Juvenile hypothyroidism among two populations exposed to radioiodine.

Goldsmith, John R.; Grossman, Charles M.; Morton, William E.; Nussbaum, Rudi H.; Kordysh, Ella; Quastel, Michael R.; Sobel, Richard; Nussbaum, Fred D.

doi:10.1289/ehp.99107303

Cited by 45 publications

(24 citation statements)

References 5 publications

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“…Some previous studies of hypothyroidism or TSH levels among children exposed to radioiodines from Chernobyl fallout have reported higher TSH concentrations in exposed subjects compared with unexposed controls (Goldsmith et al 1999; Quastel et al 1997; Vykhovanets et al 1997), though others have not (Agate et al 2008; Pacini et al 1998; Vermiglio et al 1999). Almost all above-mentioned studies were based on small samples (from 53 to 804 exposed subjects) or lacked estimates of individual 131 I thyroid doses.…”

Section: Discussionmentioning

confidence: 90%

“…Some earlier studies reported an increase in thyroid-stimulating hormone (TSH) levels and the prevalence of juvenile hypothyroidism among children exposed to 131 I following Chernobyl (Goldsmith et al 1999; Quastel et al 1997; Vykhovanets et al 1997), but other studies did not (Agate et al 2008; Kasatkina et al 1997; Pacini et al 1998; Vermiglio et al 1999). An increased prevalence of thyroid autoimmunity has been reported (Kasatkina et al 1997; Pacini et al 1998; Vermiglio et al 1999), although it seemed to be transient with no long-term effect on thyroid function (Agate et al 2008).…”

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confidence: 99%

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Measures of Thyroid Function among Belarusian Children and Adolescents Exposed to Iodine-131 from the Accident at the Chernobyl Nuclear Plant

Ostroumova

Рожко

Hatch

et al. 2013

Environ Health Perspect

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Background: Thyroid dysfunction after exposure to low or moderate doses of radioactive iodine-131 (131I) at a young age is a public health concern. However, quantitative data are sparse concerning 131I-related risk of these common diseases.Objective: Our goal was to assess the prevalence of thyroid dysfunction in association with 131I exposure during childhood (≤ 18 years) due to fallout from the Chernobyl accident.Methods: We conducted a cross-sectional analysis of hypothyroidism, hyperthyroidism, autoimmune thyroiditis (AIT), serum concentrations of thyroid-stimulating hormone (TSH), and autoantibodies to thyroperoxidase (ATPO) in relation to measurement-based 131I dose estimates in a Belarusian cohort of 10,827 individuals screened for various thyroid diseases.Results: Mean age at exposure (± SD) was 8.2 ± 5.0 years. Mean (median) estimated 131I thyroid dose was 0.54 (0.23) Gy (range, 0.001–26.6 Gy). We found significant positive associations of 131I dose with hypothyroidism (mainly subclinical and antibody-negative) and serum TSH concentration. The excess odds ratio per 1 Gy for hypothyroidism was 0.34 (95% CI: 0.15, 0.62) and varied significantly by age at exposure and at examination, presence of goiter, and urban/rural residency. We found no evidence of positive associations with antibody-positive hypothyroidism, hyperthyroidism, AIT, or elevated ATPO.Conclusions: The association between 131I dose and hypothyroidism in the Belarusian cohort is consistent with that previously reported for a Ukrainian cohort and strengthens evidence of the effect of environmental 131I exposure during childhood on hypothyroidism, but not other thyroid outcomes.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Measures of Thyroid Function among Belarusian Children and Adolescents Exposed to Iodine-131 from the Accident at the Chernobyl Nuclear Plant

Ostroumova

Рожко

Hatch

et al. 2013

Environ Health Perspect

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“…Other studies of populations of children exposed to I-131 from Chornobyl fallout have focused on hypothyroidism, which is a far more common form of thyroid dysfunction, but few have reported positive results (13,14). Although the exposure in question was not internal I-131 radiation, a recent publication based on atomic bomb survivors in Hiroshima and Nagasaki who participated in a comprehensive thyroid screening study (33) reported a nonsignificant elevated EOR/Sv for hyperthyroidism in those exposed to external radiation at 10 years of age (EOR/Sv=0.49, 95% CI: −0.06–1.69, P =0.10).…”

