Iodine deficiency and goitre in schoolchildren in Melbourne, 2001

Ciara M McDonnell, Mark Harris and Margaret R Zacharin
Med J Aust 2003; 178 (4): 159-162.


Objective: To assess iodine status and goitre prevalence in a sample of schoolchildren in Melbourne.

Design: Cross-sectional study of urinary iodine excretion and presence of goitre in a sample of schoolchildren from Years 5–12 attending two urban schools.

Participants: 607 children aged 11–18 years consented to thyroid gland palpation and 577 provided a urine sample on the day of examination in August 2001.

Outcome measure: Iodine status of the study population, based on median urinary iodine values categorised as normal (≥ 100 μg/L), mild (50–99 μg/L) or moderate–severe (< 50 μg/L), and classified according to sex, school year and presence of goitre.

Results: 76% (439/577) of students had abnormal urinary iodine values, with 27% (156/577) having values consistent with moderate–severe deficiency. The median urinary iodine excretion for the total group was 70μg/L, with values for school years 5–12 ranging from 62 μg/L (Year 12) to 76 μg/L (Year 9). The median urinary iodine value in girls was lower than that in boys (64μg/L v 82 μg/L), and girls had significantly lower urinary iodine values overall (P < 0.002). There was no association between goitre grade and moderate–severe (< 50 μg/L; P = 0.39) or mild (50–99 μg/L; P = 0.07) urinary iodine deficiency.

Conclusions: We found mild iodine deficiency in a cohort of schoolchildren in Melbourne. Our results support other data showing mild iodine deficiency in Sydney and Tasmania and the argument for a national study of iodine nutrition.

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  • Ciara M McDonnell1
  • Mark Harris2
  • Margaret R Zacharin3

  • Department of Endocrinology and Diabetes, Royal Children's Hospital, Parkville, VIC.



We are indebted to Professor Cres Eastmann, Gary Ma and the staff of the ICPMR Laboratory, NSW, for performing the urinary iodine assays.

We also wish to thank the staff of the Clinical Epidemiology and Biostatistics Unit at the Royal Children's Hospital for their advice and assistance with the statistical analysis.

Competing interests:

None identified.

