Skip to main content

Advertisement

SpringerLink
Log in

Chronic Autoimmune Thyroiditis in Industrial Areas in Brazil: A 15-Year Survey

  • Published:
Journal of Clinical Immunology Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether there is an increased incidence of chronic autoimmune thyroiditis (CAT) in individuals living in the vicinity of industrial plants that manufacture petroleum byproducts in the state of São Paulo, Brazil.

Methods

Between 1989 and 2004, 6,306 patients of both sexes, from 5 to 78 years old were divided in two groups according to their home location: Group 1: 3,356 residents living near industrial plants that manufacture petroleum byproducts (Region A), and Group 2: 2,950 residents living far from Region A in an area with predominantly steel industries (Region B). For all patients, we measured the serum levels of antithyroglobulin antibody, antithyroperoxidase antibody, triiodothyronine, thyroxine, free thyroxine and thyrostimulating hormone. Sonographic scans of the thyroid gland were also conducted.

Results

The proportion of patients with CAT coming from Region A increased from 2.5 % (5 patients with CAT/200 total patients) in 1992 to 57.6 % (106 patients with CAT/184 total patients) in 2001. This striking increase was highly significant (p < 0.001). Similar findings were not observed in Region B. The difference in the number of patients with CAT between 1989 and 2004 coming from Region A and Region B was highly significant (p < 0.001), with 905 CAT patients (83.95 %) in Region A and 173 CAT patients (16.05 %) in Region B.

Conclusion

Our results showed a striking increase in the incidence of CAT in residents in the vicinity of large industrial plants that manufacture petroleum byproducts compared with residents living near steel industries, which opens the field to new areas of research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, Grimley Evans J, Hasan DM, Rodgers H, Tunbridge F, Young ET. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol. 1995;43:55–68.

    Article  CAS  Google Scholar 

  2. Tunbridge WMG, Vanderpump MPJ. Population screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am. 2000;29:239–53.

    Article  PubMed  CAS  Google Scholar 

  3. Weetman AP. Autoimmune thyroid disease: propagation and progression. Eur J Endocrinol. 2003;148:1–9.

    Article  PubMed  CAS  Google Scholar 

  4. Collins J, Gough S. Autoimmunity in thyroid disease. Eur J Nucl Med. 2002;29 Suppl 2:S417–24.

    Article  CAS  Google Scholar 

  5. Fournier M, Brousseau P, Tryphonas H, Cyr D. Biomarkers of immunotoxicity: an evolutionary perspective. In: Guillette Jr LJ, Crain DA, editors. Environmental endocrine disrupters: an evolutionary perspective. New York: Taylor & Francis; 2000. p. 182–215.

    Google Scholar 

  6. Allsopp M, Costner P, Johnston P. Body of evidence: the effects of chlorine on human health. Pull: Greenpeace International, 1995. ISBN 1857/532 2590, 90pp.Accessd on 19 June 2009

  7. Liu CC, Chen CC, Wu TN, Yang CY. Association of brain cancer with residential exposure to petrochemical air pollution in Taiwan. J Toxicol Environ Health. 2008;A71(5):310–4.

    Article  Google Scholar 

  8. Yang CY, Chiu HF, Tsai SS, Chang CC, Chuang HY. Increased risk of preterm delivery in areas with cancer mortality problems from petrochemical complex. Environ Res. 2002;69(3):195–200.

    Article  Google Scholar 

  9. Neuberger JS, Ward-Smith P, Morantz RA, Tian C, Schmelzie KH, Mayo MS, Chin TD. Brain cancer in a residential area bordering on an oil refinery. Neuroepidemiology. 2003;22(1):46–56.

    Article  PubMed  Google Scholar 

  10. Langer P, Kocan A, Tajtakova M, Petrik J, Chovancova J, Drobna B, Jursa S, Pavuk M, Trnovec T, Seböková E, Klimes I. Human thyroid in the population exposed to high environmental pollution by organochlorinated pollutants for several decades. Endocr Regul. 2005;39(1):13–20.

    PubMed  CAS  Google Scholar 

  11. Rádiková Z, Tajtáková M, Kocan A, Trnovec T, Seböková E, Klimes I, Langer P. Possible effects of environmental nitrates and toxic organochlorines on human thyroid in highly polluted areas in Slovakia. Thyroid. 2008;18(3):353–62.

