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Fukushima's cesium spew - deadly catch-22s

28 Comments
By W David Kubiak

For those most focused on Fukushima's human toll, there are several main sources of concern: the continuing radiation menace in the region's fields, crops and seafood; and TEPCO's recent admission that its reactors won't be under control until 2012 at best. These offer critical reminders that radioactive cesium is now Japan's public enemy No. 1.

Behind the confusing fog of rad, rem, becquerel and milliseivert statistics lurks the basic fact that the spread of cesium 137 was the deadliest legacy of Chernobyl and is now the gravest health threat facing eastern Japan. Moving through strong radiation fields like chest X-rays, U.S. airport scanners or Fukushima reactor rubble is obviously hazardous, but time limited. Carrying the radiation source around inside you 24/7, however, poses an exponentially greater threat, especially when it's an aggressive ionizing radionuclide like cesium 137 with a half-life of 30 years.

Despite its meager eight-day half-life, iodine 121 somehow became the rock star of radiation reporting and always gets top billing when things slip out of control. People in affected areas routinely dose themselves with potassium iodide to protect against I-121 exposure, but they hear little and do nothing about the cesium 137 they absorb. Cesium levels are usually reported second, if at all, even though they pose far greater risks for children, farm communities and the public at large.

Spawned profusely in fission reactions, cesium 137 decays slowly, bioaccumulates rapidly, spews intense gamma rays and hitchhikes easily in water, air and food. Imbibed, inhaled or eaten, even a few atoms can stir up mutagenic havoc in the organs where they land. The U.S. National Academy of Sciences apparently had cesium in mind when it announced in 2005 that the only safe radiation level for young people is absolutely none at all.

As Kanto/Tohoku parents are becoming aware, their children are now surrounded by unnaturally high cesium levels in local neighborhoods and schoolyards, which translate into incessant exposure and countless youth at risk.

There is a common proven purge for cesium 137 called Prussian Blue (PB), but Japan blocks access to it with a tangle of catch-22s. Doctors abroad are counseled to use PB as quickly as possible for any "known or suspected radiocesium contamination" and can use a relatively simple urine test to assess cesium levels. In Japan, however, doctors can't prescribe PB without a 10 million yen "whole body radiation counter," but according to NHK, there was only one such machine in all of Fukushima as of June 2 and it can only process ten patients a day.

Finally and most curiously, the only company that Japan licenses to sell PB has no stock for sale in any case and says it probably won't have any until the end of the year.

Technically, the drug is called ferric hexacyanoferrate, which is chemist speak for insoluble drug grade Prussian Blue. It is purified from the ancient dyestuff and has emerged as the most powerful cesium remedy discovered to date.

The U.S. Food and Drug Administration (FDA) and the Center for Disease Control (CDC) endorse PB as the safest fastest way to purge radioactive cesium from the body before it creates malignant cells. Both agencies urge doctors to use it as quickly as possible after exposure, and many people are already taking it to counter Fukushima cesium. Most of them live in California, however. You still can't beg, borrow or steal the drug where it's needed in Japan.

According to the CDC, PB has been used to flush out cesium and thallium since the 1960s, and it became globally recognized after a 1987 mass cesium poisoning in Goiânia, Brazil. Hundreds were hospitalized, but a few grams of PB a day cut victims' internal contamination by over 70% in just a few weeks.

In 2003, the U.S. Department of Health and Human Services issued a press release pleading for "New Drug Application Submissions for Prussian Blue as a Treatment for Radioactive Cesium Contamination" to boost national stockpiles of the drug in case of a "dirty bomb" attack. Their appeal notes the drug is the first and only FDA-approved treatment for internalized radioactive cesium and virtually begs for generic production stating, "Because the FDA has already completed the safety and efficacy review work, applicants need only submit the chemistry information for the Prussian blue product they make."

Despite all this official encouragement only Heyl Chemisch-pharmazeutische Fabrik GmbH & Co, a small family-owned drug firm in Berlin, responded. Heyl's tiny factory now produces all the world's drug grade PB, which it markets under the Radiogardase name. The de facto monopoly allows them to sell the drug for $100 for 30 grams even though the raw material is only $3,000/ton.

In October of last year, Heyl's exclusive Japanese distributor Nihon Medi-Physics received Ministry of Health, Labor and Welfare approval to sell Radiogardase, but it has yet to reach the market anywhere.

