Pfinder M, Dreger S, Christianson L, Lhachimi S K, Zeeb H
Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. Collaborative Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. Institute for Public Health and Nursing Research, Health Sciences, University of Bremen, Bremen, Germany. Department of Health Promotion and Occupational Health Management, AOK Baden-Wuerttemberg, Stuttgart, Germany.
J Radiol Prot. 2016 Dec;36(4):R112-R130. doi: 10.1088/0952-4746/36/4/R112. Epub 2016 Sep 21.
A potential radiation protection method to reduce the risk of adverse health outcomes in the case of accidental radioactive iodine release is the administration of potassium iodide (KI). Although KI administration is recommended by WHO's Guidelines for Iodine Prophylaxis following Nuclear Accidents, a systematic review of the scientific evidence for the guidelines is lacking. Therefore, this study aims to systematically review the effects of KI administration in the case of accidental radioactive iodine release on thyroid cancer, hypothyroidism and benign thyroid nodules. We applied standard systematic review methodology for a search of the literature, selection of eligible studies, data extraction, assessment of risk of bias, assessment of heterogeneity, data synthesis, and the assessment of the quality of the evidence. We searched MEDLINE (via PubMed) and EMBASE. We found one cross-sectional study, one analytic cohort study and two case-control studies relating to our question. The number of participants ranged from 886-12 514. Two studies were conducted in children and two other studies in children and adults. It was not possible to conduct a meta-analysis. We identified low to very low-quality evidence that KI administration after a nuclear accident resulted in a reduction of the risk of thyroid cancer in children; however, the KI administration and dose was not well described in the studies. None of the studies investigated the effects of KI administration in the case of a nuclear accident on hypothyroidism and benign thyroid nodules. Low to very low-quality evidence suggests that KI intake following a nuclear accident may reduce the risk of thyroid cancer in children. No conclusions can be drawn about the effectiveness of KI intake with respect to the prevention of hypothyroidism and benign thyroid nodules.
一种在意外释放放射性碘的情况下降低不良健康后果风险的潜在辐射防护方法是服用碘化钾（KI）。尽管世界卫生组织的《核事故后碘预防指南》推荐服用KI，但缺乏对该指南科学证据的系统评价。因此，本研究旨在系统评价在意外释放放射性碘的情况下服用KI对甲状腺癌、甲状腺功能减退和良性甲状腺结节的影响。我们应用标准的系统评价方法进行文献检索、合格研究的选择、数据提取、偏倚风险评估、异质性评估、数据合成以及证据质量评估。我们检索了MEDLINE（通过PubMed）和EMBASE。我们找到了一项横断面研究、一项分析队列研究和两项与我们的问题相关的病例对照研究。参与者人数在886至12514之间。两项研究在儿童中进行，另外两项研究在儿童和成人中进行。无法进行荟萃分析。我们确定了低至极低质量的证据，表明核事故后服用KI可降低儿童患甲状腺癌的风险；然而，研究中对KI的服用和剂量描述不佳。没有一项研究调查核事故情况下服用KI对甲状腺功能减退和良性甲状腺结节的影响。低至极低质量的证据表明，核事故后摄入KI可能会降低儿童患甲状腺癌的风险。关于摄入KI在预防甲状腺功能减退和良性甲状腺结节方面的有效性，无法得出结论。
