Effect of Dietary Intake of Stable Iodine on Dose-per-unit-intake Factors for 99Tc

It is well-known that the human thyroid concentrates iodine more than 100 times the concentration in plasma. Also well-known is the fact that large amounts of stable iodine in the diet can limit thyroid uptake of total iodine; this is the basis for administering potassium iodide following a release of radioiodine from a nuclear reactor accident or nuclear weapon detonation. Many researchers have shown enhanced concentrations of both organic and inorganic iodine in saliva and breast milk. Technetium-99 is a long-lived (231,000 year half-life) radionuclide of concern in the management of high-level radioactive waste. There is no doubt that 99Tc, if it is in groundwater, will be found in the chemical form of pertechnetate, 99TcO4? Pertechnetate is a large anion, almost identical in size to iodide, I? The nuclear medicine literature shows that pertechnetate concentrates in the thyroid, salivary glands, and lactating breast in addition to the stomach, liver, and alimentary tract as currently recognized by the International Commission on Radiological Protection (ICRP). The fact that large intakes of stable iodine (127I) in the diet limit uptake of iodine by the thyroid leads one to generalize that stable iodine in the diet may also limit thyroid uptake of pertechnetate. Whilemore » there is at least one report that iodine in the diet blocks uptake of 99mTcO4? by the thyroid and salivary glands (which have the same Na/I symporter, the biochemical concentration mechanism), the level of protective effect seen for blocking radioactive iodine is not expected for 99TcO4? because pertechnetate does not become organically bound in the thyroid and thus is not retained for months the way iodide is. While it does account for Tc concentration in the thyroid, the existing ICRP biokinetic model for technetium does not take enhanced concentrations in salivary gland and breast tissue into account. From the survey of the nuclear medicine literature, it is not possible to compute the effect of stable iodine in the diet on the dose per unit intake factors for 99Tc without developing an improved biokinetic model for technetium. Specific experiments should be designed to quantitatively evaluate 99TcO4? metabolism, excretion, and secretion, as well as to evaluate its chemical toxicity It is recommended that the ICRP reexamine its biokinetics models for Tc based on nuclear medicine data that have accumulated over the years. In particular, the ICRP ignores the lactation pathway, the enhanced concentration of Tc in breast and breast milk, and enhanced concentration of Tc (and I) in the salivary glands as well as in the thyroid. The ICRP should also explicitly incorporate the effect of stable iodine in the diet into both its models for iodine and technetium. The effect of concentration of Tc in breast milk needs further study for dosimetric implications to nursing infants whose mothers may ingest 99TcO4? from groundwater sources. The ICRP should also investigate the possibility of enhanced concentration of both I and Tc in the non-lactating female breast. To do these re-evaluations of biokinetic models, new experiments designed specifically to evaluate these questions concerning the biokinetics of Tc and I are needed. « less