Non-Cancer Thyroid Diseases Among Children in the Kaluga and Bryansk Regions of the Russian Federation Exposed to Radiation Following the Chernobyl Accident

Ivanov, V. P.; Chekin, S.Yu.; Parshin, V. S.; Vlasov, O.K.; Maksioutov, М.А.; Цыб, А Ф; Andreev, Vladimir A.; Hoshi, Masaharu; Yamashita, Shunichi; Shibata, Yoshisada

doi:10.1097/01.hp.0000142501.96410.ef

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…In the next 10–20 years after the accident, the first study, undertaken from 1997 to 1999 (at 11–13 years after the accident) [ 31 ] showed no significant radiation dose–response of chronic thyroiditis as determined by thyroid ultrasound examination. In the second study, anti-thyroid antibodies as well as thyroid hormones and TSH were measured in sera collected from 1999 to 2001 (at 13 to 15 years after the accident) [ 32 ].…”

Section: The Effect Of Moderate- To Low-dose Radiationmentioning

confidence: 99%

Radiation-related thyroid autoimmunity and dysfunction

Nagayama

2017

Journal of Radiation Research

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The thyroid gland is vulnerable not only to external radiation but also to internal radiation, because the thyroid cells can incorporate radioactive iodine when synthesizing thyroid hormones. Since radiation-induction of thyroid neoplasia, including thyroid cancer, is well recognized, the data on radiation-related thyroid autoimmunity and dysfunction are summarized and reviewed. High-dose irradiation, irrespective of being external or internal, is strongly associated with a risk of hypothyroidism (with the prevalence ranging from 2.4% to 31%) and of Graves’ hyperthyroidism (with the prevalence being up to 5%). It is easy to understand that high-dose irradiation induces hypothyroidism with some frequency, because high-dose irradiation destroys the thyroid gland. On the other hand, the basis for development of hyperthyroidism is mechanistically unclear, and it is merely speculative that autoantigens may be released from damaged thyroid glands and recognized by the immune system, leading to the development of anti-thyrotropin receptor antibodies and Graves’ hyperthyroidism in subjects who are immunologically predisposed to this ailment. In contrast, the data on moderate to low-dose irradiation on thyroid autoimmunity and dysfunction are inconsistent. Although it is difficult to draw a definitive conclusion, some data may suggest a transient effect of moderate- to low-dose irradiation on hypothyroidism and autoimmune thyroiditis, implying that the effect, if it exists, is reversible. Finally, no report has shown a statistically significant increase in the prevalence of moderate- to low-dose irradiation–induced Graves’ hyperthyroidism.

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Section: The Effect Of Moderate- To Low-dose Radiationmentioning

confidence: 99%

Radiation-related thyroid autoimmunity and dysfunction

Nagayama

2017

Journal of Radiation Research

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“…Given that the effect we observed was highly non-linear and seen only at the lowest doses, it could easily be overlooked when specific thresholds for thyroid volume are applied to make the diagnosis of enlarged thyroid or diffuse goiter. The fact that some studies showed no effect [ 12 , 17 ], while others found a positive association between 131 I exposure and diffuse goiter [ 13 , 18 ] is therefore unsurprising, and may also reflect low statistical power in some of these studies. Because our study focuses solely on thyroid volume rather than on a diagnosis of thyroid enlargement or diffuse goiter, we were able to detect even weak signals in the data that might otherwise be obscured.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, this is the first study to examine association between 131 I dose to the thyroid gland and thyroid volume in a population of individuals exposed during childhood and systematically screened 10-15 years later. Previous studies had much more limited information on thyroid volume [ 18 ] or dose [ 11 – 15 ]. Our study adds to the current literature by providing evidence for a moderate statistically significant increase in thyroid volume among those who were 18 years or older 10-15 years after the accident.…”

Section: Discussionmentioning

confidence: 99%

“…Increased thyroid volume is an essential part of simple nontoxic goiter or diffuse goiter diagnoses, and several studies examined the risk of these conditions after exposure to radioiodine. However, the majority of these studies lacked individual measurements of dose to thyroid [ 11 – 16 ], and the few studies that had thyroid dose measurements had contradictory findings [ 17 , 18 ]. Understanding the dose-response relationship between 131 I exposure and thyroid volume will inform clinical decisions and public health interventions targeted at individuals exposed to radioactive iodine as a result of occupational exposure, medical treatment, or nuclear fallout.…”

