Dietary advice

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                                            Dietary advice
Objective                                        Dose reduction by giving people dietary advice to
                                                 reduce their radionuclide intake.
Other Benefits                                   Help people maintain their way of life.
                                                 Enables informed choice.
Countermeasure description                       Provision of advice to people on ways to restrict their
                                                 dietary radionuclide intake. For example, advice to
                                                 reduce consumption of specific foodstuffs (e.g. game,
                                                 mushrooms etc.), to not drink water from private
                                                 cisterns, or to prepare food in ways that reduce
                                                 contamination levels (e.g. washing and peeling
                                                 vegetables and fruit, brining fish, cooking meat etc.).
                                                 Advice may vary from suggestions as to which
                                                 foodstuffs can be eaten without restrictions, which
                                                 would be okay to eat occasionally, and which should
                                                 be avoided completely. The advice can be
                                                 communicated in the media (e.g. newspapers,
                                                 internet) and as specially produced leaflets.
Target                                           Anyone who wants to reduce their dose, or who may
                                                 have a high dose due to dietary preferences
Targeted radionuclides                           Caesium, strontium, but may be effective for other
                                                 radionuclides
Scale of application                             Generally applicable to all population groups although
                                                 may be most appropriate to critical groups (e.g.
                                                 people with a high rate of wild food consumption).
Contamination pathway                            Plant-animal-people; plant-people, animal people
Exposure pathway                                 Ingestion
Time of application                              Any time after deposition, or for as long as selected
                                                 foodstuffs have enhanced activity concentrations
Constraints
  Legal constraints                              Possible liability from unforeseen health
                                                 consequences or economic side-effects for specialist
                                                 food producers.
   Social constraints                           Countermeasure may be met with strong resistance
                                                 from local populations for whom collection of wild
                                                 (forest) food has a cultural and economic significance.
                                                 For socially isolated/independent rural Populations
                                                 e.g. the Saami, a key issue may be trust (or lack of)
                                                 in the institutions/experts advising dietary
                                                 restrictions.
   Environmental constraints                    N/A
   Communication constraints                    Availability of communication lines, language and
                                                 literacy of certain groups.
                                                 Dialogue and dissemination of information is required
                                                 with affected communities.
Effectiveness:
   Countermeasure effectiveness                 Reductions of up to 85% have been reported for food
                                                 preparation methods. Common methods are boiling,
                                                 pickling and brining
   Factors influencing effectiveness of         Effectiveness depends on foodstuffs, radionuclide
    procedure (Technical)                        concentrations and methods of preparation (see
                                                 above).
   Factors influencing effectiveness of         Willingness of affected population to accept this type
    procedure (social)                           of intervention and their willingness to follow the
                                                 advice.
                                                 The extent to which advice is used.
                                                 Individual willingness to submit to restrictions.
                                                 Effectiveness of preparation procedures will often
                                                 only be effective if cooking fluids/bones etc. are
                                                 discarded.
Feasibility:
  Required specific equipment                   Normal cooking implements
  Required ancillary equipment                  None (unless this countermeasure is to be
                                                 supplemented by provision of counting equipment)
   Required utilities and infrastructure        Communication lines (internet, fax machines,
                                                 telephones etc.).
   Required consumables                         Dependent on communication method
   Required skills                              Communication skills
  Required safety precautions         N/A
  Other limitations                   N/A
Waste:
  Amount and type                     None, except household waste.
  Possible transport, treatment and   N/A
   storage routes.
  Factors influencing waste issues    N/A
Doses:
  Averted dose                        Individual averted doses
  Factors influencing averted dose    Willingness to follow advice, contamination level in
                                       foodstuffs, time after deposition
   Additional dose                    N/A
Intervention costs:
   Equipment                          N/A
   Consumables                        Price for printing leaflets to be collated for different
                                       countries
   Operator time                      The time used for giving advice will depend on the
                                       communication method (personal contact, internet,
                                       telephone, fax etc.)
   Factors influencing costs
   Communication costs                Dialogue and dissemination of information about the
                                       countermeasure (its rationale and possible
                                       alternatives) within affected communities.
