Thyroid Research and Practice

: 2019  |  Volume : 16  |  Issue : 3  |  Page : 93--94

Thyroidology and public health: Challenges within the medical profession

Sanjay Kalra 
 Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India

Correspondence Address:
Dr. Sanjay Kalra
Department of Endocrinology, Bharti Hospital, Karnal - 132 001, Haryana

How to cite this article:
Kalra S. Thyroidology and public health: Challenges within the medical profession.Thyroid Res Pract 2019;16:93-94

How to cite this URL:
Kalra S. Thyroidology and public health: Challenges within the medical profession. Thyroid Res Pract [serial online] 2019 [cited 2020 Apr 1 ];16:93-94
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In 2011, Thyroid Research and Practice carried an editorial describing the public health challenges faced in thyroidology. This discussed iodine and selenium insufficiency, maternal hypothyroidism, water pollution, insecticide use, and radioactive iodine exposure as well-known causes of thyroid disease. The authors also highlighted the potential perils of direct access testing of thyroid function.[1] All these have varying impact on the health of our communities.

The 2011 editorial took a patient-centric viewpoint of community health. In this editorial, we describe thyroid-related public health issues from a health-care provider's perspective.

Fluoroscopy is an integral part of many doctor's professional careers, including cardiologists, neurosurgeons' radiologists, and orthopedic surgeons.[2] Yet, many physicians report suboptimal interest, knowledge, and awareness regarding radiation safety.[3],[4] Media reports have highlighted the increased radiation exposure to the thyroid during procedures such as mammography and dental X-rays.[5] While consensus suggests that patients do not need a thyroid shield during most procedures, this is not true for health-care providers.

Repeated exposure to irradiation may harm the thyroid which is an extremely radiosensitive organ.[6] Radiation can lead to two types of adverse effects, namely, deterministic and stochastic. While deterministic effects do not occur below a particular threshold, stochastic effects may occur at any level of exposure.[7] These include carcinogenesis and teratogenesis.

From a thyroid perspective, thyroid shields are essential for radiosafety. The thyroid gland can tolerate a maximum dose of 300 msv per annum.[8] Radiation safety can be enhanced by reducing the time of exposure to radiation, increasing one's distance from the source of radiation, and shielding oneself from radiation. Proper use of a thyroid shield can help halve total exposure to radiation. For this, a shield with ≥0.5 mm lead equivalent thickness must be worn tightly and properly, or loosely in combination with bismuth masking reagent. The thyroid shield should also be checked for damage by annual inspection.[9]

As responsible endocrinologists, we should take on the responsibility of educating and raising awareness of fellow medical professionals. The incidence of thyroid carcinoma is increasing rapidly. Evidence from persons with accidental exposure to radioactivity, including Chernobyl and Fukushima, suggests that this is a major cause of thyroid cancer.[10] Health-care professionals should, therefore, take appropriate action to protect themselves from such exposure. The availability and utility of potassium iodate as a prophylactic against thyrocarcinogenesis should also be explained.


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10Socolow EL, Hashizume A, Neriishi S, Niitani R. Thyroid carcinoma in man after exposure to ionizing radiation. A summary of the findings in Hiroshima and Nagasaki. N Engl J Med 1963;268:406-10.