    Article  PubMed  Google Scholar 

  12. CETESB 2008. Available at: http://www.cetesb.sp.gov.br>. Accessed on 2 April 2010

  13. Akamizu T, Amino N, De Groot LJ. Hashimoto’s thyroiditis. Thyroid Disease Manager 2008. Available at:http://www.thyroidmanager.org/Chapter8/8-contents.htm. Accessed on 6 March 2011

  14. Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med. 1996;335(2):99–107.

    Article  PubMed  CAS  Google Scholar 

  15. Esteves RZ, Kasamatsu TS, Kunii IS, Furuzawa GK, Vieira JGH, Maciel RMB. Development of a semi-automated method of measuring urinary iodine and its application in epidemiological studies in Brazilian schoolchildren [Port]. Brazilian Arch Endocrinol Metab. 2007;51/9:1477–84.

    Article  Google Scholar 

  16. Zaccarelli-Marino MA, Martins LC, Esteves RZ, Kasamatsu TS, Maciel RMB. Urinary iodine in patients with auto-immune Thyroid disorders in Santo André, SP, is comparable to normal controls and has been steady for the last 10 years [Port]. Brazilian Arch Endocrinol Metab. 2009;53/1:55–63.

    Article  Google Scholar 

  17. Paknys G, Kondrotas AJ, Kevelaitis E. Risk factors and pathogenesis of Hashimoto’s thyroiditis. Medicina (Kaunas). 2009;45(7):574–83.

    Google Scholar 

  18. Rose NR, Rasooly L, Saboori AM, Burek CL. Linking iodine with autoimmune thyroiditis. Environ Health Perspect. 1999;107:749–52.

    PubMed  CAS  Google Scholar 

  19. Prummel MF, Strieder T, Wiersinga WM. The environment and autoimmune thyroid diseases. Eur J Endocrinol. 2004;150:605–18.

    Article  PubMed  CAS  Google Scholar 

  20. Aminorroaya A, Janghorbani M, Amini M, Hovsepian S, Tabatabaei A, Fallah Z. The prevalence of thyroid dysfunction in an iodine-sufficient area in Iran. Arch Iranian Med. 2009;12(3):262–70.

    Google Scholar 

  21. Langer P, Tajtáková M, Fodor G, Kocan A, Bohov P, Michálek J, Kreze A. Increased thyroid volume and prevalence of thyroid disorders in an area heavily polluted by polychlorinated biphenyls. Eur J Endocrinol. 1998;139(4):402–9.

    Article  PubMed  CAS  Google Scholar 

  22. Delange F, Benker G, Caron Ph, Eber O, Ott W, Peter F, Podoba J, Simescu M, Szybinsky Z, Vertongen F, Vitti P, Wiersinga W, Zamrazil V. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol. 1997;136:180–7.

    Article  PubMed  CAS  Google Scholar 

  23. Gilbert KM, Griffin JM, Pumford NR. Trichloroethylene activates CD4+ T cells: potential role in an autoimmune response. Drug Metab Rev. 1999;31(4):901–16.

    Article  PubMed  CAS  Google Scholar 

  24. Griffin JM, Blossom SJ, Jackson SK, Gilbert KM, Pumford NR. Trichloroethylene accelerates an autoimmune response by Th1 T cell activation in MRL +/+ mice. Immunopharmacology. 2000;46:123–37.

    Article  PubMed  CAS  Google Scholar 

  25. Gist GL, Burg JR. Trichloroethylene: a review of the literature from a health effects perspective. Toxicol Ind Health. 1995;11:253–307.

    PubMed  CAS  Google Scholar 

  26. Agency for Toxic Substances and Disease Registry (ATSDR). National exposure registry, trichloroethylene subregistry baseline technical report (revised). 1994. US Department of Health and Human Services, Public Health Service, Atlanta, GA.

  27. Selgrade MK. Immunotoxicity: the risk is real. Toxicol Sci. 2007;100(2):328–32.

    Article  PubMed  CAS  Google Scholar 

  28. Rizzo M, Rossi RT, Bonaffini O, Scisca C, Altavilla G, Calbo L, Rosano A, Sindoni A, Trimarchi F, Benvenga S. Increased annual frequency of Hashimoto’s thyroiditis between years 1988 and 2007 at a cytological unit of Sicily. Ann Endocrinol (Paris). 2010;71(6):525–34.