Section: Discussionmentioning

confidence: 99%

“…There have also been limited reports on risk of functional thyroid abnormalities related to Chornobyl fallout, although with mixed results and methodological limitations (10,11,12,13,14,15,16). We have been studying thyroid function in a cohort of ~13,000 persons exposed to I-131 in Ukraine under the age of 18 years, who had thyroid radioactivity measurements taken within eight weeks of the accident and who were screened by clinicians using a standardized protocol.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Hyperthyroidism after Exposure during Childhood or Adolescence to Radioiodines from the Chornobyl Nuclear Accident: Dose–Response Results from the Ukrainian-American Cohort Study

et al. 2010

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Relatively few data are available on the prevalence of hyperthyroidism (TSH concentrations of < 0.3 mIU/L, with normal or elevated concentrations of free T4) in individuals exposed to radioiodines at low levels. The accident at the Chornobyl (Chernobyl) nuclear plant in Ukraine on April 26, 1986 exposed large numbers of residents to radioactive fallout, principally to iodine-131 (I-131) (mean and median doses = 0.6 Gray (Gy) and 0.2 Gy). We investigated the relationship of I-131 and prevalent hyperthyroidism among 11,853 individuals exposed as children or adolescents in Ukraine who underwent an in-depth, standardized thyroid gland screening examination 12–14 years later. Radioactivity measurements taken shortly after the accident were available for all subjects and were used to estimate individual thyroid doses. We identified 76 cases of hyperthyroidism (11 overt, 65 subclinical). Using logistic regression, we tested a variety of continuous risk models and conducted categorical analyses for all subjects combined and for females (53 cases, n=5,767) and males (23 cases, n=6,086) separately, but found no convincing evidence of a dose response relationship between I-131 and hyperthyroidism. There was some suggestion of elevated risk among females in an analysis based on a dichotomous dose model with a threshold of 0.5 Gy chosen empirically (OR=1.86, P=0.06), but the statistical significance level was reduced (P=0.13) in a formal analysis with an estimated threshold. In summary, after a thorough exploration of the data, we found no statistically significant dose response relationship between individual I-131 thyroid doses and prevalent hyperthyroidism.

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“…The results of post-Chornobyl studies have been mixed. While some studies reported a significant upward shift in TSH levels and increased rates of juvenile hypothyroidism in children living in radionuclide contaminated areas (46–48), the remaining ecological studies were negative (49–52). In a recent cohort study of 11,853 individuals under the age of 18 years at the time of the Chornobyl accident living in an area of mild-to-moderate iodine deficiency (53), the overall prevalence of subclinical hypothyroidism was about 6% (54), an estimate that is somewhat higher than that reported for the U.S. population of comparable age (12).…”

Section: Thyroid Diseasesmentioning

confidence: 99%

Non-malignant Thyroid Diseases after a Wide Range of Radiation Exposures

Ron

Brenner

2010

Radiation Research

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Background The thyroid gland is one of the most radiosensitive human organs. While it is well known that radiation exposure increases the risk of thyroid cancer, less is known about its effects in relation to non-malignant thyroid diseases. Objectives The aim of this review is to evaluate the effects of high and low dose radiation on benign structural and functional diseases of the thyroid. Methods We examined the results of major studies from cancer patients treated with high-dose radiotherapy or thyrotoxicosis patients treated with high doses of iodine-131, patients treated with moderate to high dose radiotherapy for benign diseases, persons exposed to low doses from environmental radiation and survivors of the atomic bombings who were exposed to a range of doses. We evaluated radiation effects on structural (tumors, nodules), functional (hyper- and hypothyroidism), and autoimmune thyroid diseases. Results Following a wide range of doses of ionizing radiation, an increased risk of thyroid adenomas and nodules was observed in a variety of populations and settings. The dose response appeared to be linear at low to moderate doses, but in one study there was some suggestion of a reduction in risk above 5 Gy. The elevated risk for benign tumors continues for decades following exposure. Considerably less consistent findings are available regarding functional thyroid diseases including autoimmune diseases. In general, associations for these outcomes were fairly weak and significant radiation effects were most often observed following high doses, particularly for hypothyroidism. Conclusions A significant radiation dose-response relation was demonstrated for benign nodules and follicular adenomas. The effects of radiation on functional thyroid diseases are less clear, partly due to the greater difficulties studying these diseases.

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Juvenile hypothyroidism among two populations exposed to radioiodine.

Cited by 45 publications

References 5 publications

Measures of Thyroid Function among Belarusian Children and Adolescents Exposed to Iodine-131 from the Accident at the Chernobyl Nuclear Plant

Measures of Thyroid Function among Belarusian Children and Adolescents Exposed to Iodine-131 from the Accident at the Chernobyl Nuclear Plant

Prevalence of Hyperthyroidism after Exposure during Childhood or Adolescence to Radioiodines from the Chornobyl Nuclear Accident: Dose–Response Results from the Ukrainian-American Cohort Study

Non-malignant Thyroid Diseases after a Wide Range of Radiation Exposures

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