Electric Blanket Use and Risk of Thyroid Cancer in the Women’s Health Initiative Observational Cohort

Thyroid cancer disproportionally affects more women than men. The aim of this study was to assess whether exposure to extremely low frequency electric magnetic fields from electric blankets (EBs) was associated with the development of thyroid cancer. Data were analyzed from 89,527 women who participated in the Women’s Health Initiative Observational Study and who responded to questions concerning prior use of EBs. During a mean follow-up of 12.2 years, 190 incident cases of thyroid cancer were identified. We estimated the hazard ratio (HR) and 95 percent confidence interval (CI) of incident thyroid cancer associated with EB use by Cox’s proportional hazard model, adjusted for selected covariates. A majority, 57 percent, of the women in the cohort reported the use of EBs while sleeping and/or for warming the bed before sleep. No association was found between use of EBs and subsequent risk of thyroid cancer (HR = 0.98, 95 percent CI 0.72–1.32). Duration of EB use measured in years, months, or hours had no effect on risk. These results did not change when the cases were limited to papillary thyroid cancer, the most frequently occurring histologic type. The results of this study do not support possible health hazards of EBs in regards to thyroid cancer risk.     

Thyroid size and goiter prevalence after introduction of iodized salt: a 5-y prospective study in schoolchildren in Côte d'Ivoire

BACKGROUND: The long-term goal of salt iodization is elimination of iodine deficiency and reduction of the goiter rate to < 5% in school-aged children. Normalization of the goiter rate probably indicates disappearance of iodine deficiency disorders as a public health problem. However, thyroid size may not return to normal for months or years after correction of iodine deficiency. OBJECTIVE: We described the time course and pattern of changes in thyroid size and goiter rate in response to the introduction of iodized salt in an area of severe endemic goiter. DESIGN: In a 5-y prospective study, we measured thyroid size by ultrasonography and urinary iodine and thyroid hormone concentrations in schoolchildren 6 mo before the introduction of iodized salt and annually for 4 y thereafter. RESULTS: Four years after the introduction of iodized salt and normalization of the median urinary iodine concentration, mean thyroid size had decreased 56% (P < 0.0001). However, 29% of the children remained goitrous, with a significant age shift in the distribution of goiter. At baseline, the goiter rate was significantly higher in younger (age: 5-9 y) than in older (age: 10-14 y) children (P < 0.0001). At 2, 3, and 4 y after salt iodization, the goiter rate was significantly higher in the older than in the younger children (at 4 y: 52% compared with 19%), and the difference increased with time (P < 0.0001). CONCLUSION: The goiter rate in school-aged children may remain sharply elevated for up to 4 y after successful introduction of iodized salt, primarily because of persistent goiter in older children.     

Cross-Sectional Associations of Serum Perfluoroalkyl Acids and Thyroid Hormones in U.S. Adults: Variation According to TPOAb and Iodine Status (NHANES 2007–2008)

Background:

Perfluoroalkyl acids (PFASs) are suspected thyroid toxicants, but results from epidemiological studies are inconsistent.

Objectives:

We examined associations between serum PFASs and thyroid hormones (THs) in a representative, cross-sectional sample of U.S. adults. We hypothesized that people with high thyroid peroxidase antibodies and low iodine would be more susceptible to PFAS-induced thyroid disruption.

Methods:

Our sample included 1,525 adults (≥ 18 years) from the 2007–2008 NHANES study with available serum PFASs and THs. We examined associations between four serum PFASs [perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFNA), perfluorooctanoate (PFOA), and perfluorooctane sulfonate (PFOS)], and serum THs [free triiodothyronine (fT3), free thyroxine (fT4), fT3/fT4, thyroid-stimulating hormone (TSH), total T3 (TT3), and total T4 (TT4)] using multivariable linear regression. We stratified subjects into four groups by two indicators of thyroid “stress”: thyroid peroxidase antibody (TPOAb ≥ 9 IU/mL) and iodine status (< 100 μg/L urine).

Results:

Of 1,525 participants, 400 (26%) had low iodine only (T0I1), 87 (6%) had high TPOAb only (T1I0), and 26 (2%) had both high TPOAb and low iodine (T1I1). In general, associations were similar among participants in the groups with neither (T0I0) or only one thyroid stressor (T0I1 or T1I0), suggesting that PFAS–TH associations were not modified by high TPOAb or low iodine alone. However, PFHxS and PFOS were negatively associated (p < 0.05) with fT4, and all four PFASs were positively associated (p < 0.05) with fT3, fT3/fT4, TSH, and TT3 in the group with joint exposure to high TPOAb and low iodine (T1I1).