    Article  CAS  Google Scholar 

  29. Benvenga S, Trimarchi F. Changed presentation of Hashimoto’s thyroiditis in North-Eastern Sicily and Calabria (Southern Italy) based on a 31-year experience. Thyroid. 2008;18(4):429–41.

    Article  PubMed  CAS  Google Scholar 

  30. Vanderpump MPJ, Tunbridge WMG. The epidemiology of thyroid diseases. In: Braverman LE, Utiger RD, editors. Werner and Ingbar’s The Thyroid: A Fundamental and Clinical Text, 8/E. Philadelphia: JB Lippincott- Raven; 2000. p. 467–73.

    Google Scholar 

  31. PetrochemicalComplexABC2008.Availableat:attp://www.agenciabrasil.gov.br/noticias/2008/02/22.Accessed on 12 December 2009.

  32. Landrigan PG. Children as a vulnerable population. Int J Occup Med Environ Health. 2004;17(1):175–7.

    PubMed  Google Scholar 

  33. Freitas CU, Campos RAG, Silva MAFR, Panachão MRI, Moraes JC, Waissmann W, Chacra AR, Maeda MYS, Rodrigues RSM, Belchor LG, Barbosa SO, Santos RTM. Can living in the surroundings of a petrochemical complex be a risk factor for autoimmune thyroid disease? Environ Res. 2010;110:112–7.

    Article  PubMed  Google Scholar 

  34. Kilburn KH, Washaw RW. Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well. Environ Res. 1992;57:1–9.

    Article  PubMed  CAS  Google Scholar 

  35. Lockey JE, Kelly CR, Cannon GW, Colby TV, Aldrich V, Livingston GK, Lockey JE, Kelly CR, Cannon GW, Colby TV, Aldrich V, Livingston GK. Progressive systemic sclerosis associated with exposure to trichloroethylene. J Occup Med. 1997;29:493–6.

    Google Scholar 

  36. Martin A, Barbesino G, Davies TF. T-cell receptors and autoimmune thyroid disease-signposts for T-cell-antigen driven diseases. Int Rev Immunol. 1999;18:111–40.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

To our patients for all of their information and understanding.

To Professor Walter Bloise, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, we grant a special recognition for his important support in the elaboration of this paper.

To Antonio Achur, MD, for laboratory examinations (Fleming Laboratory) and to Edson R. Iglezias, MD, for Image examinations (DISA), Santo André, SP, Brazil, for their collaboration and confidence.

To Professors Rui M. B. Maciel and Roberto Z. Esteves, PhD, at the Federal University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (UNIFESP), São Paulo, SP, Brazil, for their collaboration and confidence.

To Professor Éder Quintão, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, for his trust and support.

To Professor Paulo H. N. Saldiva, PhD, at the University of São Paulo Medical School, Pathology Department, Laboratory of Atmospheric Pollution (FMUSP), São Paulo, SP, Brazil, for his collaboration, trust and support.

Conflicts of Interest

The author declares that she has no conflicts of interest that could be perceived as affecting the impartiality of the research reported. In particular, this study did not receive any support from industry or the makers of the studied compounds.

Author information

Authors and Affiliations

  1. Rua Dr. Gabriel dos Santos, 405 -20° Andar, São Paulo, SP, CEP: 01231-011, Brazil

    Maria Angela Zaccarelli-Marino

  2. Internal Medicine Department, Endocrinology Service, ABC Foundation Medical School, Santo André, SP, Brazil

    Maria Angela Zaccarelli-Marino

  3. Internal Medicine Department, Endocrinology Service, University of São Paulo Medical School, São Paulo, SP, Brazil

    Maria Angela Zaccarelli-Marino

Authors
  1. Maria Angela Zaccarelli-Marino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Angela Zaccarelli-Marino.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zaccarelli-Marino, M.A. Chronic Autoimmune Thyroiditis in Industrial Areas in Brazil: A 15-Year Survey. J Clin Immunol 32, 1012–1018 (2012). https://doi.org/10.1007/s10875-012-9703-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10875-012-9703-2

Keywords

Search

Navigation