Abstract

Our study aims to clarify the population nutrient status in locations with different levels of iodine in the water in China; to choose effective measurements of water improvement(finding other drinking water source of iodine not excess) or non-iodised salt supply or combinations thereof; to classify the areas of elevated water iodine levels and the areas with endemic goiter; and to evaluate the risk factors of water iodine excess on pregnant women, lactating women and the overall population of women. From Henan, Hebei, Shandong and Shanxi province of China, for each of 50∼99 µg/L, 100∼149 µg/L, 150∼299 µg/L, and ≥300 µg/L water iodine level, three villages were selected respectively. Students of 6–12 years old and pregnant were sampled from villages of each water-iodine level of each province, excluded iodized salt consumer. Then the children's goiter volume, the children and pregnant's urinary iodine and water iodine were tested. In addition, blood samples were collected from pregnant women, lactating women and other women of reproductive age for each water iodine level in the Shanxi Province for thyroid function tests. These indicators should be matched for each person. When the water iodine exceeds 100 µg/L; the iodine nutrient of children are iodine excessive, and are adequate or more than adequate for the pregnant women. It is reasonable to define elevated water iodine areas as locations where the water iodine levels exceed 100 µg/L. The supply of non-iodised salt alone cannot ensure adequate iodine nutrition of the residents, and water improvement must be adopted, as well. Iodine excess increases the risk of certain thyroid diseases in women from one- to eightfold.

Highlights

  • Iodine excess can be caused by various sources

  • Several questions remain: 1) For different areas with elevated water iodine levels, what are the iodine levels in the population? 2) Should water improvement, the supply of non-iodised salt, or a combination of both interventions be adopted based on the specific context of relevant areas? 3) How should the areas with elevated water iodine and the areas with endemic iodine excess goitres be determined and classified? the Study Project on the Standard and Intervention Measures for Areas of Elevated Water Iodine was implemented by the Endemic Disease Centre of China in the elevated water iodine provinces, including Shandong, Shanxi, Henan and Hebei Provinces, from July 2011 to March 2012

  • Survey subjects were further grouped based on the actual drinking water iodine levels

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Summary

Introduction

Iodine excess can be caused by various sources. In 1960, Suzuki reported cases of goiter in Hokkaido caused by eating kelp[1],[2], and Mecullagh observed that the goiter prevalence increase after iodised oil injection[3]. Iodine excess caused by elevated water iodine has been reported mainly in China, some other countries suffer this problem, such as Columbia[7], Sudan[8], Germany[9], Denmark[10], Niger[11], Saharawi[12] and Sri Lanka[13]. The supply of noniodised salt has been adopted for these areas as the only intervention measure, with the exception of Beijing and Fujian, where water improvement has been used. The Study Project on the Standard and Intervention Measures for Areas of Elevated Water Iodine was implemented by the Endemic Disease Centre of China in the elevated water iodine provinces, including Shandong, Shanxi, Henan and Hebei Provinces, from July 2011 to March 2012.

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