Conclusions:

We found evidence of PFAS-associated thyroid disruption in a subset of U.S. adults with high TPOAb (a marker of autoimmune hypothyroidism) and low iodine status, who may represent a vulnerable subgroup. However, the small sample size, cross-sectional design, and possibility of reverse causation are limitations of this work.

Citation:

Webster GM, Rauch SA, Ste Marie N, Mattman A, Lanphear BP, Venners SA. 2016. Cross-sectional associations of serum perfluoroalkyl acids and thyroid hormones in U.S. adults: variation according to TPOAb and iodine status (NHANES 2007–2008). Environ Health Perspect 124:935–942; http://dx.doi.org/10.1289/ehp.1409589     

Interfollicular Fibrosis in the Thyroid of the Harbour Porpoise: An Endocrine Disruption?

Previous studies have described high levels of polychlorobiphenyls (PCB), polybrominated diphenylether (PBDE), toxaphene, p,p′-dichlorodiphenyltrichloroethane (DDT), and p,p′-dichlorodiphenyldichloroethylene (DDE) in the blubber of the harbour porpoise from the North Sea raising the question of a potential endocrine disruption in this species. In the present study, the thyroids of 57 harbour porpoises from the German and Danish (North and Baltic Seas), Norwegian, and Icelandic coasts have been collected for histological and immunohistological investigations. The number of follicles and the relative distribution of follicles, connective, and solid tissues (%) were quantified in the thyroid of each individual. Then, the potential relationship between the thyroid morphometry data and previously described organic compounds (namely, PCB, PBDE, toxaphene, DDT, and DDE) was investigated using factor analysis and multiple regressions. Thyroid morphology differed strongly between sampling sites. Porpoises from the German (North and Baltic Seas) and Norwegian coasts displayed a high percentage of connective tissues between 30 and 38% revealing severe interfollicular fibrosis and a high number of large follicles (diameter >200 μm). A correlation-based principal component analysis (PCA) revealed two principal components explaining 85.9% of the total variance. The variables PCB, PBDE, DDT, and DDE compounds loaded highest on PC1 whereas toxaphene compound loaded most on PC2. Our results pointed out a relationship between PC1 (PCBs, PBDE, DDE, and DDT compounds) and interfollicular fibrosis in the harbour porpoise thyroids. Such an association is not alone sufficient for a cause–effect relationship but supports the hypothesis of a contaminant-induced thyroid fibrosis in harbour porpoises raising the question of the long-term viability in highly polluted areas.     

Thyroid cancer incidence in Chornobyl liquidators in Ukraine: SIR analysis, 1986–2010

We studied thyroid cancer incidence in a cohort of 150,813 male Chornobyl clean-up workers (“liquidators”) from Ukraine by calculating standardized incidence ratio (SIR) using national cancer statistics. Follow-up began on the liquidator’s registration date with the Chornobyl State Registry of Ukraine (the earliest date was 05. 05. 1986) and continued through December 31, 2010, date of thyroid cancer diagnosis, date of death, or date of last known vital status, whichever came first. There were 196 incident thyroid cancers in the study cohort with an overall SIR of 3.50 [95 % confidence interval (CI) 3.04–4.03]. A significantly elevated SIR estimate of 3.86 (95 % CI 3.26–4.57) was observed for liquidators who had their first clean-up mission in the Chornobyl zone in 1986, when levels of external and internal exposure to radiation were highest; the SIR estimates for later calendar years of first clean-up mission, while significantly elevated, were lower. The SIR estimates were elevated throughout the entire follow-up period but were especially high 10–18 years after the accident: 4.62 (95 % CI 3.47–6.15) and 4.80 (95 % CI 3.78–6.10) for the period 1995–1999 and 2000–2004, respectively. Our findings support the growing evidence of increased thyroid cancer rates among Chornobyl liquidators. Although this could be partially attributed to increased medical surveillance, the observed pattern of SIR increase warrants further investigation of a potential contribution of radiation exposure to the elevated thyroid cancer rates in this large population.     

