The role of environmental factors in the formation of the incidence of autoimmune thyroiditis

The relationship between the ecological factors in the city of Krasnodar and the incidence of autoimmune thyroiditis (AIT) has been studied. Ecological situation was evaluated on the basis of the data bank of the Municipal Center for State Sanitary and Epidemiological Surveillance for the period 1992-1997. The incidence of AIT was analyzed by the municipal outpatient endocrinological service.

Evaluation of sanitary and hygienic situation in the city showed progressive contamination of water bodies and alteration of microbiocenosis at the expense of predominance of potentially hazardous bacteria (Klebsiella, Cytobacter, and Proteus). The maximum epidemic strain was recorded in 1995, when the incidence of salmonellosis, hepatitis B, diphtheria, and leptospirosis increased. Analysis of correlation between the incidence of enteric infections in 1995 and the quality of drinking water showed a statistically significant direct medium relationship. Complex index of atmospheric air pollution was 6.3 (third-degree pollution). The peak of AIT was recorded in 1995 (90.9 per 100,000 population).

Within the AIT structure, the incidence of the hypothyroid status increased from 26.2%) in 1993 to 34.9%) in 1995 and 41%) in 1997. A direct medium relationship has been detected between the total incidence of AIT and complex indicator of atmospheric air pollution (r—^0.54, p<0.05).

Comparative characterization of clinical patterns of the disease showed a notable increase in the number of cases with manifest hypothyrosis by the end of 1995 (615 cases vs. 171 in 1993). In 1996 and 1997 the number of patients with manifest hypothyrosis remained high (684 and 793, respectively). Hence, our complex medical ecological surveillance showed an increased contribution of unfavorable environmental factors to the increased incidence of AIT; this permits us to consider this condition an ecologically determined nosological entity.

All this necessitates a comprehensive approach to studies of thyroid diseases and the environment, making use of multifactorial analysis. The ecological monitoring system should include evaluation of the thyroid function.

autoimmune thyroiditis, the impact of a set of environmental factors, state sanitary and epidemiological surveillance

1. Бактериологический мониторинг состояния объектов окружающей среды: Метод, рекомендации / Под ред. А. И. Потапова. — М., 1995.

2. Балаболкин М. И. // Тер. арх. — 1997. — № 10. — С. 5—12.

3. Ветшев П. С., Мельниченко Г. А. Заболевания щитовидной железы. — М., 1995.

4. Лещева Г. А., Кинтер О. В., Задорожнюк Е. А. и др. // Бюл. "Здоровье населения и среда обитания". — 1996. — № 10/43. С. 11-16.

5. Онищенко Г. Г., Чибураев В. И. // Материалы 8-го Всерос. съезда гигиенистов и санитарных врачей: Сборник науч, трудов. — М., 1996. — Т. 1. — С. 5—7.

6. Петунина Н. А., Герасимов Г. А. // Пробл. эндокринол. — № 4. С. 30-35.

7. Потапов А. И., Ястребов Г. Г. // Материалы 8-го Всерос. съезда гигиенистов и санитарных врачей: Сборник науч, трудов. — М., 1996. — Т. 1. — С. 7—10.

8. Рафибеков Д. С., Калинин А. П. Аутоиммунный тиреоидит. — Бишкек, 1996.

9. Савина Л. В., Чекмарева С. Е. // Кубан. науч. мед. вести. — № 4. С. 46-48.