Bürgi H, Supersaxo Z, Selz B
Medizinische Klinik, Bürgerspital, Solothurn, Switzerland.
Acta Endocrinol (Copenh). 1990 Dec;123(6):577-90. doi: 10.1530/acta.0.1230577.
In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and 1980, to the present 15 mg I per kg. In 1988, 92% of retail salt and 76% of all salt for human consumption (including food industry) was iodized, even though its use is voluntary. Urinary iodine excretion, previously between 18 and 64 micrograms per per day, has now risen to 150 micrograms per day. No new endemic cretins born after 1930 have been identified. Goitre disappeared rapidly in newborns and schoolchildren, more slowly in army recruits, and incompletely in elderly adults. In some Cantons (by constitution in charge of health matters and the salt monopoly) which allowed iodized salt only in 1952, disappearance of goitre lagged behind accordingly, proof that iodized salt was the cause of regression. The Swiss data provide evidence that isolated deafness, mental deficiency, and short stature, each without the other attributes of cretinism have also decreased. Adverse effects of iodized salt were minimal, possibly because the initial iodine content of salt was chosen very low. Iodization of salt has proved a highly cost-effective preventive measure in Switzerland.
在瑞士的某些地区，在采取预防措施之前，0.5%的居民患有呆小症，几乎100%的学童有大甲状腺肿，高达30%的年轻男子因甲状腺肿而不适于服兵役。1922年开始推行食盐碘化，碘含量为每千克3.75毫克碘，1962年和1980年碘含量两次翻倍，达到目前的每千克15毫克碘。1988年，92%的零售盐和76%的所有供人类食用的盐（包括食品工业用盐）都进行了碘化，尽管其使用是自愿的。以前每天尿碘排泄量在18至64微克之间，现在已升至每天150微克。1930年以后出生的新的地方性呆小症患者尚未被发现。甲状腺肿在新生儿和学童中迅速消失，在新兵中消失较慢，在老年人中消失不完全。在一些直到1952年才允许使用加碘盐的州（根据宪法负责卫生事务和食盐专卖），甲状腺肿的消失相应滞后，这证明加碘盐是病情消退的原因。瑞士的数据表明，孤立性耳聋、智力缺陷和身材矮小，即使没有呆小症的其他特征，也有所减少。加碘盐的不良影响微乎其微，可能是因为最初选择的食盐碘含量非常低。在瑞士，食盐碘化已被证明是一种极具成本效益的预防措施。
