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Hypothyroidism Rising Among Newborns in Humboldt Co After the Fukushima Nuclear Meltdown

April 2, 2013 3 comments
This report appeared in the Open Journal of Pediatrics.  The study found that newborns in the Pacific Northwest have experienced a sharp rise in infant hypothyroidism following the Fukushima nuclear disaster, bucking a nationwide declining trend.  Eureka Ca had the biggest change in hypothyroidism rates of all the sites surveyed.  Radioactive iodine, released in large quantities from the crippled nuclear power plant, tends to accumulate in the thyroid where it can interfere with normal thyroid function and cause cancer.
Open Journal of Pediatrics, 2013, 3, 1-9
OJPed
doi:10.4236/ojped.2013.31001 Pub
lished Online March 2013 (
g/journal/ojped/
)
Published Online March 2013 in SciRes.
Elevated airborne beta levels in Pacific/West Coast US
States and trends in hypothyroidism among newborns
after the Fukushima nuclear meltdown
*
Joseph J. Mangano, Janette D. Sherman
Radiation and Public Health
Project, New York, USA
Email:
odiejoe@aol.com
Received 2 October 2012; revised 24 De
cember 2012; accepted 29 January 2013
ABSTRACT
Various reports indicate that the incidence of con-
genital hypothyroidism is increasing in developed
nations, and that improved detection and more inclu-
sive criteria for the disease do not explain this trend
entirely. One risk factor documented in numerous
studies is exposure to radioactive iodine found in nu-
clear weapons test fallout and nuclear reactor emis-
sions. Large amounts of fa
llout disseminated world-
wide from the meltdowns in
four reactors at the Fu-
kushima-Dai-ichi plant in Japan beginning March 11,
2011 included radioiodine isotopes. Just days after
the meltdowns, I-131 concentrations in US precipita-
tion was measured up to 211 times above normal.
Highest levels of I-131 and airborne gross beta were
documented in the five US States on the Pacific Ocean.
The number of congenital hypothyroid cases in these
five states from March 17-December 31, 2011 was
16% greater than for the same period in 2010, com-
pared to a 3% decline in 36
other US States (p < 0.03).
The greatest divergence in these two groups (+28%)
occurred in the period March
17-June 30 (p < 0.04).
Further analysis, in the US and in other nations, is
needed to better understand any association between
iodine exposure from Fuku
shima-Dai-ichi and con-
genital hypothyroidism risk.
Keywords:
Congenital Hypothyroidism;
Fukushima-Dai-Ichi; Iodine; Nuclear
1. INTRODUCTION
1.1. Rise in Congenital Hypothyroidism
Incidence Not Well Understood
Since the development of a simple blood spot test
through a neonatal heel prick in the 1960s [1], newborns
in developed nations have been routinely screened for
congenital hypothyroidism. CH is a disorder that results
in stunted growth, lowered
intelligence, deafness, and
neurological abnormalities [2], but can be effectively
treated if detected early. Increased incidence has been
observed during the past two decades, including the
United States, Australia, Italy, the United Kingdom, and
Greece [3-7]. In the
U.S., the rate in
creased 75.3% from
1987 to 2002 [3]. While changes in American laboratory
practices and screening methods along with changes in
proportions of multiple pregna
ncies, race, birth weight,
and gender in the population may explain some of the
increase, several reports conclude that there are other,
unknown factors that account for this temporal trend
[3,8-11].
Environmental factors pose
one possible cause of
these increases. One report examining the potential risk
of CH from perchlorate in drinking water found no asso-
ciation [12]. Another found significant links between CH
risk and levels of dioxin-like compounds and organo-
chloride pesticides detected
in the maternal breast milk
[13].
