Medeiros-Neto G A
Bull World Health Organ. 1988;66(5):637-42.
Iodine-deficiency disorders have been a serious public health problem in Brazil because of the failure of a salt iodination programme established in 1953. The reasons for this failure were logistical, e.g., potassium iodide was not supplied to all salt-producers, iodination of salt was largely erratic, and part of the population at risk used only non-refined salt, which was not iodinated. In 1978 a task force was therefore formed to implement measures to eliminate iodine-deficiency disorders from the country. For this purpose, potassium iodate was distributed, free-of-charge, to all salt mills and an iodate dosing spray was supplied without cost to small salt producers. Also, regional laboratories for determining iodine in salt were set up, inspectors made regular visits to the salt mills, and samples of salt from commerce and from the producers were analysed. More than 90% of the samples contained 10-30 mg iodine per kg. In three typical areas of the country with endemic goitre the urinary excretion of iodine increased from an average of less than 40 mug iodine to 125 +/- 38 mug iodine per g creatinine. In conclusion, the salt iodination programme was a complete success and could serve as a model for other countries with a high prevalence of iodine-deficiency disorders.
由于1953年设立的食盐碘化计划失败，碘缺乏症在巴西一直是一个严重的公共卫生问题。计划失败的原因在于后勤方面，例如碘化钾并非供应给所有食盐生产商，食盐碘化工作在很大程度上不稳定，而且部分高危人群只使用未精制食盐，而这种食盐未经过碘化处理。因此，1978年成立了一个特别工作组，以实施从该国消除碘缺乏症的措施。为此，向所有盐厂免费分发碘酸钾，并向小型食盐生产商免费提供碘酸盐定量喷雾器。此外，还设立了测定食盐中碘含量的区域实验室，检查员定期走访盐厂，并对商业和生产商提供的食盐样本进行分析。超过90%的样本每千克含碘量为10 - 30毫克。在该国三个典型的地方性甲状腺肿流行地区，碘的尿排泄量从平均每克肌酐少于40微克碘增加到125±38微克碘。总之，食盐碘化计划取得了圆满成功，可为碘缺乏症高发的其他国家提供借鉴。
