IODIZED SALT PROPHYLAXIS OF ENDEMIC GOITER - AN EXPERIENCE IN TOSCANA(ITALY)

It is well established that iodine supplementation is effective in cor recting iodine deficiency and reducing goiter prevalence. In Italy, le gislation has allowed the production of iodized salt since 1972, but i ts consumption is on a voluntary basis. In the present study, the effi cacy of legislative measures that made compulsory the availability of iodized salt in foodstores has been evaluated. Urinary iodine excretio n and thyroid size, scored according to Pan American Health Organizati on recommendations, were determined prior to (1981) and 10 years after (1991) the introduction of legislative measures in the whore schoolch ildren population residing in a restricted area of the Tuscan Appennin es. Moreover, in 1991, thyroid volume was determined by ultrasonograph y. In 1981, mean urinary iodine excretion was 47.1+/-22.4 mg/kg creati nine (0.412 mu mol/l) and goiter prevalence was 60%, indicating a mode rate iodine deficiency. Eighty of the families subsequently used iodiz ed salt on a regular basis; as a result of this excellent compliance, in 1991 the mean urinary iodine excretion increased to 129.7 +/- 73 mg /kg creatinine (1.24 mu mol/l) and goiter prevalence dropped to 8.1%. The results of this study underline the effectiveness of iodine prophy laxis in correcting iodine deficiency and abating endemic goiter in sc hoolchildren, and suggest that implementation of measures that make co mpulsory the availability of iodized salt in foodstores overcomes the fact that there is no law governing the exclusive production and tradi ng of iodized salt.