Section: Introductionmentioning

confidence: 99%

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Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later

et al. 2022

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Background While there is a robust literature on environmental exposure to iodine-131 (131I) in childhood and adolescence and the risk of thyroid cancer and benign nodules, little is known about its effects on thyroid volume. Methods To assess the effect of 131I dose to the thyroid on the volume of the thyroid gland, we examined the data from the baseline screening of the Belarusian-American Cohort Study of residents of Belarus who were exposed to the Chernobyl fallout at ages ≤18 years. Thyroid dose estimates were based on individual thyroid activity measurements made shortly after the accident and dosimetric data from questionnaires obtained 10-15 years later at baseline screening. During baseline screening, thyroid gland volume was assessed from thyroid ultrasound measurements. The association between radiation dose and thyroid volume was modeled using linear regression where radiation dose was expressed with power terms to address non-linearity. The model was adjusted for attained age, sex, and place of residence, and their modifying effects were examined. Results The analysis was based on 10,703 subjects. We found a statistically significant positive association between radiation dose and thyroid volume (P < 0.001). Heterogeneity of association was observed by attained age (P < 0.001) with statistically significant association remaining only in the subgroup of ≥18 years at screening (P < 0.001). For this group, increase in dose from 0.0005 to 0.15 Gy was associated with a 1.27 ml (95% CI: 0.46, 2.07) increase in thyroid volume. The estimated effect did not change with increasing doses above 0.15 Gy. Conclusions This is the first study to examine the association between 131I dose to the thyroid gland and thyroid volume in a population of individuals exposed during childhood and systematically screened 10-15 years later. It provides evidence for a moderate statistically significant increase in thyroid volume among those who were ≥ 18 years at screening. Given that this effect was observed at very low doses and was restricted to a narrow dose range, further studies are necessary to better understand the effect.

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“…The association was modest and best described by several concave models. In a similar study of Russian children exposed to Chornobyl fallout who had measurement-based individual thyroid doses, there was no evidence of a dose-response relationship for autoimmune thyroiditis that was diagnosed by ultrasound and confirmed by TSH and ATPO measurements 11–13 years after the accident (65). The authors did not evaluate the dose-response relationship for ATPO prevalence separately because ATPO measurements were not available for all study participants.…”

Section: Thyroid Diseasesmentioning

confidence: 99%

Non-malignant Thyroid Diseases after a Wide Range of Radiation Exposures

Ron

Brenner

2010

Radiation Research

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Background The thyroid gland is one of the most radiosensitive human organs. While it is well known that radiation exposure increases the risk of thyroid cancer, less is known about its effects in relation to non-malignant thyroid diseases. Objectives The aim of this review is to evaluate the effects of high and low dose radiation on benign structural and functional diseases of the thyroid. Methods We examined the results of major studies from cancer patients treated with high-dose radiotherapy or thyrotoxicosis patients treated with high doses of iodine-131, patients treated with moderate to high dose radiotherapy for benign diseases, persons exposed to low doses from environmental radiation and survivors of the atomic bombings who were exposed to a range of doses. We evaluated radiation effects on structural (tumors, nodules), functional (hyper- and hypothyroidism), and autoimmune thyroid diseases. Results Following a wide range of doses of ionizing radiation, an increased risk of thyroid adenomas and nodules was observed in a variety of populations and settings. The dose response appeared to be linear at low to moderate doses, but in one study there was some suggestion of a reduction in risk above 5 Gy. The elevated risk for benign tumors continues for decades following exposure. Considerably less consistent findings are available regarding functional thyroid diseases including autoimmune diseases. In general, associations for these outcomes were fairly weak and significant radiation effects were most often observed following high doses, particularly for hypothyroidism. Conclusions A significant radiation dose-response relation was demonstrated for benign nodules and follicular adenomas. The effects of radiation on functional thyroid diseases are less clear, partly due to the greater difficulties studying these diseases.

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Non-Cancer Thyroid Diseases Among Children in the Kaluga and Bryansk Regions of the Russian Federation Exposed to Radiation Following the Chernobyl Accident

Cited by 10 publications

References 13 publications

Radiation-related thyroid autoimmunity and dysfunction

Radiation-related thyroid autoimmunity and dysfunction

Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later

Non-malignant Thyroid Diseases after a Wide Range of Radiation Exposures

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