PROBLEMATIC ASPECTS, COMPLICATIONS, MISCONCEPTIONS AND DEBATABLE ISSUES OF IODINE PROPHYLAXIS IN RADIATION EVENTS (REVIEW)
Authors:   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Afanasiev D. E. , Kaminskyi O. V. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Loganovska T. K. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Kopylova O. V. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Chikalova I. G. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Muraviova I. M. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Dombrovska N. S. ,   State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine»
Published: December 2022

Prerequisite. Since the advent of nuclear energy, industry and weapons, a possibility of radiation events i.e. incidents and accidents had emerged. Given the presence of radioactive iodine as part of environmental contamination, the response of authorities and medical services consists, in particular, in carrying out the emergency iodine prophylaxis among specialists and general population. And along with the fact that emergency iodine prophylaxis is a generally accepted measure in radiation events accompanied by the release of radioactive iodine, some methods of its implementation were and remain in certain sources and instructions/recommendations contradictory and even false. Such inconsistency increases the potential risks of health effects of radioactive iodine and exacerbates the sense of fear and uncertainty among the population involved in the incident. Objective: to consider and review the essence of emergency iodine prophylaxis during radiation events, physiological aspects of iodine metabolism in the body, properties of individual iodine prophylaxis agents that are recommended, and to justify the rationality of using some of them along with absurdity/inadmissibility of others; substantiate the creation of a unified preventive information strategy regarding the event in order to reduce anxiety and other negative psychological consequences among the affected population. Materials and methods. The review was performed by searching the abstract and scientometric databases and printed publications. Results. In the event of serious radiation events at nuclear power plants and industry facilities, radioactive iodine is highly likely to enter the environment. With the threat of radioactive iodine incorporation or with its incorporation that has already begun, it is absolutely necessary to carry out the emergency iodine prophylaxis. Such prevention should be carried out with stable iodine preparations such as potassium iodide or potassium iodate in special pharmaceutical formulas. Dosing of drugs in age and population groups should be carried out by specialists in radiation medicine and radiation safety in accordance with internationally recognized guidelines. The use of iodinecontaining food additives, iodine solution for external use and Lugol’s solution is categorically unacceptable due to complete ineffectiveness, impracticality of implementation, and sometimes due to the threat of serious harm to health. Conclusions. Clear preparedness plans for possible radiation accidents and incidents, as well as successfully implemented appropriate preventive measures, including emergency iodine prophylaxis, are crucial for the effective and successful response to such events. Emergency iodine prophylaxis during radiation events should be carried out exclusively under the guidance of specialists in radiation medicine and radiation safety using special pharmaceutical formulas of potassium iodide or potassium iodate in doses recognized by the international scientific community. Other means of emergency iodine prophylaxis, including «handicraft»/home preparations, are absolutely unacceptable. Implementation of this protective measure should be accompanied by a coordinated information campaign in order to minimize purely radiation risks and to preserve the psychological well-being of the population. Key words: radiation events, radiation accident, radiation incident, nuclear industry, nuclear power, radioactive iodine, exposure, emergency iodine prophylaxis, stable iodine, potassium iodide, potassium iodate, psychological well-being of population.