consent for schools to administer KI to children, in the event of an emergency, and if advised to do so by the appropriate public health authority, would appear advisable.

Resources and Opportunity Costs

Plans should determine the resources needed for KI distribution and consider the opportunity costs of forgoing other emergency or health activities when resources are devoted to KI distribution. The benefit of KI administration should be weighed against the costs.

Evaluation and Tracking System

Plans should include setting up an evaluation and tracking system to evaluate the effectiveness of predistribution programs before and after an incident. For example, the percentage of people who know where their predistributed tablets were could be tracked after 1 year, 3 years, and 5 years. The mobility of the population in the vicinity of a plant could be examined to determine how often new tablets should be predistributed.

National Registry

A national registry should be developed to be activated in the event of an incident for tracking radioactive iodine exposures (including airborne release concentrations, contamination levels in food and drink and measured thyroid radioiodine levels in individuals) and the extent of use of KI as a preventive measure (including date and time taken and dosage vs. time of release or exposure to radioiodine) and for evaluating long-term health outcomes. This would allow accumulation of greater knowledge that would be helpful in later planning.

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