense against such an event is to get out of town, out of the way of harmful radiation.

But that could take time. And time can mean the difference between life and death when it comes to exposure.

It was with that in mind that the Perry School District began stockpiling radiation protection pills of potassium iodide, often referred to by its chemical formula, KI.

Like most medications, it has a shelf life. And the school district's supply is set to expire in 2007.

That has district officials recommending doing away with an ambitious plan to administer the drug to its 1,800 students - a plan that some say was flawed from the start.

THE PLAN

Potassium iodide is a cheap, nonprescription mineral that is proven to prevent thyroid cancer, which is one of the main causes of death after radiation exposure. To be effective, it must be administered within three to four hours of a nuclear release.

It's far from a magic bullet that will ward off the harmful effects of radiation, as it protects only one organ against one type of radiation, radioactive iodine.

The mineral was shown to prevent thyroid cancer in those who took it during the Chernobyl disaster in the former U.S.S.R. (now Ukraine), according to the U.S. Food and Drug Administration.

The Perry School District began stockpiling the pills about five years ago, according to district Wellness Director Connie Bowler.

At that time, a state program made the pills available to schools within a 10-mile radius of nuclear power plants.

The go-ahead for administering the pills in a nuclear event would come from county emergency managers, Bowler said, not from school leaders.

Pills stored in a central location in each school building would then be carried down to classrooms along with a list of students whose parents approved administering the drug.

Nearly all students are approved to receive it, she said.

Bottled water, also stored in the schools as a safe alternative to potentially irradiated tap water, would be passed out to help in swallowing the pills.

While some experts recommend varying dosage levels based on age, weight and level of radiation release, the schools carry a universal 130-milligram dose for each student.

"It would be the same dose for a 5-year-old as it would be for a 250-pound linebacker," Bowler said.

It is uncertain just when the county might make a call for administering the pills.

"Just because you're in a shelter doesn't mean you have an emission that requires that the pills be consumed," she said.

Students would receive an ink stamp to show that they ingested the pill, to avoid accidental overdosing.

The district also has an entirely separate supply of pills and permission slips on hand with their transportation department, designed as an alternative plan for administering the drug in the midst of an evacuation.

THE CONCERN

Despite years of planning and maintaining a KI stockpile for a potential nuclear disaster, Bowler and Perry's nursing staff now say it's not such a good idea for a number of reasons.

"We have a concern that, in the middle of an emergency evacuation procedure, that a student could have an anaphylactic reaction," Bowler said.

"The iodine that's in those pills is very similar to what's in shellfish. We've got young kids who may not have ever been exposed to it."

Bowler worries that a student having a severe allergic reaction could have an even greater effect on the district's evacuation effort, slowing things down and putting others at risk.

"It is a safety measure, but it also creates a safety concern," she said.

Then there's the sheer magnitude of getting nearly 2,000 pills into the mouths of students and staff.

"What are the logistics of getting everybody a pill, plus our staff, in a short length of time?" Bowler asked. "It's not just a matter of handing out a pill and they're on the way," she said.

The primary goal is a smooth evacuation, which may come sooner than expected after a recent revision of the plant's recommended evacuation procedures.

With that, Bowler and other district leaders hope Perry students would be out of harm's way before they would ever need a KI pill.

OTHER OPTIONS

County Health Commissioner Joel Lucia said school officials did not consult the Health District prior to making their recommendation to eliminate the emergency KI distribution plan, nor are they required to do so.

But he believes the issue needs to be considered carefully before making a move.

"I have to fall down on the side of safety," he said. "If it takes a few more hours of paperwork, then let's do it for the safety of the kids."

Should the district decide to do away with its own plan to administer KI to students, the pills will still be available free to residents from the Health District.

But current school policy would not allow students to bring their own KI to school without registering it with the nurse's office.

The Health District's KI pills will also expire at some point, along with the thousands that have been distributed among residents within a 10-mile radius of the plant.

But the expiration date could be extended, Lucia said.

The county began offering the pills to residents in 2003, after years of debate over how and when to distribute KI.

The pills' shelf life is generally five to seven years, and can be extended by testing stockpile samples according to Nuclear Regulatory Commission guidelines.

While the school does not have to consult with the Health District on its plans to administer KI, Lucia said he would like to know more about the district's rationale.

Lucia said the chances of ever needing the pill are slim, but then again, so were the chances of Lake County getting hit with nearly 10 inches of rain in a 24-hour period a little more than a week ago, he said.

"If you deal in probabilities, the probability of radioactive iodine being released is small," he said. "The probability of it being taken up by the thyroid is small. There's not a great probability, but there was enough concern at some level ... to ask local health districts and schools to make it available to the population. It adds an extra level of protection."

Lucia said the Health District's effort to get KI into the hands of Lake County residents has been successful, estimating that 50 percent of eligible residents have picked up pills.

"In the first six months to a year, not only did we deliver them to a lot of industries, we had a site over at the fairgrounds where we just passed them out," Lucia said. "Any time we advertised, people just came running in to pick them up."

Lucia said although no federal funding has been earmarked for an eventual restocking of the county KI, he believes the program will continue.

"We may have to replace all the potassium iodide," he said. "We don't know that yet."

The Perry School Board has not taken any formal steps to eliminate the KI distribution plan.

It would cost the district about $1,000 to restock the drug after its current stockpile expires, Bowler said.

School board members have also expressed an interest in conducting emergency bus-loading drills to test the district's ability to respond to a potential nuclear emergency.

The board meets at 7 p.m. today at the Perry Elementary School.

© The News-Herald 2006