Japan radiation fears: Health officials try to calm U.S. anxiety
■ Doctors can ease people's worries by having the best and most up-to-date information and helping to educate patients.
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Reports of problems at the Fukushima Dai-ichi nuclear power plant in the weeks since Japan's March 11 earthquake and subsequent tsunami have stoked fears in the United States of radiation drifting across the Pacific Ocean in dangerous levels.
Despite reassurances from meteorologists, radiation experts and federal, state and local government officials that there is no domestic danger, public health officials have fielded calls from panicked citizens.
West Coast pharmacy shelves were depleted of potassium iodide pills soon after the first news reports about the power plant. Many health departments have developed websites and hotlines to respond to frequently asked questions and provide the latest information on local radiation levels.
On the Internet, opportunistic sellers are asking hundreds of dollars for items such as potassium iodide pills, kelp and air purification systems -- all advertised to counteract some of the harmful effects of radiation.
Many physicians are confronting the hysteria, as patients inquire about the dangers of radiation and what they can do to protect themselves and their loved ones.
"It's just absolutely incredible the degree of panic," said California endocrinologist Glenn D. Braunstein, MD, who has received calls from concerned patients, family and friends.
Media reports and 24-hour television coverage showing computer-generated models of radiation plumes coming across the Pacific don't help, said Dr. Braunstein, chair of the Dept. of Medicine at Cedars-Sinai Medical Center in California and director of the Cedars-Sinai Thyroid Cancer Center.
"Patients don't understand that we are exposed all the time to background radiation, and the radiation that we might get from this is well below the known harmful levels," he said.
It's understandable that people are concerned, said Jonathan Fielding, MD, MPH, director of public health and health officer for Los Angeles County.
"The biggest health impact is the psychological impact," he said. "Anytime people hear the word 'radiation,' it invokes a level of concern that in this case is disproportionate to the threat."
Physicians can play an important role in calming people's fears by having the best and latest information and helping to educate patients. "Doctors can be our partners in this," Dr. Fielding said.
Calls flooding in
Radiation fears have permeated the country, but the West Coast seems to be bearing the worst of the panic. Although still more than 5,000 miles away from Japan's eastern coast, many residents of states like California, Oregon and Washington feel vulnerable to radiation from the Fukushima Dai-ichi plant.
The California Dept. of Public Health handled several hundred calls daily to its new radiation information hotline, said Mike Sicilia, the department's assistant deputy director of public affairs.
More than 100 residents called the Oregon Dept. of Human Services Public Health Division in the first week after Japan's earthquake. They asked where they can buy potassium iodide and whether they should take it, said Melvin Kohn, MD, MPH, director of the division and state health officer.
"Callers are asking about potassium iodide, about their safety and about what they can do," he said. "Our primary message is that there is no public health risk to people in Oregon from the current situation in Japan. In addition, we want people to know that we are monitoring the situation carefully."
Trace amounts of radiation were reported in Oregon, and the state launched a new website that lists information and daily averages of radiation amounts in some cities along the Oregon coast.
The Washington State Dept. of Health has received numerous calls from media and concerned residents, said department spokesman Donn Moyer.
The agency has monitored daily radiation levels along the coast for years but is reporting those numbers more frequently throughout the day to reassure residents there is no danger. "While we do not expect to see elevated radiation levels, and certainly not at a health risk threshold, I think it is comforting to people," Moyer said.
Fear of the unknown
The fears are reminiscent of the 2001 anthrax attacks and the 2003 SARS outbreak, Dr. Braunstein said.
Doctors need to be emphatic in telling their patients that there is no danger from the Japanese power plant and they should not take potassium iodide, he said. Although available over the counter, the drug is meant to be taken only in the immediate threat of high levels of radiation exposure and could cause gastrointestinal distress, inflammation of the salivary glands and serious thyroid problems.
"Taking potassium iodide is all risk and no benefit," Dr. Braunstein said.
But unlike most disasters that have a clear beginning and ending, radiation lingers and brings fear of the unknown, said Jeffrey Patterson, DO, a professor of family medicine at the University of Wisconsin School of Medicine and Public Health. "Radiation disasters go on and on, and you can't see or feel or smell radiation. That fear just kind of lingers into the future."
Past missteps in nuclear disasters such as Three Mile Island and Chernobyl also have led many to distrust the nuclear power industry and governments in general, said Dr. Patterson, a board member of Physicians for Social Responsibility, a nonprofit advocacy organization aimed at preventing nuclear war and proliferation.
He advises other physicians to be empathetic when talking with patients about their fears and explain the facts to the best of their ability. After all, no one really knows what is going to happen, or how long or how serious the problems will become at the Japanese power plant, he said.
"It does a real injustice to denigrate that fear," Dr. Patterson said. "I think we need to listen sympathetically to that and not negate that. For me or anybody to predict how much radiation there is and where it is going to go is impossible. All we can do is look at best-case and worst-case scenarios and hope for the best."