Effects of time of administration and dietary iodine levels on potassium iodide (KI) blockade of thyroid irradiation by 131I from radioactive fallout

Radioiodines, particularly (131), may be released into the environment in breach-of-containment nuclear reactor accidents and localize in and irradiate the thyroid with an attendant risk of neoplastic growth and other adverse health effects. Pharmacologic thyroid blockade by oral potassium iodide (KI) (50-100 mg in adults) can substantially reduce thyroid uptake of and irradiation by internalized radioiodine, In the current analysis, computer modeling of iodine metabolism has been used to systematically elucidate the effects of two practically important but highly variable factors on the radioprotective effect of KI: the time of administration relative to exposure to radioiodine and the dietary level of iodine. In euthyroid adults receiving iodine-sufficient diets (250 mu g d(-1) in the current analysis), KI administered up to 48 h before I-131 exposure can almost completely block thyroid uptake and therefore greatly reduce the thyroid absorbed dose. However, KI administration 96 h or more before I-131 exposure has no significant protective effect. In contrast, KI administration after exposure to radioiodine induces a smaller and rapidly decreasing blockade effect. KI administration 16 h or later after I-131 exposure,Fill have little effect on thyroid uptake and absorbed dose and therefore little or no protective effect. The I-131 thyroid absorbed dose is two-fold greater with insufficient levels of dietary iodine, 2,900 cGy/37 hlBq, than with sufficient levels of dietary iodine, 1500 cG2/37 hlBq. When KI is administered 38 h or less before I-131 intake, the thyroid absorbed doses (in cGy/37 MBq) are comparably. low with both sufficient and insufficient dietary iodine levels. When KI is administered after I-131 intake, however, the protective effect of I(I is less and decreases more rapidly with insufficient than with sufficient dietary iodine. For example, KI administration 2 and 8 h after I-131 intake yields protective effects of 80 and 40%, respectively, with iodine-sufficient diets, but only 65 and 15% with iodine-deficient diets. In conclusion, whether exposed populations receive sufficient or insufficient dietary iodine, oral I(I is an effective means of reducing thyroid irradiation from enviromnentally dispersed radioiodine but is effective only when administered within 2 d before to -8 h after radioiodine intake.