Trying to source the drug for friends and family in Japan, I asked CEO Alexander Heyl about this dearth in early May, shortly after he visited Tokyo for "official talks." He said supplies are in fact being made available, but he was not at liberty to divulge how much he is shipping or to whom. He directed me to Kiyoshi Tatsuo, Nihon Medi-Physics' sales manager, but Tatsuo-san swore he had no stock at all for hospitals or the public and that anyone wishing to order it would have to wait at least five or six months.

Since whatever quantities Heyl is shipping seem to be vanishing quietly into government stockpiles, this route was evidently not going to help my friends or answer Japan's urgent needs.

Given PB's decades of medical history, its nonproprietary status and the FDA's urgent efforts to develop new sources of supply, Japan's leading generic firms seemed the next logical possibility. Unfortunately, the research and development executives at Sawai Pharmaceuticals and Towa Yakuhin respectively responded, "Sawai is just not interested in radiation period" and "MHLW has classified Prussian Blue as a 'new drug' so Towa can't create a generic version for at least 8 years."

The MHLW Pharmaceutical and Medical Safety Bureau later clarified to me that they may consider other PB products during that time, but FDA assurances notwithstanding, all prospective makers would have to submit the same voluminous safety and efficacy studies required for any new prescription drug.

In sum, thanks to bureaucratic dysfunction and/or corporate disregard, Japan is compounding a dire and widening public health emergency because it can't or won't release a harmless antidote that's been around for 50 years. For the nation's already affected citizens and the many yet to come, this artificial embargo is both injurious and insane.

It may take a public outcry or an entrepreneurial epiphany, but with so many lives now in harm's way, this criminal neglect of a spreading carcinogen must be addressed immediately.

W David Kubiak is a Project Censored Award-winning journalist and a Kyoto Journal contributing editor currently working on a public service website called Radiation Self-Defense. He can be reached at wdk@cop10.org.

© Truthout

©2019 GPlusMedia Inc.

28 Comments
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When I saw the lack of citations ion this article I was wondering if the author was a physicist or a doctor. Then I scroll down and see "journalist". Pretty lazily written for a professional journalist.

In sum, thanks to bureaucratic dysfunction and/or corporate disregard, Japan is compounding a dire and widening public health emergency because it can’t or won’t release a harmless antidote that’s been around for 50 years.

And not even an attempt to find out from government sources why that is. Sad, and lazy.

-2 ( +2 / -4 )

Farmboy posted the other day that Prussian Blue tablets are able to remove cesium from one's body.

After reading this article all I can say is, PB should be made widely available period.

1 ( +1 / -0 )

As Smorkian, I to would like to have seen some sources in this article.

On the other hand, this is the first time I see any article clearly trying to inform people of the differences between internal and external radiation doses. For this I am grateful.

The comparisons given by government offices to dental x-ray etc etc always make me cringe as they are only speaking of the external doses. While all the stuff you inhale and ingest is not accounted for.

1 ( +2 / -1 )

Iodine is accumulated in the body. Some people way before said that cesium is not accumulated in the body so there is nothing to worry but digestion doesn't take just a couple of minutes. Not to mention that if you keep ingesting cesium, you maintain a radioactive source in your body. Also, it should be noted that the food chain is a cycle. Cesium will come back somehow in your body.

2 ( +2 / -0 )

To those distressed by the "lack of sourcing," would refer them to the original article at truthout.org which contains all the linked sources embedded in the text - http://www.truth-out.org/fukushimas-cesium-spew-eludes-prussian-blues-deadly-catch-22s-japan-disaster-relief/1308930096. Don't know why they don't appear in the JT version here, but would like readers such as Smorkian to know this is not simply an "opinion piece." As noted, I did in fact talk to a government rep at the MHLW (Kusumoto-san of the Food & Drug Dept) who explained that no matter what other countries' health departments said or did all pharmaceuticals coming into Japan would be treated as "new drugs" and have to pass through all the hoops and gauntlets of a totally untested medicine. "Japan just has higher standards." Whether that is true or a relic of the non-tariff trade barriers of yore, I shall leave to your personal judgment. I just suggest you reference the FDA docs cited in the original piece or the British Health Services guidance - http://www.hpa.org.uk/Publications/Radiation/DocumentsOfTheHPA/RCE17UseofPrussianBlue/ - and decide for yourself.

