Objective: To describe changes in the iodine status of Tasmanians following voluntary fortification of bread with iodine in October 2001.
Design and setting: Post‐intervention, cross‐sectional urinary iodine surveys of Tasmanian schoolchildren aged 8–11 years were used to assess population iodine status. Participants were selected using a one‐stage cluster sampling method. The sampling frame comprised classes containing fourth‐grade children from all Tasmanian government, Catholic and independent schools. Results were compared with pre‐intervention survey results.
Main outcome measures: Median urinary iodine concentration (UIC) and percentage of UIC < 50 μg/L ascertained from spot urine samples.
Results: Median UIC was 75 μg/L in 1998, 72 μg/L in 2000, 105 μg/L in 2003, 109 μg/L in 2004 and 105 μg/L in 2005. Median UIC in post‐intervention years (2003–2005) was significantly higher than in pre‐intervention years. The percentage of UIC results < 50 μg/L was 16.9% in 1998, 18.7% in 2000, 10.1% in 2003, 10.0% in 2004 and 10.5% in 2005.
Conclusion: Despite methodological differences between the pre‐ and post‐intervention surveys, switching to iodised salt in bread appears to have resulted in a significant improvement in iodine status in Tasmania. Given iodine deficiency has been identified in other parts of Australia and in New Zealand, mandatory iodine fortification of the food supply in both countries is worthy of consideration. As voluntary fortification relies on industry goodwill, mandating fortification could be expected to enhance population reach and give a greater guarantee of sustainability in Tasmania.
BackgroundDepressive and anxiety disorders are common among working adults and costly to employers and individuals. Mental health screening is often an important initial strategy, but the resultant data are often of unknown representativeness and difficult to interpret. In a public sector workforce, this study used a brief screener for depression/anxiety to: a) compare prevalence of high psychological distress obtained from a researcher survey with an employer survey and population norms and b) verify whether expected correlates were observed in a screening setting.MethodsParticipants were public servants working for an Australian state government. High psychological distress (Kessler-10 ≥22) stratified by age and sex was compared for a random weighted sample researcher survey (n = 3406) and an anonymous volunteer employer survey (n = 7715). Prevalence ratios (PR) were estimated from log binomial regression.ResultsReferencing the researcher survey, prevalence of high psychological distress was greater by age and sex in the employer survey but was only dependably higher for men when compared with population norms. Modelling suggested this may be due to work stress (effort-reward imbalance) (PR = 3.19, 95% CI 1.45-7.01) and casual/fixed-term employment (PR 2.64, 95% CI 1.26-5.56).ConclusionsDepression and anxiety screening using typical employer survey methods could overestimate prevalence but expected correlates are observed in a screening setting. Guidance for employers on screening and interpretation should be provided to encourage engagement with mental health prevention and treatment programs in the workplace.
Iodine status in Tasmania can now be considered optimal. Mandatory iodine fortification has achieved significantly greater improvements in population iodine status compared with voluntary fortification. However, surveys of schoolchildren cannot be generalised to pregnant and breastfeeding women, who have higher iodine requirements. Measurement of iodine status in population surveys is warranted for ongoing monitoring and to justify the appropriate level of fortification of the food supply into the future.
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