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Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Radiation Exposure from Iodine 131

Course: SS3117
Original Date: November 25, 2002
CE Expiration Date: November 31, 2008

Key Concepts

During 1945 through 1962, many people in the United States were exposed to radiation fallout from iodine 131 (I-131) from multiple sources. Many of those exposed were children younger than 10 years of age, the population most vulnerable to radiation exposure. This exposure put those children at risk for thyroid and parathyroid disease and cancer of the thyroid.
The health care community should be able to medically evaluate the health effects resulting from past exposure to releases of I-131.
The health care community should be prepared to handle their patients' health effects from acute unintentional or intentional releases of I-131.


Guest Technical Editor

Peter Wald, MD, MPH

Guest Contributors

Anca Gurzau, MD, PhD; Eugen Gurzau, MD, PhD; Alan Hall, MD; Sam Keith, MS, CHP; Michael Kosnett, MD, MPH; Polyxeni D. Koutkia, MD; Steven Marcus, MD; Stela Ramboiu, MD; L.B. Sandy Rock, MD; Jim Ruttenber, PhD, MD; Jack Snyder, MD, PhD, JD; Robert Spengler, PhD; Daniel Sudakin, MD, MPH; Oscar Tarragó, MD, MPH; Pamela Tucker, MD; Richard Wang, DO; Janet Weiss, MD; Luke Yip, MD

Peer Reviewers

Jacqueline Agnew, PhD, MPH; David V. Becker, MD; Kathleen McPhaul, RN, MPH; Noel R. Rose, MD, PhD; Robert Sawyer, MD; Michael Tuttle, MD


Diane M. Drew, RN; Lauren Swirsky, CHES; Oscar Tarragó, MD, MPH

ATSDR/DHEP Case Studies Team

Diane Dennis-Flagler, MPH; Sharon Hall, RN, BSN (CDC/PHPPO); Kim Gehle, MD, MPH; Oscar Tarragó, MD, MPH

Each content expert for this case study indicated no conflict of interest to disclose with the case study subject matter.

ATSDR Publication No.: ATSDR-HE-CS-2004-0001


This monograph is one in a series of self-instructional publications designed to increase the primary care provider's knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. See the Accreditation section for more information about continuing medical education credits, continuing nursing education units, and continuing education units.

We would like to extend a special thank you to the members of the Hanford community and others who provided input and comments on this document. Their comments have contributed greatly to this case study.

This case study was prepared with the assistance of those who share a common concern for health professional education, public health, and the environment, including the American College of Medical Toxicology (ACMT) and the American College of Preventive Medicine (ACPM). Final responsibility for the contents and views expressed in this case study resides with ATSDR.


The state of knowledge regarding the treatment of patients potentially exposed to hazardous substances in the environment is constantly evolving and is often uncertain. In this monograph, ATSDR has made diligent effort to ensure the accuracy and currency of the information presented, but makes no claim that the document comprehensively addresses all possible situations related to this substance. This monograph is intended as an additional resource for physicians and other health professionals in assessing the condition and managing the treatment of patients potentially exposed to hazardous substances. It is not, however, a substitute for the professional judgment of a health care provider. The document must be interpreted in light of specific information regarding the patient and in conjunction with other sources of authority.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.

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Revised 2002-11-05.