Chronic Autoimmune Thyroiditis in Industrial Areas in Brazil: A 15-Year Survey
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To investigate whether there is an increased incidence of chronic autoimmune thyroiditis (CAT) in individuals living in the vicinity of industrial plants that manufacture petroleum byproducts in the state of São Paulo, Brazil.
Between 1989 and 2004, 6,306 patients of both sexes, from 5 to 78 years old were divided in two groups according to their home location: Group 1: 3,356 residents living near industrial plants that manufacture petroleum byproducts (Region A), and Group 2: 2,950 residents living far from Region A in an area with predominantly steel industries (Region B). For all patients, we measured the serum levels of antithyroglobulin antibody, antithyroperoxidase antibody, triiodothyronine, thyroxine, free thyroxine and thyrostimulating hormone. Sonographic scans of the thyroid gland were also conducted.
The proportion of patients with CAT coming from Region A increased from 2.5 % (5 patients with CAT/200 total patients) in 1992 to 57.6 % (106 patients with CAT/184 total patients) in 2001. This striking increase was highly significant (p < 0.001). Similar findings were not observed in Region B. The difference in the number of patients with CAT between 1989 and 2004 coming from Region A and Region B was highly significant (p < 0.001), with 905 CAT patients (83.95 %) in Region A and 173 CAT patients (16.05 %) in Region B.
Our results showed a striking increase in the incidence of CAT in residents in the vicinity of large industrial plants that manufacture petroleum byproducts compared with residents living near steel industries, which opens the field to new areas of research.
KeywordsAutoimmune thyroiditis petroleum byproducts industrial Brazil
To our patients for all of their information and understanding.
To Professor Walter Bloise, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, we grant a special recognition for his important support in the elaboration of this paper.
To Antonio Achur, MD, for laboratory examinations (Fleming Laboratory) and to Edson R. Iglezias, MD, for Image examinations (DISA), Santo André, SP, Brazil, for their collaboration and confidence.
To Professors Rui M. B. Maciel and Roberto Z. Esteves, PhD, at the Federal University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (UNIFESP), São Paulo, SP, Brazil, for their collaboration and confidence.
To Professor Éder Quintão, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, for his trust and support.
To Professor Paulo H. N. Saldiva, PhD, at the University of São Paulo Medical School, Pathology Department, Laboratory of Atmospheric Pollution (FMUSP), São Paulo, SP, Brazil, for his collaboration, trust and support.
Conflicts of Interest
The author declares that she has no conflicts of interest that could be perceived as affecting the impartiality of the research reported. In particular, this study did not receive any support from industry or the makers of the studied compounds.
- 5.Fournier M, Brousseau P, Tryphonas H, Cyr D. Biomarkers of immunotoxicity: an evolutionary perspective. In: Guillette Jr LJ, Crain DA, editors. Environmental endocrine disrupters: an evolutionary perspective. New York: Taylor & Francis; 2000. p. 182–215.Google Scholar
- 6.Allsopp M, Costner P, Johnston P. Body of evidence: the effects of chlorine on human health. Pull: Greenpeace International, 1995. ISBN 1857/532 2590, 90pp.Accessd on 19 June 2009Google Scholar
- 12.CETESB 2008. Available at: http://www.cetesb.sp.gov.br>. Accessed on 2 April 2010
- 13.Akamizu T, Amino N, De Groot LJ. Hashimoto’s thyroiditis. Thyroid Disease Manager 2008. Available at:http://www.thyroidmanager.org/Chapter8/8-contents.htm. Accessed on 6 March 2011
- 16.Zaccarelli-Marino MA, Martins LC, Esteves RZ, Kasamatsu TS, Maciel RMB. Urinary iodine in patients with auto-immune Thyroid disorders in Santo André, SP, is comparable to normal controls and has been steady for the last 10 years [Port]. Brazilian Arch Endocrinol Metab. 2009;53/1:55–63.CrossRefGoogle Scholar
- 17.Paknys G, Kondrotas AJ, Kevelaitis E. Risk factors and pathogenesis of Hashimoto’s thyroiditis. Medicina (Kaunas). 2009;45(7):574–83.Google Scholar
- 20.Aminorroaya A, Janghorbani M, Amini M, Hovsepian S, Tabatabaei A, Fallah Z. The prevalence of thyroid dysfunction in an iodine-sufficient area in Iran. Arch Iranian Med. 2009;12(3):262–70.Google Scholar
- 22.Delange F, Benker G, Caron Ph, Eber O, Ott W, Peter F, Podoba J, Simescu M, Szybinsky Z, Vertongen F, Vitti P, Wiersinga W, Zamrazil V. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol. 1997;136:180–7.PubMedCrossRefGoogle Scholar
- 26.Agency for Toxic Substances and Disease Registry (ATSDR). National exposure registry, trichloroethylene subregistry baseline technical report (revised). 1994. US Department of Health and Human Services, Public Health Service, Atlanta, GA.Google Scholar
- 30.Vanderpump MPJ, Tunbridge WMG. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD, editors. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text, 8/E. Philadelphia: JB Lippincott- Raven; 2000. p. 467–73.Google Scholar
- 31.PetrochemicalComplexABC2008.Availableat:attp://www.agenciabrasil.gov.br/noticias/2008/02/22.Accessed on 12 December 2009.
- 33.Freitas CU, Campos RAG, Silva MAFR, Panachão MRI, Moraes JC, Waissmann W, Chacra AR, Maeda MYS, Rodrigues RSM, Belchor LG, Barbosa SO, Santos RTM. Can living in the surroundings of a petrochemical complex be a risk factor for autoimmune thyroid disease? Environ Res. 2010;110:112–7.PubMedCrossRefGoogle Scholar
- 35.Lockey JE, Kelly CR, Cannon GW, Colby TV, Aldrich V, Livingston GK, Lockey JE, Kelly CR, Cannon GW, Colby TV, Aldrich V, Livingston GK. Progressive systemic sclerosis associated with exposure to trichloroethylene. J Occup Med. 1997;29:493–6.Google Scholar