The International Journal of Romanian Society of Endocrinology / Registered in 1938

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April - June 2005, Volume 1, Issue 2
Endocrine Care

Toma A, Sava M, Delia C, Simescu M, Tomescu E, Coculescu M

Universal salt iodization effects on endemic goiter in Arges county, Romania

Acta Endo (Buc) 2005, 1 (2): 167-180
doi: 10.4183/aeb.2005.167

Background. In the Carpathian area of Romania the Iodine Deficiency Disorders (IDD) including endemic goiter are a public health problem. Recently, the legislation imposing salt iodization was strengthened (from 10 to 20 ± 5 mg iodine/kg salt) and enlarged (universal salt iodization, USI, has been applied to bread industry since 2002). Objective. The effect of bread iodization by law upon the characteristics of goiter endemy was assessed in Arges county, Romania. Design. The characteristics of goiter endemy (as defined by WHO/ICCIDD/UNICEF) were determined in children in the years 1999 (control group C) and 2004 (study group S), two years after universal bread iodization. In the control group C there were 1,241 schoolchildren 6-14 years old, living in 5 villages and in Pitesti town. In the study group S there were 408 schoolchildren 6-12 years old, living in 7 villages and in Pitesti town. After universal bread iodization, a neonatal screening for hypothyroidism was also performed on 11,216 newborns in Arges county, between January 2003 and December 2004. The content of KIO3 in the salt was assessed both in samples collected from village shops in the years 1999 (10 samples) and 2004 (17 samples). The iodine content of drinking water in Arges county villages was assessed in 1999. Methods. Three parameters of IDD endemy were evaluated, i.e. the thyroid volume in schoolchildren by palpation or/and ultrasonography, urinary iodine by the Sandell-Kolthoff method, and neonatal blood TSH levels in dry spot by immunoassay. A questionnaire was filled in by 912 schoolchildren in 1999 and by 408 schoolchildren in 2004.

Keywords: bread iodization, endemic goiter, TSH neonatal screening, thyroid volume, IDD monitoring

Correspondence: Mihail Coculescu, Institute of Endocrinology, 36 Bd. Aviatorilor, 011683, Bucharest, Romania, e-mail:


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