Szybinski Z, Delange F, Lewinski A, Podoba J, Rybakowa M, Wasik R, Szewczyk L, Huszno B, Gołkowski F, Przybylik-Mazurek E, Karbownik M, Zak T, Pantoflinski J, Trofimiuk M, Kinalska I
Department of Endocrinology, Medical College, Jagiellonian University in Krakow, Poland.
Eur J Endocrinol. 2001 Apr;144(4):331-7. doi: 10.1530/eje.0.1440331.
Iodine prophylaxis in Poland started in 1935 and has been interrupted twice: by World War II and in 1980 for economic reasons. Epidemiological surveys carried out after the Chernobyl accident in 1989 as well as in 1992/1993 and in 1994 as a 'ThyroMobil' study, revealed increased prevalence of goitre in children and adults. Ninety per cent of Poland was classified as an area of moderate iodine deficiency, and 10%, in the seaside area, as mild iodine deficiency territory. Iodine prophylaxis based on iodisation of household salt was introduced again in 1986 as a voluntary model and in 1997 as a mandatory model with 30+/-10 mg KI/kg salt.
The evaluation of the obligatory model of iodine prophylaxis in schoolchildren from the same schools in 1994 and 1999.
Thyroid volume was determined by ultrasonography. Ioduria in casual morning urine samples was measured using Sandell-Kolthoff's method, within the framework of the ThyroMobil study.
Goitre prevalence decreased from 38.4 to 7% and urinary iodine concentration increased from 60.4 to 96.2 microg/l mean values between 1994 and 1999. In four schools the prevalence of goitre diminished below 5%. In 1999, 70% of children excreted over 60 microg I/l, and 36% over 100 microg I/l, whereas in 1994 the values were 44 and 13% respectively.
The present findings indicate that iodine prophylaxis based only on iodised household salt is highly effective.
波兰的碘预防措施始于1935年，曾两次中断：一次是第二次世界大战期间，另一次是1980年因经济原因中断。1989年切尔诺贝利事故后以及1992/1993年和1994年作为“甲状腺行动”研究开展的流行病学调查显示，儿童和成人甲状腺肿患病率有所上升。波兰90%的地区被归类为碘中度缺乏地区，10%的沿海地区为碘轻度缺乏地区。1986年再次引入基于家庭食盐碘化的碘预防措施，最初是自愿模式，1997年成为强制模式，碘含量为30±10毫克碘化钾/千克盐。
评估1994年和1999年同一学校学童碘预防强制模式的效果。
通过超声检查确定甲状腺体积。在“甲状腺行动”研究框架内，采用桑德尔 - 科尔托夫法测定随机晨尿样本中的尿碘含量。
1994年至1999年期间，甲状腺肿患病率从38.4%降至7%，尿碘浓度均值从60.4微克/升增至96.2微克/升。在四所学校中，甲状腺肿患病率降至5%以下。1999年，70%的儿童尿碘排泄量超过60微克/升，36%超过100微克/升，而1994年这两个比例分别为44%和13%。
目前的研究结果表明，仅基于家庭碘化食盐的碘预防措施非常有效。
