GOITRE IN NEW ZEALAND

Manawatu Times, Volume XLIX, Issue 2713, 22 June 1925, Page 6

GOITRE IN NEW ZEALAND

Its Relation To lodine In Soil VALUABLE REPORT ON PREVENTION AND CURE The Health Department has received a valuable report on “Endemic Goitre in New Zealand,” from Professor Hercus, with whom have associated in this inquiry Professor W. N. Benson, Professor of Geology, and Mr C. L. Carter, Lecturer on Chemistry. •Important extracts are given below: Dr. It. M'Carrison, who was in charge of the Deficiency Diseases Inquiry in England, and who is probably the most eminent British authority on the subject of goitre, in concluding a lecture on “Simple Goitre,” recently said: —“I have beea prompted to write this brief outline of our present knowledge of the causes of goitre, because this knowledge is now sufficiently definite to enable us to prevent and to cure this condition. The prevention of goitre is a matter of . attention to food and water supply, to individual and to general hygienic conditions of life, and to the various needs of the body for iodine.” As indicating the prevalence of goitre in New Zealand, it may be mentioned that the routine school medical. inspection for 1924 shows that out of a total of 55,000 children examined goitre (of different degree) existed in 18.33 per cent., made up as follows: —Incipient, 12.53 per cent.; small, 5 per cent.; medium 7 per cent.; large, 11 per cent. Following is in part the report of Professor Hercus and his associates; New Zealand Healtfi Advantages. “The climatic advantages of New Zealand are accompanied by a relatively high standard of general sanitation ana of personal hygiene. There is a well-organised and active Department of Health, with Division of Public Hygiene, Iniant Welfare, School Hygiene, Maori Hygiene, Dental Hygiene, and Food and Drugs. These agencies combine to produce a reasonably satisfactory standard of general health, as is shown by such delicate indices as the infantile mortality rate (41.8 9), the typhoid morbidity rate (.41), and the crude death rate (8.77). . . The high average health in New Zealand makes all. the more noteworthy the presence of endemic goitre to marked extent among both the Maori and European population. "It w r as only after an absence of over five years from his native soi of Canterbury that one of us (Professor Hercus) realised the extent of its endemic goitre problem, and endeavoured to determine with some degress of accuracy its incidence. This work was extended throughout the country, and led to the chemical and geological studies which are here presented. School Children: 31 Per Cent. Affected. “As a result of the studies here presented, we have established the fact that goitre is widely prevalent in New Zealand (31 per cent, of the school children are affected by it), and that its incidence is in general roughly inversely proportional to the average amount of iodine in the soil, which determines the amount of iodine in the plant and animal food consumed by the population of the district. Where exceptions to this occur, it has been shown that the requhed iodine is supplied in drinking water rather than in foods. "It may bo worthy of note that the majority of the analyses were made before the sources of the'- samples were disclosed or the reginal incidence of goitre ascertained. Any unconscious bias on the part of thi analysts has thus been practically eliminated. Causation of the Disease. “This leads us to infer that so far as this country is concerned the most important factor in the causation of the disease is an iodine intake below the safety limit. “We conclude, therefore, that in districts where the disease is endemic .and where the soils and food have been shown to be deficient in iodine, the iodine should be supplied by adding minute quantities of the element to some widely-used article w* diet. Evidence of the value and the harm, lessness of this procedure is advanced in a discussion of prophylactic measures that are being investigated. . . The amount of iodine in the soil is the determining factor. Arising also from these studies is the question of the distribution oi lodine in the soils and waters in relation to the geological formations from which they are derived, and also the question of the source of iodine in these' formations. Investigation in Canterbury. In April, 1920, one of us, assisted by Dr. Eleanor Baker of the School Medical Service, set, out to establish accurately the extent to which thyroid enlargement prevailed amongst the school children of Canterbury and Westland. The majority of the children examined were in the age group of five to fourteen years. “The results may be summarised as follow:—14,910 children examined; 39 per cent, were found to have normal, and 61 per cent, enlarged, thyroids. . . Goitre was also found in many species of animals in the district. An account is also given of an extension of the survey of goitre throughout Now Zealand including the Maoris in the llrewa Country. Approximately, 18 per cent, of the Maoris there were found to be affected. Amount of lodine in Soil. "In order to ascertain if possible the geographical factors (including ! the geological) influencing the incidence of goitre, we have divided the country into 33 districts of varying size, each more or less uniform in regard to its geographical conditions, and have determined the average amount of iodine in a representative series of soils from each. In each

district also has been determined the average incidence of goitre as determined by the examination of school children by the State medical officers: , Percentage Crude Incidence Average of of lodine District. Goitre In Soil. Stewart Island .... - 87

"Assuming that the fundamental factor in the causation of goitre is a deficient Intake of iodine, the prevention of the disease should be a comparatively simple problem. . . . “In 1917 Marino and Kimball renewed the attempt abandoned on the Continent to apply iodine prophylaxis to man. In the endemic district of Ohio they worked on 1000 school girls of the age period when thyroid enlargement is most frequently developed, using adequate controls. They gave four grammes of sodium iodine in 0.2 gramme doses daily for ten consecutive school days during the spring and autumn, terms. Their results were extremely good. Thus at the end of thirty months 283 normal girls, who had taken the iodine showed no cases of goitre, whereas out of 205 normal control girls who had not taken the treatment OS showkod definite signs of goitre. In Switzerland also the prophylaxis of goitre amongst school children has been extensively practised with extremely good results. The Best Method. "We believe that the best method of prophylaxis, considered on physiological grounds, as well as those of efficiency and economy, would be derived from daily ingestion of minute amounts of iodine, by the utilisation for all culinary and tabS9 purposes of an iodised salt, In which 1 part of potassium lodide had been added to 100,000 of sodium chloride —the method which has been attended by such satisfactory results in Switzerland. This would afford the minimum amount of .01 mg. per day, which seems necessary for the functional requirements of the thyroKV gland, while it would be far toe small to have any 111 effects In the production qf hyperthyroidism/'

Bluff 21 20 Invercargill a n d Southland 35 20 Waimea Plains 31 6 Clutha Valley 40 4 Taieri Valley and Milton 30 G Dunedin 19 32 North Otago 37 13: South Canterbury ” 62 — 3 Christchurch ”. . C4 9 Banks Peninsula 31 9 North Canterbury 58 6 Marlborough 38 3 Nelson 29 17 West Coast 5 2 12 Wellington .... 25 40 Hutt Valley .... 41 1G Walrarapa a n Danncvirke d 2G 24 Hawke’s Bay 1.5 .9 Gisborne 1.4 13 Horowlionua 4 133 Palmerston a n Marton d 1-5.5 9 Wanganui a n Patoa d 44 8 Taranaki 4 166 Main Trunk Line 22 — Taumarunul 35 14 West Coast and Te Kulti 59 25 Waikato and Piako Valley 7 0 55 Taupo and Rotorua 69 TO Bay of Plenty .. 2 G IS Cape Colville Penininsula 2 11 Auckland 4 158 North Auckland 3 53 Prevention of Goitre.