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      Association between the Occurrence of Primary Hypothyroidism and the Exposure of the Population Near to Industrial Pollutants in São Paulo State, Brazil

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          Abstract

          Background: Environmental agents interfere with thyroid function at multiple levels. This study was to investigate the association between pollutant concentrations and the primary hypothyroidism (PH) occurrence odds in residents living in the Capuava Petrochemical Complex (CPC) influence area. Methods: This area was evaluated with the combination of the AERMOD dispersion model with the Weather Research Forecast (WRF) meteorological model (2016). The concentration of atmospheric pollutants were analyzed in 2017 using meteorological data on the period from 2005 to 2009, correlating this data with the research done in 2003 to 2005. A home-based questionnaire was applied to evaluate 2004 residents, of both sexes, aged from 8 to 72 years, based on their proximity to the industrial areas; were select residents with PH. Results: Volatile organic compounds (VOCs), carbon monoxide (CO), and nitrogen dioxide (NO 2) concentrations presented the highest correlations between the PH odds and pollutant concentrations. Conclusion: Air pollution associated with the presence of the CPC is an important environmental factor contributing to the development of PH in the nearby population. As the first study showing this association in Brazil, research should be continued to better understand the mechanisms and to find ways to compensate for or remedy to avoid health impacts in future populations.

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          Most cited references36

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          Epidemiology and Estimated Population Burden of Selected Autoimmune Diseases in the United States

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            Chronic autoimmune thyroiditis.

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              Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002).

              Describe thyrotropin (TSH) and thyroxine (T4) levels in the U.S. population and their association with selected participant characteristics. Secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) collected from 4392 participants, reflecting 222 million individuals, during 1999-2002. Hypothyroidism prevalence (TSH > 4.5 mIU/L) in the general population was 3.7%, and hyperthyroidism prevalence (TSH < 0.1 mIU/L) was 0.5%. Among women of reproductive age (12-49 years), hypothyroidism prevalence was 3.1%. Individuals aged 80 years and older had five times greater odds for hypothyroidism compared to 12- to 49-year-olds (adjusted odds ratio [OR] = 5.0, p = 0.0002). ORs were adjusted for sex, race, annual income, pregnancy status, and usage of thyroid-related medications (levothyroxine/thyroid, estrogen, androgen, lithium, and amiodarone). Compared to non-Hispanic whites, non-Hispanic blacks had a lower risk for hypothyroidism (OR = 0.46, p = 0.04) and a higher risk for hyperthyroidism (OR = 3.18, p = 0.0005), while Mexican Americans had the same risk as non-Hispanic whites for hypothyroidism, but a higher risk for hyperthyroidism (OR = 1.98, p = 0.04). Among those taking levothyroxine or desiccated thyroid, the adjusted risk for either hypothyroidism (OR = 4.0, p = 0.0001) or hyperthyroidism (OR = 11.4, p = 4 x 10(-9)) was elevated. Associations with known factors such as age, race, and sex were confirmed using this data set. Understanding the prevalence of abnormal thyroid tests among reproductive-aged women informs decisions about screening in this population. The finding that individuals on thyroid hormone replacement medication often remain hypothyroid or become hyperthyroid underscores the importance of monitoring.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                18 September 2019
                September 2019
                : 16
                : 18
                : 3464
                Affiliations
                [1 ]Internal Medicine Department, Endocrinology Service, ABC Medical School, Foundation, Santo André, SP 09060-870, Brazil
                [2 ]Internal Medicine Department, ABC Medical School Foundation, Santo André, SP 09060-870, Brazil; ruda.alessi@ 123456gmail.com
                [3 ]Internal Medicine Service, Santa Paula Hospital, São Paulo, SP 04556-100, Brazil; thalles@ 123456institutoneurologico.com.br
                [4 ]Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; mmartins@ 123456hsph.harvard.edu
                Author notes
                [* ]Correspondence: mangelazaccarelli@ 123456yahoo.com.br ; Tel.: +55-(11)-3824-9060 or +55-(11)-3141-9556
                Author information
                https://orcid.org/0000-0003-1448-7609
                https://orcid.org/0000-0002-0771-9697
                Article
                ijerph-16-03464
                10.3390/ijerph16183464
                6765954
                31540358
                1a7b24c7-ff8e-427a-ab00-137b00b9325e
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 28 August 2019
                : 13 September 2019
                Categories
                Article

                Public health
                primary hypothyroidism,petrochemical complex,industrial pollutants,são paulo state,brazil

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