Соціально-екологічна та медична проблеми нестачі йоду серед населення України

Abstract

Aim. Study of iodine supply in different segments of the population throughout Ukraine, establishment of the morbidity level caused by iodine deficiency, analysis of preventive measures and their effectiveness and development of adequate ways of mass, group and individual prophylaxis of iodine deficiency in the body, which will reduce morbidity in areas of endemic iodine deficiency. The article considers the most important results of long-term epidemiological studies of iodine supply in different categories of the population of almost all regions of Ukraine. Significant volume of work was performed with the support of the Ministry of Healthcare of Ukraine, UNICEF Ukrainian office, and the CDC in Atlanta (USA), which for more than 19 years has provided external quality control of the study of iodine status of the population of Ukraine. The data on iodine content in food and biological fluids of the population affected by the Chernobyl accident are given and the dependence of the irradiation dose of the thyroid on the body supply with stable iodine and on the optimization of the latter after the adoption of the State Programme for Iodine Deficiency Prevention for 2002–2005 is shown. The effectiveness of mass iodine prophylaxis by using universally iodized table salt is emphasized. The article presents data on suggested and implemented ways of mass, group and individual iodine prophylaxis, studies of their effectiveness and shows the positive dynamics of changes in providing the population with dietary iodine. The need for constant consumption of food products with sufficient iodine content, including iodized salt, is proven. Significant changes in the prevalence and incidence of thyroid pathology, socio-ecological and medical benefits of prevention of iodine-dependent disorders are described. The article was prepared as a scientific information material for family doctors, endocrinologists, obstetricians and gynaecologists, hygienists, the public, the Ministry of Healthcare of Ukraine in connection with the need for a legislative solution to the prevention of iodine-dependent disorders in Ukraine. Materials and Methods. To study the problem and assess the state of iodine deficiency in Ukraine the criteria recommended by the WHO and the United Nations Children’s Fund (UNICEF) were applied for the first time, a method for determining the iodine content in the body was developed and implemented, which allowed to join the international “Equip” system of iodine supply control in the world and in Ukraine. This made it possible to move from indirect to direct methods of determining the intake of iodine in the body. Conclusions. A detailed study of iodine supply in different segments of the population of Ukraine proved the negative effects of iodine deficiency on health; in particular, it was found that the overall decrease in productivity of the generation of children in iodine deficiency populations is 5%. Measures to eliminate iodine-dependent disorder among the population of Ukraine have been developed and implemented. The development and production of iodized food salt, adequate to the needs of the population, has been carried out. The result of these measures, developed and implemented to eliminate iodine-dependent disorders and to improve the nation’s intelligence, is, according to the official data, the improvement of iodine supply of the population, significant reduction in the number of thyroid disorders, especially among those affected with 131I, which, even just because of this indicator, has significant social-economic effect. Key Words: Chernobyl accident, iodine deficiency, iodized salt, population, prevention, regions.