  • 1. McElduff A, McElduff P, Gunton JE, et al. Neonatal thyroid-stimulating hormone concentrations in Northern Sydney: further indications of mild iodine deficiency? Med J Aust 2002; 176: 317-320. <MJA full text>
  • 2. Li M, Ma G, Guttikonda K, et al. Re-emergence of iodine deficiency in Australia. Asia Pacific J Clin Nutr 2001; 10: 200-203.
  • 3. Gunton JE, Hams G, Fiegert M, McElduff A. Iodine deficiency in ambulatory participants at a Sydney teaching hospital: is Australia truly iodine replete? Med J Aust 1999; 171: 467-470. <MJA full text>
  • 4. Guttikonda K, Burgess JR, Hynes K, et al. Recurrent iodine deficiency in Tasmania, Australia: a salutary lesson in sustainable iodine prophylaxis and its monitoring. J Clin Endocrinol Metab 2002; 87: 2809-2815.
  • 5. Delange F. The disorders induced by iodine deficiency. Thyroid 1994; 4: 107-128.
  • 6. Pharoah POD, Buttfield IH, Hetzel B. Neurological damage to the foetus resulting from severe iodine deficiency during pregnancy. Lancet 1971; 1: 308-310.
  • 7. Thilly CH, Delange F, Lagasse R. Foetal hypothyroidism and maternal thyroid status in severe endemic goitre. J Clin Endocrinol Metab 1978; 47: 354-360.
  • 8. Topliss DJ. Iodine deficiency disorders. Med J Aust 1989; 150: 669-671.
  • 9. Chaouki ML, Maoui R, Benmiloud M. Comparative study of neurological and myxoedematous cretinism associated with severe iodine deficiency. Clin Endocrinol 1988; 28: 399-408.
  • 10. Boyages SC. Clinical review 49: iodine deficiency disorders. J Clin Endocrinol Metab 1993; 77: 587-591.
  • 11. Halpern JP, Boyages SC, Maberly GF, et al. The neurology of endemic cretinism. A study of two endemias. Brain 1991; 114: 825-841.
  • 12. Delong GR, Stanbury JB, Fierro-Benitez R. Neurological signs in congenital iodine deficiency disorder (endemic cretinism). Dev Med Child Neurol 1985; 27: 317-324.
  • 13. Dillon JC, Milliez J. Reproductive failure in women living in iodine deficient areas of West Africa. BJOG 2000; 107: 631-636.
  • 14. Boyages SC, Collins JK, Maberly GF, et al. Iodine deficiency impairs intellectual and neuromotor development in apparently normal persons. A study of rural inhabitants of north-central China. Med J Aust 1989; 150: 676-682.
  • 15. Fenzi GF, Giusti LF, Aghini-Lombardi F, et al. Neuropyschological assessment in schoolchildren from an area of moderate iodine deficiency. J Endocrinol Invest 1990; 13: 427-431.
  • 16. Azizi F, Sarshar A, Nafarabadi M, et al. Impairment of neuromotor and cognitive development in iodine deficient schoolchildren with normal physical growth. Acta Endocrinol 1993; 129: 501-504.
  • 17. Azizi F, Kalani H, Kimiagar M, et al. Physical, neuromotor and intellectual impairment in non-cretinous schoolchildren with iodine deficiency. Int J Vitamin Nutr Res 1995; 6199-205.
  • 18. Tiwari BD, Godbole MM, Chattopadhyay N, et al. Learning disabilities and poor motivation to achieve due to prolonged iodine deficiency. Am J Clin Nutr 1996; 63: 782-786.
  • 19. Ares S, Quero J, Dum S, et al. Iodine content of infant formulas and iodine intake of premature babies. Arch Dis Child 1994; 71: F184-191.
  • 20. DeVries LS, Heckmatt J, Burrin JM, et al. Low serum thyroxine concentrations and neural maturation in preterm infants. Arch Dis Child 1986; 61: 862-866.
  • 21. Hetzel BS. Iodine deficiency disorders and their eradication. Lancet 1983; 2: 1226-1229.
  • 22. Eastman CJ. The status of iodine nutrition in Australia. In: Delange F, Dunn JT, Glinoer D. Iodine deficiency in Europe — a continuing concern. New York: Plenum Press, 1993: 133-139.
  • 23. Eastman CJ. Where has all our iodine gone? Med J Aust 1999; 171: 455-456. <MJA full text>
  • 24. Zacharin MR. Iodine deficiency and goitre in an urban population of children and adolescents, Victoria 2000. Proceedings of the Australasian Paediatric Endocrine Group; 2000 Oct 27-29; Sydney.
  • 25. World Health Organization. Progress towards the elimination of iodine deficiency disorders (IDD). WHO/NUT/99.4 Geneva: WHO, 1999.
  • 26. Vitti P, Martino E, Aghini-Lombardi F, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994; 79: 600-603.
  • 27. World Health Organization and International Council for Control of Iodine Deficiency Disorders. Recommended normative values for thyroid volume in children aged 6-15 years. Bull World Health Organ 1997; 75: 95-97.
  • 28. Hollowell JG, Staehling NW, Hannon WH, et al. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III (1971-74 and 1988-94). J Clin Endocrinol Metab 1998; 83: 3401-3408.
  • 29. Wiersinga WM, Podoba J, Srbecky M, et al. A survey of iodine intake and thyroid volume in Dutch schoolchildren: reference values in an iodine sufficient area and the effect of puberty. Eur J Endocrinol 2001; 144: 595-603.
  • 30. Knudsen N, Bulow I, Jorgensen T, et al. Goitre prevalence and thyroid abnormalities at ultrasonography: a comparative epidemiological study in two regions with slightly different iodine status. Clin Endocrinol 2000; 53: 479-485.
  • 31. Lamberg BA. Endemic goitre-iodine deficiency disorders. Ann Med 1991; 23: 367-372.
  • 32. Hintze G, Emrich D, Richter K, et al. Effect of voluntary intake of iodinated salt on prevalence of goitre in children. Acta Endocrinol 1988; 117: 333-338.
  • 33. Gibson HB. Surveillance of iodine deficiency disorders in Tasmania 1949-1984. Hobart: Department of Health Services.
  • 34. Delange F, Van Onderbergen A, Shabana W, et al. Silent iodine prophylaxis in Western Europe only partly corrects iodine deficiency; the case of Belgium. Eur J Endocrinol 2000; 143: 189-196.
  • 35. Maberly GF. Iodine deficiency disorders: contemporary scientific issues. J Nutr 1994; 124 (Suppl): S1473-S1478.


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