A programme of iodine supplementation using only iodised household salt isefficient - the case of Poland

Background: Iodine prophylaxis in Poland started in 1935 and has been inter rupted twice: by World War II and in 1980 for economic reasons. Epidemiolog ical surveys carried out after the Chernobyl accident in 1989 as well as in 1992/1993 and in 1994 as a 'ThyroMobil' study. revealed increased prevalen ce of goitre in children and adults. Ninety per cent of Poland was classifi ed as an area of moderate iodine deficiency, and 10%, in the seaside area. as mild iodine deficiency territory. Iodine prophylaxis based on iodisation of household salt was introduced again in 1986 as a voluntary model and in 1997 as a mandatory model with 30 +/- 10 mg KI/kg salt. Objective: The evaluation of the obligatory model of iodine prophylaxis in schoolchildren from the same schools in 1994 and 1999. Methods: Thyroid volume was determined by ultrasonography. Ioduria in casua l morning urine samples was measured using Sandell-Kolthoff's method, withi n the framework of the ThyroMobil study. Results: Goitre prevalence decreased from 38.4 to 7% and urinary iodine con centration increased from 60.4 to 96.2 mug/l mean values between 1994 and 1 999. In four schools the prevalence of goitre diminished below 5%. In 1999, 70% of children excreted over 60 mug I/l, and 36% over 100 mug I/l, wherea s in 1994 the values were 44 and 13% respectively. Conclusion: The present findings indicate that iodine prophylaxis based onl y on iodised household salt is highly effective.