Open Access Open Access  Restricted Access Subscription or Fee Access

Baseline assessment of a potassium iodide distribution for nuclear power plant emergencies in the Canadian-United States border region

Donna L. Desantis, CET, CBCO, Kendall A. Leser, PhD, James D. Blando, PhD


Objective: This study sought to evaluate resident demographics and resident understanding of the proper use of potassium iodide (KI) pills as a countermeasure in the event of a nuclear power plant emergency. We also described expected behaviors of community members in the event of a nuclear accident.

Design: The study design utilized a cross-sectional survey with a validated written questionnaire.

Subjects, Participants: The study subjects were Canadian residents living within the primary emergency planning zone of the Fermi 2 nuclear power reactor. There was a 77 percent participation rate (n = 180) in Amherst Point and 61 percent for Bois Blanc Island (commonly referred to as Bob-Lo Island) (n = 57).

Main Outcome Measure(s): The primary study outcome measures were the number of knowledge-based questions survey respondents correctly answered about proper KI use (Ksum) and various behavior-based survey questions in the context of the extended parallel process model (EPPM).

Results: Overall, we found that residents in general had a very low overall comprehension of proper KI use. We found that most resident demographics (eg, age, gender) did not significantly impact their knowledge of proper KI use but did find that households with children under 13 years of age tended to have higher comprehension scores than households without young children. Most residents reported that if they thought they were exposed to radiation they would go to the hospital or call 911 and few residents knew their evacuation routes, few were aware of the emergency siren, none knew where the reception center was located, and most did not have an emergency kit in their home. The majority of the survey respondents did indicate that they would evacuate if told to do so by their government.

Conclusions: Public health outreach is crucial for KI distribution programs because of the overall low pre-existing comprehension in communities. Also, hospitals and 911 must be prepared to deal with higher volume of residents seeking help should an accident occur.



potassium iodide, KI, nuclear, outreach, education, countermeasure

Full Text:



Braverman E, Blum K, Loeffke B, et al.: Managing terrorism or accidental nuclear errors, preparing for iodine-131 emergencies: A comprehensive review. Int J Environ Res Public Health. 2014; 11(4): 4158–4200. doi: 10.3390/ijerph110404158.

Schneider AB, Smith JM: Potassium iodide prophylaxis: What have we learned and questions raised by the accident at the Fukushima Daiichi Nuclear Power Plant. Thyroid. 2012; 22(4): 344-346.

Takamura N, Hamada A, Yamaguchi N, et al.: Urinary iodine kinetics after oral loading of potassium iodine. Endocrine J. 2003; 50(5): 589-593.

Becker DV: Physiological basis for the use of potassium iodide as a thyroid blocking agent, logistic issues in its distribution. Bull New York Acad Med. 1983; 59(10): 1003.

Canadian Nuclear Laboratories: CRL KI Pill Distribution—Communication Plan. Chalk River, Ontario, Canada: Canadian Nuclear Laboratories; 2015.

Feng T, Keller R: A multi-objective decision analysis for terrorism protection: Potassium iodide distribution in nuclear incidents. Decis Anal. 2006; 3(2): 76-93.

Franic Z: Iodine prophylaxis and nuclear accidents. Arh Hig Rada Toksikol. 1999; 50(2): 223-233.

Ministry of Health and Long-Term Care EMB: Potassium Iodide (KI) Guidelines. Toronto, Ontario: Ministry of Health and Long-Term Care EMB; 2014.

Fowinkle EW, Sell SH, Wolle RH: Predistribution of potassium iodide—The Tennessee experience. Public Health Rep. 1983; 98(2): 123.

Canadian Nuclear Safety Commission: Emergency management and fire protection: Nuclear Emergency Preparedness and Response. 2016. Available at Accessed October 1, 2019.

Dodgen D, Norwood A, Becker S, et al.: Social, psychological, and behavioral responses to a nuclear detonation in a us city: implications for health care planning and delivery. Disaster Med Public Health Preparedness. 2011; 5(S1): 64.

Blando J, Robertson C, Pearl K, et al.: Evaluation of KI prophylaxis knowledge and nuclear emergency preparedness—New Jersey, 2005. Am J Public Health. 2007; 97(Suppl 1): S100-S102.

Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2): 143-164.

Zwolinski L, Stanbury M, Manente S: Nuclear power plant emergency preparedness: Results from an evaluation of Michigan’s potassium iodide distribution program. Disaster Med Public Health Preparedness. 2012; 6(3): 263-269.

Blando J, Robertson C, Pearl K, et al.: Assessment of potassium iodide (KI) distribution program among communities within the emergency planning zones (EPZ) of two nuclear power plants. Health Phys. 2007; 92(2)(Suppl 1): S18-S26.

Blando J, Robertson C, Bresnitz E: Communicating information in an emergency preparedness pill distribution campaign. Biosecur Bioterror. 2008; 6(1): 57-65.

Witte K: Putting the fear back into fear appeals: The extended parallel process model. Commun Monographs. 1992; 59(4): 329-349.

Public Safety Canada: An Emergency Management Framework for Canada. 2nd ed. Ottawa, Canada: Public Safety Canada; 2011.



  • There are currently no refbacks.

Copyright (c) 2020 Journal of Emergency Management