Abstract
Introduction: Iodine deficiency is the single most important cause of hypothyroidism. Drinking water is an important source of iodine for humans. Objective: To identify the common potable water sources available to the estate population in the Ratnapura District, to determine the iodine concentrations in different water sources and to ascertain the relationship between water iodine concentrations and thyroid status of children 5 to 9 years of age. Method: A descriptive cross sectional study was carried out in three phases in 20 randomly selected estates in the Ratnapura district of Sri Lanka from September to November 2009. In phase 1, 1,683 households in the selected estates were surveyed to identify the drinking water sources. In phase 2, blood samples from 519 randomly selected children aged 5-9 years from the same estates were taken to assay TSH levels after obtaining informed written consent from parents. In phase 3, water samples from 23 identified sources (wells, rivers and springs) were analysed for iodine levels by the catalytic reduction method. Water sources were grouped on elevation above mean sea level. The mean TSH levels and water iodine concentrations were correlated. Results: The main source of drinking water was spring water (83.7%). Spring water at low altitudes had significantly higher iodine concentrations than that located at higher altitudes (p 0.05). There was no significant association between TSH levels of children and iodine concentration in drinking water (p>0.05). Conclusions: The main potable water source available to the population in the Ratnapura District was spring water (84%). The mean iodine concentration of spring water was significantly lower as compared to other water sources. There was no significant association between serum TSH levels in children 5 to 9 years of age and iodine concentration in drinking water. (Key words: Water iodine concentration; children; TSH levels; Sri Lanka) DOI: http://dx.doi.org/10.4038/sljch.v41i4.4980
Highlights
Iodine deficiency is the single most important cause of hypothyroidism
Spring water at low altitudes had significantly higher iodine concentrations than that located at higher altitudes (p
There was no association between the mean thyrotrophin stimulating hormone (TSH) levels of children and the altitudes at which they lived (p>0.05)
Summary
Iodine deficiency is the single most important cause of hypothyroidism. Drinking water is an important source of iodine for humans. Iodine deficiency leading to hypothyroidism is the single most important cause of preventable brain damage and mental retardation. The clinical and sub clinical manifestations of iodine deficiency, collectively identified as iodine deficiency disorders (IDD), affect all stages of human growth and development[1,2]. Chronic iodine deficiency results in low serum thyroxin levels which stimulate secretion of thyrotrophin stimulating hormone (TSH) from the pituitary. Persistent stimulation of the thyroid gland by TSH results in a goitre. There have been many studies on goitre prevalence in Sri Lanka[3]. The first systematic assessment of IDD, conducted in 1986, revealed a goitre prevalence of 18.2%4. After 10 years of the salt iodization programme, goitre prevalence in Sri Lanka decreased to 3.8% in 20055
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