RESUMO
A survey of 37 communities supplied by stream water and receiving iodised salt for the last 10-20 years indicates that the presence of sedimentary rocks in the watersheds of streams more closely correlates with goiter prevalence than 12 other possible causative variables. These results support the hypothesis that sedimentary rocks rich in organic matter are the main source of water-borne goitrogens.
Assuntos
Bócio Endêmico/epidemiologia , Criança , Colômbia , Fenômenos Geológicos , Geologia , Bócio Endêmico/etiologia , Humanos , Iodo/análise , Análise de Regressão , Abastecimento de Água/análiseRESUMO
This paper reports on recent epidemiological observations in western Colombia, which further demonstrate the presence of naturally-occurring goitrogens contaminating water supplies in areas where goitre persists despite prolonged and continuous iodine supplementation. 'Prospective' and 'cross-sectional' studies in 41 localities where the populations have been on a uniform and adequate iodine supplementation for the last 10-20 years indicate that, in the endemia of western Colombia, environmental factors other than nutritional iodine deficiency are responsible for differences in goitre prevalence. Further epidemiological studies to determine the causal factors for the persistence of the endemia established a correlation between the sources of drinking water and goitre prevalence rates. Organic compounds containing sulfur with marked thionamide-like antithyroid activity were isolated from water supplying endemic goitre districts, and results are presented supporting the hypothesis that sedimentary rocks rich in organic matter are the main source of water-borne goitrogens. Bacteriological investigations showed that the presence of Klebsiella pneumoniae in drinking water and bacterial concentration were related significantly with goitre prevalence only in the presence of other variables, particularly the presence of sedimentary rocks. In the light of these epidemiological observations and experimental studies it may be concluded that, at present, endemic goitre in western Colombia is not due to nutritional iodine deficiency, but that water supplies are contaminated with sulfur-bearing organic compounds with thionamide-like antithyroid activity most probably deriving from sedimentary rocks rich in organic matter and that these compounds are the main factor underlying the endemia.