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This version published online on May 10, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0286
A more recent version of this article appeared on August 1, 2005
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Submitted on February 9, 2005
Accepted on May 3, 2005

Occupational Exposure to Ionizing Radiation is Associated With Autoimmune Thyroid Disease

Henry Völzke*, André Werner, Henri Wallaschofski, Nele Friedrich, Daniel M. Robinson, Stefan Kindler, Matthias Kraft, Ulrich John, and Wolfgang Hoffmann

Institute of Epidemiology and Social Medicine, Medical Department, Institute for Community Medicine, Ernst Moritz Arndt University Greifswald, Germany

* To whom correspondence should be addressed. E-mail: voelzke{at}uni-greifswald.de.

Context: The thyroid gland is a potential target organ for radiation-related damage.

Objective: The aim of the analysis was to investigate the association between occupational exposure to ionizing radiation and autoimmune thyroid disease (AITD).

Design: The cross-sectional Study of Health in Pomerania.

Setting: General community.

Subjects: Analyses were performed in a population-based sample of 4299 subjects. Among them, 160 persons reported a history of occupational exposure to ionizing radiation.

Main outcome measure: AITD was defined as the combined presence of hypoechogenicity in thyroid ultrasound and antithyroxiperoxidase antibodies >200 IU/mL.

Results: Females with occupational exposure to ionizing radiation had more often AITD than non-exposed females (10.0% vs. 3.4%, P < 0.05). This association persisted after adjustment for relevant confounders (odds ratio [OR] 3.46, 95%-confidence interval [95%-CI] 1.16; 10.31, P < 0.05). In males, there were too few subjects who fulfilled the criteria of AITD, but the association between the exposure to radiation and hypoechogenicity of the thyroid gland barely missed statistical significance (OR 2.20, 95%-CI 0.92; 5.26, P = 0.08). In both females and males, subjects who reported a length of exposure of >5 yr exhibited the highest risk of the endpoints.

Conclusions: We conclude that occupational exposure to ionizing radiation is related to the risk of AITD. The usage of thyroid protection shields by radiation workers is strongly recommended.
Key words: Autoimmune Thyroid Disease • Risk Factors • Radiation • Study of Health in Pomerania (SHIP)




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