Pathology Hawai‘i Hotline: A Brief Description of the Bethesda System for Reporting Thyroid Fine Needle Aspirates

Fine needle aspiration has become the most prominent, and the easiest way, to morphologically evaluate lesions of the thyroid. When done correctly, the sensitivity and specificity of thyroid aspirates for detecting malignancy is very high. Unfortunately, clinicians are sometimes confused by the terminology used in thyroid cytopathology reports. One way to mitigate confusion is for all pathologists to use the same diagnostic criteria and terminology. Standardized terminology for thyroid cytopathology reports has recently been proposed. The following article introduces the concept of the Bethesda System for reporting thyroid aspirates. Sample diagnoses are given to illustrate how thyroid cytopathology reports may appear using the Bethesda System.     

Housing and health—Current issues and implications for research and programs

This article provides an overview of the ways in which the home environment can affect human health, describes how specific health hazards in housing are related, and considers implications of these concerns for research and programs to address the health-housing connection. The widespread availability of decent housing has contributed greatly to improvements in health status in developed countries through, for example, provision of safe drinking water, proper sewage disposal, and protection from the elements. However, a lack of decent housing and homelessness among a significant number of Americans remains a significant public health concern. In addition, a number of specific health hazards can be found even in housing that is in good condition and provides all basic amenities. Specific health hazards related to housing include unintentional injuries, exposure to lead, exposure to allergens that may cause or worsen asthma, moisture and fungi (mold), rodent and insect pests, pesticide residues, and indoor air pollution. A number of these specific hazards share underlying causes, such as excess moisture, and all may be influenced by factors in the community environment or by occupant behaviors. We make recommendations for developing programs and research efforts that address multiple housing problems in an integrated way, rather than categorically, and for closer collaboration between housing and public health programs. The views expressed in this article are those of the authors and do not necessarily reflect official policies of the US Centers for Disease Control and Prevention or the US Department of Housing and Urban Development.     

and biology

有一个富翁,带了许多金银财宝,到很远的地方去寻找快乐。但他走过了千山万水,到过了无数的地方,却始终没有找到快乐。一天,正当他沮丧地坐在山道旁休息时,见一位农夫背着一大捆柴草快乐地唱着山歌从山上下来,富翁急忙上前向农夫问道:“我是个令人羡慕的富翁,为什么却总是找不到     

Comparing objective and subjective status: Gender and space (and environmental justice?)

The environmental justice literature has described differential health effects of environmental toxins and pollutants on people of different socio-economic status (SES) that may not always reflect differing levels of exposure. We offer four questions or contentions that together may contribute to understanding this conundrum and then present an empirical exploration of one of these questions: Does the relationship between SES and self-perceived status vary in space? Utilizing data from an original questionnaire survey of randomly selected adults conducted in twenty-five communities in British Columbia, Canada, a supplementary data set containing demographic and socio-economic characteristics of the communities themselves, and multilevel modelling techniques, this article describes relationships between objective and subjective measures of social status, by gender and in space. Our analysis contributes to the development of innovative environmental justice models by bringing some spatial sensitivity to interrelationships among these aspects of status.     

Brominated Indoles and Phenols in Marine Sediment and Water Extracts from the North and Baltic Seas–Concentrations and Effects

This work presents results from analytical as well as ecotoxicologic investigations of sediment and water samples from the North and Baltic Seas. A bioassay-directed procedure was used to investigate cause–effect relationships between observed effects in acute laboratory bioassays (luminescent bacteria assay with Vibrio fischeri and embryo test with Danio rerio) and analyte concentrations in extracted samples. Brominated phenols and indoles—including 4-bromophenol; 2,4-dibromophenol; 4- and 6-bromoindole; 3,4-, 4,6-, and 3,6-dibromoindole; and tribrominated compounds—were identified in partly remarkable concentrations (up to 40,000 ng g⁻¹ total organic carbon TOC for 4-bromophenol) in North Sea sediment samples and water samples (913 ng L⁻¹ 3,6-dibromoindole) from the German Bight. The toxicity of some of the identified brominated substances was low, with median effect concentration levels (EC₅₀) ranging from 0.08 to 21.7 mg/L for V. fischeri and 4.3 to 46.3 mg/L for D. rerio. Comparison of the concentrations of analytes with ECs showed a toxicity contribution of brominated phenols and indoles to overall toxicity of the fraction. In the case of one water sample from the German Bight, brominated phenols and indoles accounted for the observed toxicity. Brominated phenols and indoles, which are assumed to be of biogenic origin, have rarely been discussed so far in the context of ecotoxicologic effects in marine ecosystems.