Best wishes, david k-

5 ( +5 / -0 )

Read between the lines here - Prussian Blue is being shipped to Japan but it's not going to the hospitals. Assuming the Government is starting to stockpile the drug, this COULD indicate that their analysis of the situation suggests there will be significant widespread ingestion of cesium, POSSIBLY through the food chain. For months to come? Years?

If so, are they also assuming they won't be able to control ingestion through the banning of tainted products, or are they hedging their bets? This is speculation of course, because it seems we are not being told something important here (what's new?).

I appreciate the article for bringing this to our attention, but it needs to be published in mainstream Japanese publications for it to have significant impact. I hope David K can do this.

2 ( +2 / -0 )

What I find most alarming is that we already have evidence of ingested cesium (the 15 residents tested in Fukushima, as reported a few days ago in JT), yet the government seems not to be responding to the problem and making established remedies available.

1 ( +1 / -0 )

What are they doing with all the Prussian Blue they have been collecting since last year. Cause 5 or 6 months from now is kind of late.

0 ( +0 / -0 )

What are they doing with all the Prussian Blue that's been ordered since October of last year and why is it not available. None of this makes since. Japan's Pharmaceutical Company's should be making it and distributing this medicine Right Now. This is an emergency.

0 ( +0 / -0 )

Why not simply ask a relative in Germany to buy it there and ship it?

0 ( +0 / -0 )

Actually, Ferric hexacyanoferrate (Prussian blue) was used in Japanese paintings long ago. Maybe by calling it by another name, one can find it in Japan, too.

0 ( +0 / -0 )

Sounds like Prussian Blue will be handed out on a select basis by the government.

0 ( +0 / -0 )

hatsoff: "Read between the lines here - Prussian Blue is being shipped to Japan but it's not going to the hospitals. Assuming the Government is starting to stockpile the drug, this COULD indicate that their analysis of the situation suggests there will be significant widespread ingestion of cesium, POSSIBLY through the food chain. For months to come? Years?"

Dude, this is Japan. Largest stockpile of Tamiflu in the world. Largest number of MRIs. They stockpile everything here then sell it back for a fortune.

1 ( +1 / -0 )

@Smith - Agreed. I'm on the same page, just couched my comment in more hesitant language.

0 ( +0 / -0 )

If I were living in Japan now, I would take to the streets 24/7 and demand that the government immediately distribute PB to those in the areas most affected by the radiation, starting with the children and making it available to all of Japan, as production allows. Since the Japanese distributor Nihon Medi-Physics has already received Ministry of Health, Labor and Welfare approval to sell RadiogardaseI in Japan there is obviously no concern over it's safety or effectiveness and the 8 year approval process, should either no longer apply or be waived. For a Japanese pharmaceutical company like Sawai to state that they are "just not interested in radiation", under these extraordinary circumstances, seems cruel beyond words, and I beg them and pharmaceutical companies around the world to join together to manufacture and make PB available help save children's lives. Time is of the essence. The positive psychological effect of making PB available in Japan as soon as possible, would be huge. A smart government would realize you cannot expect a people to accept being possibly poisoned everyday in every way, and withhold a REAL PROVEN CURE, a magic pill that really exists, like Prussian Blue.

2 ( +2 / -0 )

So, let us suppose the whole of Japan was covered in caesium-137 to give everybody a dose similar to the helicopter crews flying over the Chernobyl reactor core. Let us further suppose that there was subsequently a tripling of leukemia rates throughout the whole of Japan. What are we up to? I have postulated a ridiculous worst case scenario over a ridiculously large area causing a rate of leukemia way above anything actually measured. The result would be that leukemia would rise to about 13 cases per 100,000 people per year. This is about half the rate of bowel cancer increase that has afflicted the country as a result of shifting from their traditional diet to one with more red and processed meat. It is about a third of the male rate of bowel cancer.

from "Would sir like a Caesium salad with his steak?" by Geoff Russell

1 ( +1 / -0 )

Agree with the message of the article, but is it really necessary to use phrases like 'mutagenic havoc'?

