The “Goitre monitor” was the child whose duty it was to give out goitre tablets to classmates. This was a weekly event in schools in Tasmania from 1950 to 1966. It had great merit as a population health measure, yet only delivered a modest reduction in goitre among Tasmania’s youth — in some areas, the prevalence of goitre increased.

This is only one part of the story of iodine deficiency in Tasmania since British settlement in 1803, told through the eyes and words of many of the participants. Richards and Stewart have compiled a broad range of contributions describing the impact of iodine deficiency on the health of Tasmania’s population, and continuing attempts to effectively address this problem. It is a somewhat eclectic collection, including ancient remedies, the history of thyroid surgery, why Tasmania’s soil is iodine-deficient, the veterinary perspective, and personal accounts from health workers, goitre monitors and affected individuals.

There was no evidence for widespread goitre among Aboriginal inhabitants before British settlement — their nomadic lifestyles and seasonal dietary patterns, including iodine-rich seafoods, ensured they were iodine-sufficient. This book describes the harsh lifestyle of early settlers and the gradual emergence of iodine deficiency and goitres, to the point where these were seen as the norm. School surveys in the early 1900s tracked the increase in goitre from 5.8% of children in 1923 to 33% of boys and 37% of girls in 1950.

Tasmania has served as a “population health” laboratory, showing us the results of planned and unplanned interventions. Richards unravels the effects of iodide tablets (1950–1966), residual iodine in milk (from 1963), iodinated improver in bread (from 1966) and iodised salt in bread (from 2001).

This book is recommended to health professionals in the food industry, anyone working with micronutrients, and policy analysts contemplating the addition of nutrients to food. It is a fascinating and instructive history and guide to how we view iodine deficiency. By knowing our history, we are better placed to move forward.

Postscript: In February 2008, Food Standards Australia New Zealand acknowledged that exceptional health and safety reasons existed that required the development of a separate standard for New Zealand, while the Australian situation is being further investigated. The mandatory replacement of non-iodised salt with iodised salt in breads is the preferred option to address the re-emergence of iodine deficiency in New Zealand.