Probable impact of environmental radiation on thyroid swellings in areas of Eastern Hyderabad and Nalgonda

Abstract

IntroductionThyroid swellings are prevalent in 4 to 7% of the Indian population and are commonly present in females. Thyroid swelling has been attributed to various causes, such as ingestion of goitrogens and low iodine in the diet in benign, radiation exposure, and genetic in malignancies. Eastern Hyderabad and Nalgonda have a high fluoride content in the ground water, which can potentially disrupt thyroid functioning. Moreover, the region also harbors high uranium content and environmental radiation; hence, a retrospective analysis of the FNAC and histopathology of the thyroid swellings was done to evaluate the paradigm.MethodA retrospective analysis of the patient’s records from February 1, 2022, to January 31, 2023, was conducted considering all the patients who presented with thyroid swelling. The variables taken into consideration were age, gender, and FNAC findings. A correlation was also made with the histopathology of the specimen of operated patients.ResultA total of 88 medical records of the patients were evaluated, and it was determined that there was a preponderance of females with a ratio of 8.77:1. Majority of the swellings were Benign labeled as Bethesda category 2 (n = 61) followed by category 3 (n = 11). To be considered are the cases of malignancies falling into category 6, which comprise 7.95% (n = 7). The majority of the patients were seen between the ages of 31 to 40 (n = 28), followed by 41 to 50 (n = 25).On comparing with the histopathological reports, two cases of category 5 were found to be having papillary thyroid carcinoma and another with follicular thyroid carcinoma making the number of proven malignancies to be 10.22% (n = 9). Other histopathological findings correlated with the results of FNAC.ConclusionThrough this pilot study, we conclude that most thyroid swellings were benign, but there is a higher incidence of thyroid malignancies (10.22%), significantly higher than the country average of 2 to 4%. The higher number of malignant cases can be attributed to many factors, including high fluoride content and environmental radiation. Further studies need to be conducted, taking each element individually.