Decorporation drugs like KI or PB usually don't go to the hospitals or clinics... they are actually stockpiled by governments because 1)Supply is limited and manufacturers/factories are very small, 2)They are not useful in times other than emergencies. Since the manufacturing companies are small they have no capacity to ramp up production during times of need. One would assume that at least part of the reason that the drug may not be being made available to everyone right now is that the supply level is just too low and that the government is keeping stocks for distribution for those who need it the most (to prevent panic buying, etc).

Just a couple of weeks after the disaster began, the American and Japanese governments were apparently in talks with 'Heyltex' in order to discuss this drug.... we can only speculate at this time how much stock is available and hope that there will be enough when the time comes (it may be now for those living in/near Fukushima, etc.).

http://www.heyltex.com/blog/2011/03/30/heyltex-corporation-working-with-united-states-and-japan-to-add-production-of-radiological-antidotes/

The time period that any new drug has to go through for approval is long in any country.... even with documentation and tests in other countries, it is nothing new for a long testing period to be implemented before a drug can be introduced. Also drug patent law is a sticky thing... it is not so easy to legally immediately manufacture generic drugs. If it is necessary in this case, hopefully these processes can be somehow expedited or bypassed.

1 ( +1 / -0 )

Oi, 'reporter' it's iodine-131 you wanna be talking about in your 'article'.

1 ( +1 / -0 )

Unfortunately, the research and development executives at Sawai Pharmaceuticals and Towa Yakuhin respectively responded, “Sawai is just not interested in radiation period” and “MHLW has classified Prussian Blue as a ‘new drug’ so Towa can’t create a generic version for at least 8 years.”

This is past all reasoning, Japan needs Prussian Blue Right at this moment and they are playing the Money game with peoples lives.

0 ( +0 / -0 )

Somehow the government as well as the citizens regard the nuclear incident a "National Disgrace", an "Economic Disaster" which leads to evasiveness, playing down, or covering up. Hope they throw away such stupid philosophy and concentrate in safeguarding people's well-being (straightforwardly tell people what is safe and what is not !!).

0 ( +0 / -0 )

It isn't a closely guarded secret about the dangers of Caesium 137 , it's well-known.

Is it seriously only just coming into the public domain over there?

Oh dear oh dear. What kind of people are running the nuclear industry in Japan?

0 ( +0 / -0 )

Bazza,

It isn't a closely guarded secret about the dangers of Caesium 137 , it's well-known. Is it seriously only just coming into the public domain over there? Oh dear oh dear. What kind of people are running the nuclear industry in Japan?

Short answer:Idiots and imbeciles ;-)

1 ( +1 / -0 )

I have Prussian blue in my oil and acrylic paint sets. Maybe I should make some sand with it.

0 ( +1 / -1 )

@Bazza

People have been aware of the risks from the beginning.. from Cesium as well as Iodine...this is just one article that has come out right now...

0 ( +0 / -0 )

Smorkian -- seems like you made another knee-jerk, off-target attack on something because it presented a critical/objective view, and some critically needed information on the radiation problem -- which, of course, differs from your rose-colored-glasses view of the situation. Something that the J-government is certainly not doing. Nor this country's "journalists". The author is absolutely on-target when he states that the world-famous bureaucratic maze of Japan, especially as it pertains to drugs, has come back to hurt the citizens, in its ridiculous attempt to protect Japanese firms from international competition.

0 ( +1 / -1 )

Smorkian -- seems like you made another knee-jerk, off-target attack on something because it presented a critical/objective view, and some critically needed information on the radiation problem -- which, of course, differs from your rose-colored-glasses view of the situation.

herefornow, it sounds like the article wasn't posted correctly, and my criticism of the article as posted is correct.

Save your baseless ad hominem attacks for someone else, bub.

1 ( +1 / -0 )

It's an interesting article. But the source (Truthout.org) can't be trusted for much.

0 ( +0 / -0 )

Agree with some of teh thoughts posted by readers here. The one line that gets me irritated is "unnaturally high cesium levels in local neighborhoods and schoolyards, which translate into incessant exposure and countless youth at risk". It highlights a lack of detail that could really help people as opposed to be just yet another radiation scare story to capture statistics.

OK, so tell me the natural level of Caesium, and how high it is now in these neighbourhoods. then tell me how much that increase relates to a potential risk of contracting terminal (or any other) cancer.

The author hasn't done that, and to balance the equation, neither has the government.

0 ( +0 / -0 )

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