The May 2012 paper "Radioactive fallout in the United States due to the Fukushima nuclear plant accident" (P. Thakur, S. Ballard and R. Nelson, J. Environ. Monit., 2012, 14, 1317-1324), does not address medical patient excreta as a source of (131)I (t1/2 = 8.04 d) to the environment. While (131)I is generated during fission reactions and may be released to the environment from nuclear power plants, nuclear weapons tests, nuclear fuel reprocessing and weapons production facilities, it is also produced for medical use. Iodine-131 administered to patients, excreted and discharged to sewer systems is readily measureable in sewage and the environment; the patient-to-sewage pathway is the only source of (131)I in many locations.