1. the projected benefits and harms of a KI distribution program as part of a nuclear incident preparedness program;

  2. the most effective and safe way to distribute and administer KI on a mass scale to prevent radiation effects;

  3. the populations that should be included in the KI distribution program;

  4. the appropriate roles for local, state and federal agencies related to KI distribution in such a preparedness program; and

  5. any additional issues that need to be researched, resolved, or addressed.

To understand the context of the statement of task presented above, the committee believed that it was important to provide background information on the effects of radioactive iodine and KI on the thyroid gland and to explore various options for using KI to protect the thyroid. In this report, we describe the benefits of and risks posed by KI administration to different population groups and focus particularly on protecting children, the most vulnerable group (tasks a and c); identify alternatives for KI distribution that have been chosen to be best in different parts of the United States and in other countries and recommend a procedure for a local area to evaluate different distribution plans on the basis of site-specific characteristics (task b) and current roles played by local, state, and federal agencies regarding KI distribution (task d); make some recommendations regarding the level at which decisions should be made (state and local level), programs should be funded (federal level), and supplemental stockpiles should be maintained and adequate KI supply (in suitable dosages) ensured (federal level); and identify additional issues that need to be researched or addressed (task e).

Radioactive iodines (radioiodines, such as 131I) are produced during the operation of nuclear power plants (NPPs) and during the detonation of nuclear weapons. Radioiodine is one of the contaminants that could be released into the environment in the event of a nuclear incident that involves a disruption of the integrity of the fuel assembly and containment structures of a NPP, because of an



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