Western Canada is likely to bear the brunt of a looming medical-isotope shortage, experts warn.
When a leak first shut down Canada's isotope-producing reactor last year, the resulting shortage of radioactive material was most acutely felt in Eastern Canada.
This time, however, Christopher O'Brien, president of the Ontario Association of Nuclear Medicine, said it is Western Canada that will likely shoulder the worst.
That's because Lantheus, the U.S.-based distributor that supplies much of the East, is now better positioned than Covidien, the distributor responsible for most of the West.
"As we know with the last shortage, the West was mostly spared and the East got battered," Dr. O'Brien said.
"This time around, we think the West is going to be really battered and the East will fare a little better."
Doctors have been grappling with a decline in isotope production since last May, when Canada's NRU nuclear reactor in Chalk River, Ont., was shuttered for repairs.
But supply is deteriorating further because the aging Petten reactor in the Netherlands - which has helped fill the void while Chalk River sits idle - will be turned off on Feb. 19 to repair leaks. It is expected to remain closed until summer.
This means supplies will shrink until the Chalk River facility can be restarted. Chalk River and Petten together normally produce about 70 per cent of the world's supply of an isotope called technetium 99, used in 85 per cent of diagnostic imaging procedures.
Canadian medical officials warn a lack of supply could hamper diagnoses of life-threatening illnesses such as cancer and heart disease. (Isotopes can't be stockpiled because they decay rapidly.)
Doctors don't yet know how they are going to work around isotope shortages. "Between the beginning of March until the NRU is restarted, we will go through very tough times," said Jean-Luc Urbain, president of the Canadian Association of Nuclear Medicine.
Canada had hoped to restart the Chalk River reactor in time to cope with the long-expected Petten shutdown.
But Atomic Energy Canada Ltd. chief executive Hugh MacDiarmid said technical problems have delayed the project. He now projects an April restart date. "We're driving very, very hard to do that," he said.
A federal Department of Natural Resources spokeswoman said Canada has created a system of early notification for the health-care system and, as a result, doctors have been warned by the suppliers to expect disruptions in March.
"The isotope industry and international community have been mobilized to co-ordinate reactor schedules and to maximize supplies where and when possible, and to explore new possible sources in 2010," Patti Robson said in an e-mail.
"For instance, Belgium has added a cycle to its reactor schedule, South Africa will continue to operate at elevated levels, and France has agreed to delay a scheduled outage."
But Belgium, South Africa and France can't make up all the shortfall. They are smaller-scale operations that have traditionally supplied 30 per cent of global consumption.
Nuclear-medicine doctors fear that the health of their patients will be jeopardized.
Opposition critics say the Harper government must bear some of the blame for not developing a plan to deal with potential shortages after the NRU was shut down for several weeks in late 2007 to make safety adjustments demanded by the Canadian Nuclear Safety Commission.
"The stars are lining up for a perfect storm here - a busy time of year, major production down, isotopes not as available," NDP natural resources critic Nathan Cullen said.
Even if isotopes are available from the world's smaller reactors, the law of supply and demand will make them very expensive, said Mr. Cullen.
The opposition Liberals plan to hold informal hearings on Parliament Hill today about the isotope situation.
Experts have suggested Poland or China may eventually serve as alternative suppliers of medical isotopes.
"We are aware of no realistic near-term prospects for imports from new sources such as China or Poland," a Health Canada spokesman said in an e-mail.
With a report from Shawn McCarthy