   Compensation costs                 Compensation can be considered in special cases,
                                       such as populations for whom “free-food” as a
                                       cultural or economic significance. For example, in
                                       Norway, reindeer herders are given compensation for
                                       having an alternative diet amounting to 250 EUR/y
                                       per family member if the contamination in their
                                       reindeers was above 600 Bq/kg the previous year
                                       (the CFIL for general foodstuffs). If the contamination
                                       was over 3000 Bq/kg (CFIL for reindeer meat for
                                       sale) the previous year, each person receives an
                                       extra compensation of 125 EUR/y. The compensation
                                       can be used for buying less contaminated reindeer
                                       meat from other areas, buying other kinds of meat or
                                       clean feeding reindeers consumed by the family to
                                       obtain <600 Bq/kg.
   Waste cost                         N/A
   Assumptions
Cost effectiveness:
Side-effect evaluation:
        Ethical considerations        Self help
                                       Improves personal control and ability to make
                                       informed choices
                                       Communicates authorities‟ trust in the public
                                       Possible liability issues in the case of unforeseen
                                       health effects
                                       Possible negative effects on food producers if the
                                       public avoids specialist foodstuffs from contaminated
                                       areas.
                                       Possible negative effects on the poor if the
                                       countermeasure results in cheap “contaminated
                                       foodstuffs”.
       Environmental impact           Possible ecological effect from increase in game
                                       population if hunting/fishing declines, or cessation of
                                       large-scale fungi/berry collection. Could be positive
                                       (e.g. conservation of habitats and increased nutrient
                                       availability resulting from increased decomposition)
                                       or negative (e.g., change in ecological equilibrium,
                                       lack of foodstuffs for due to increased competition).
       Agricultural impact             Knock-on lack of production from social side-effects
                                       on food production in one area may result in
                                       increased production on other areas.
                                       Possible increased utilisation of agricultural
                                       grasslands or crops by „uncontrolled‟ game species
       Social impact                      Changed relationship to land/forests and potential
                                           change of behaviour resulting from changes in
                                           people‟s perceptions of land as a „natural‟ resource, to
                                           being „unnatural‟ or in some way its resources
                                           damaged/polluted.
                                           Loss of traditional activities e.g. gathering free food
                                           Negative social and psychological impact – loss of
                                           sense of control over the situation as all local/home-
                                           produced foods are „bad‟. Should perhaps be
                                           combined with advice on how to manage diets (also
                                           depends on trust in experts/responsible authorities).
       Other side effects, pos. or neg.   Replacement foods may be required
Stakeholder opinion
Practical experience                       Used in western Europe (especially Scandinavia) and
                                           the FSU after the Chernobyl accident. Proven to be a
                                           cheap and effective countermeasure, if people are
                                           willing to follow the advice.
Key references                             Brynildsen, L.I. et al., 1996. Countermeasures for
                                           radiocaesium in animal products in Norway after the
                                           Chernobyl accident – techniques, effectiveness and
                                           costs. Health Physics 70: 665-672.
                                           Strand, P. et al. Chernobyl fallout: internal doses to
                                           the Norwegian population and the effect of dietary
                                           advice. Health Physics 63(4), 385-392, 1992.
                                           Petäjä, E. et al. Reduction of radioactive caesium in
                                           meat and fish by soaking. Journal of Env.
                                           Radioactivity 16:273-285, 1992.
                                           IAEA Technical Report Series No. 364: Handbook of
                                           parameter values for the prediction of radionuclide
                                           transfer in temperate environments, 1994.
                                           Long et al., 1995
                                           Tønnessen, A. et al. 1996. Personal use of
                                           countermeasures seen in a coping perspective.
                                           Radiation Protection Dosimetry, 68: 261-266.
Comments                                   Self-help countermeasure.
                                           Can be combined with provision of counting
                                           equipment.
                                           Examples of edible fungi species grouped on basis of
                                           radiocaesium accumulating ability:
                                                Suillus, Tricholoma, Xerocomus, Rozites (high
                                                 accumulators)
                                                Cantharellus, Lactarius (medium accumulators)
                                                Leccinum, Boletus (low accumulators)