It has been the editorial policy of Pennsylvania Medicine to comment not only on recent developments in medicine, but also on the broader political, social, and economic events as they relate to health.

 

Obviously, the Three Mile Island nuclear accident is within this scope.

 

The incident has received international, national, state, and local media attention during the past month, and has been thoroughly examined from many aspects. Questions relative to health and radiation and nuclear power have been explored. Technical questions about reactors, their safety and design, have been asked. Civil defense activities, including evacuation planning on a scale never before attempted, were initiated.

 

The Three Mile Island accident has taught us this: we do not know the answers to many of the questions that were asked, and we were unprepared for a disaster such as might have occurred. It has forced us to look closely at our energy sources, especially nuclear power, and to weight the risks and benefits. It has revealed a need for research on the effects of low dose radiation.

 

Currently, we know very little about the cancer-causing potential of small doses of radiation over a long period of time. It has revealed a need for the development of rational evacuation plans in areas around nuclear reactors. While a five-mile evacuation plan did exist, one million people in six counties were more than authorities were prepared to manage.

 

Three Mile Island has revealed a need for stringent safety standards, better reactor operation training, and strict enforcement of these requirements. While no totally fail-safe operation can be guaranteed, more effort should be put into refinement of the safety standards.

 

What Three Mile Island has shown us is that at least two government representatives and their agencies are to be commended. Harold Denton, director of the Nuclear Regulatory Commission's Office of Reactor Regulation, and his team supplied the expertise to bring Unit 2 under control.

 

Denton's cooperation with Gov. Dick Thornburgh in supplying much needed reliable, factual information, enabled the governor, in consultation with Secretary of Health Gordon K. MacLeod, MD, to render careful decisions in the best interest of the people in the immediate area.

 

These men, working together, brought about the restoration of confidence in a near panic situation. For that they have earned national, if not international, respect. They have assuredly earned the "thanks" of Central Pennsylvanians. The bureaucracy that so often is criticized polished its reputation in the person of Harold Denton.

 

What Three Mile Island has drawn attention to is the problem of radioactive waste product disposal. South Carolina refused to accept a shipment of waste from the TMI reactor. This worry is the real nuclear nightmare now and may be in the future.

 

Radioactive byproducts of nuclear reactors (also defense activities and mining) can not be thrown away like other garbage, because they are extremely toxic and remain so for hundreds of years. The BEIR Report of "The Effects on Populations of Exposure to Low Levels of Ionizing Radiation" observes:

 

"In general terms, man's welfare depends upon the long-range quality of his total environment. Substances removed or added in large enough amounts can lead to imbalance or disorder of a life support system that is the result of evolutionary development over the ages. Within recent years, many thousands of waste products from man's agricultural, industrial and domestic activities have been poured into the natural environment. There they may be stored, moved, accumulated, or dispersed, finally reaching equilibrium positions with the effects apparent either at the time of contamination or much delayed, depending on ecological behavior.'

 

Radioactive contaminants reach man by way of the food chain, thus the concern registered over the appearance of Iodine 131 in air samples and milk close to the plant.

 

What Three Mile Island has generated is renewed attacks on the already plagued nuclear industry. The emotionalism of extremists should not be allowed to decide the crucial energy issues. "Nukes are lemons" and "not a single death has occurred" are not reasonable arguments.

 

The choice to have or not to have nuclear power must be based upon the desire to continue our present lifestyle, the commitment to conserve energy voluntarily, and the development of other energy sources. In this decision, the people of Central Pennsylvania, as well as others who reside near operating or planned reactor sites, are entitled to a little healthy skepticism.

 

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