Ontario's Ministry of Health is warning the province's hospitals to brace for further shortages of medical isotopes, following the month-long maintenance shutdown of a Dutch nuclear reactor scheduled for this weekend. Nuclear medicine specialists fear that Canada's most populous province will feel the brunt of the shortage, leaving them without enough isotopes to treat emergency-room patients.
The worldwide supply of medical isotopes is already shaky because of the shutdown of the reactor at Chalk River, Ont., that until a few weeks ago produced a third of the world's medical isotopes. The planned shutdown of the Netherlands reactor will place greater strain on the global supply.
A health notice posted on the ministry's website Monday says it expects the supply of medical isotopes may be reduced in the province from July 28 to Aug. 21 because of the prescheduled maintenance on the Dutch reactor.
Premier Dalton McGuinty asked Prime Minister Stephen Harper in a letter last month to urge the Netherlands to delay the shutdown. Mr. McGuinty says the supply of medical isotopes has been jeopardized because of the problems at the aging Chalk River reactor, which was taken offline in May after it was found to be leaking heavy water and won't be back in operation until at least late 2009.
"My colleagues and I are deeply concerned that the situation may worsen soon," he says in the letter, asking Mr. Harper how he plans to address the problem.
Mr. Harper does not directly respond to Mr. McGuinty's request regarding the Dutch reactor. He says in a letter to the Premier that a secure supply of medical isotopes is an international matter that must be addressed by all producing countries. The isotopes are supplied by five reactors around the world.
"The health and safety of Canadians is a primary concern for the Government of Canada," Mr. Harper wrote, adding that his government is taking action to address the isotope shortage.
Until recently, hospitals were coping fairly well with the shortage by following contingency plans drafted by the federal and provincial governments on using isotopes most effectively to maximize available supplies, Christopher O'Brien, president of the Ontario Association of Nuclear Medicine, said in an interview Monday. But with the prolonged shutdown of Chalk River, he said the ability to do emergency tests in the evening is becoming compromised.
"That is the thing that is exceedingly frightening," he said.
The Dutch reactor also produces a third of the worldwide supply of molybdenum-99 isotopes, considered the best tool for many heart and cancer tests, leaving companies scrambling for alternate sources.
The shortage is expected to hit Ontario hardest because of geography and the sheer volume of patients. The province does 9,000 bone scans a month. With many hospitals located in remote rural communities, it is difficult to set up a central distribution centre for medical isotopes as British Columbia has, Dr. O'Brien said.
The federal government has established an expert panel to explore ways of securing a long-term supply. The four-man panel, headed by Peter Goodhand, president of the Canadian Cancer Society, meets for the first time on Thursday.
Karen Howlett