1.2. Exposure to Radioactive Iodine as a Factor
in Congenital Hypothyroidism
Another potential environmental risk factor is prenatal
exposure to radioactive iodi
ne isotopes, which seek out
the susceptible fetal thyroid gland. For decades radioac-
tive iodine has been recognized to cause adverse effects
(including hypothyroidism) to the thyroid gland. The
fetal thyroid, the first glandular structure to appear in the
human embryo [14], begins to concentrate iodine and
produce thyroid hormones by the 70
th
day of gestation
[15]. In the mid-1950s, during the period of atmospheric
nuclear weapons tests, I-131 produced by fission was
first detected in the adult human thyroid [16,17]. I-131
concentrations were calculated to be about 10 times
higher in the human fetal thyroid vs. the human adult or
hog thyroid [18], and maximum elevations in fetal thy-
*
There were no direct sponsors for th
is research, as the authors devel-
oped the manuscript independently. Mangano is an employee of the
Radiation and Public
Health Project.

J. J. Mangano, J. D. Sherman / Open
Journal of Pediatrics 3 (2013) 1-9
Copyright © 2013 SciRes.
OJPed
2
roids were detected approximately one month after nu-
clear explosions [19]. The main path of exposure to short-
lived isotopes such as I-131 is via dairy products due to
radioactive fallout deposition on forage [20].
One report on relatively low doses of I-131 exposures
to rat embryos resulted in large decreases in fetal thy-
roxine and increases in Thyroid Stimulating Hormone
(TSH), dependent upon the time of pregnancy that the
exposure occurred [21]. A recent analysis discovered
levels of whole blood iodine in three infants from Ore-
gon (US) screened at birth
exceeded the average for con-
trols by a factor of 10 [22].
While anthropogenic radioactive iodine has existed
following the discovery of fission in the 1940s, relatively
few studies have examined the potential association be-
tween iodine exposure to the fetus and CH risk. The
massive hydrogen bomb explosion “Bravo” on March 1,
1954 resulted in high doses to residents of the Marshall
Islands and various thyroid disorders, including hypo-
thyroidism in the child and adult. However, only two
cases of CH were detected in the relatively small popula-
tion [23,24]. In the five areas closest to the Chernobyl
nuclear meltdown, the highest prevalence of hypothy-
roidism in children was observed in Gomel, the area with
the highest exposures [25]. An examination of 160,000
local children exposed to Ch
ernobyl fallout before age
ten found a link with I-131 exposure and risk of juvenile
hypothyroidism [26].
In Pennsylvania (US), the site of the March 1979 par-
tial meltdown at the Three Mile Island nuclear power
plant, the change in CH in nine month period before and
after the event differed in
upwind/western area (8 to 7
cases) and downwind/eastern areas (9 to 20 cases). [27,
28] The peak of I-131 from Chernobyl fallout in May
1986 in US milk was three times greater in northwest
states than in southeast states; 1984-1985 vs. 1986-1987
changes in CH rates was +23.3% in the northwest and
1.0% in the southeast [29]. I-131 exposure due to re-
leases from the Hanford (U.S.) nuclear weapons installa-
tion found a significantly el
evated number of preterm
births, which are linked to risk of CH [30]. The CH rate
closest to the Savannah River (US) nuclear weapons
plant was not found to be elevated [31].
More recently, CH rates of the four counties closest to
the Indian Point, New York (US) nuclear plant, located
mostly under 20 miles, are about twice that of the US,
and especially high in the
most recent period available
[32]. The 1970-1993 total of airborne I-131 and particu-
lates released by Indian Point was the 5
th
greatest of 72
nuclear plants [33]. Data in
Table 1
reflect official com-
plications from state screening programs [34].
The meltdowns of four nucl
ear reactors at the Fuku-
shima-Dai-ichi plant in Japan that began on March 11,
2011 after an earthquake and tsunami creates another ba-
sis to examine any potential
effects of radioiodine expo-
sure on CH rates. This report will review temporal CH
trends in the US following the meltdowns, comparing
those areas having elevated ra
dioactivity with the rest of
the US.
2. METHODS
2.1. Measuring Exposures from Fukushima
Meltdown
The first of two major components needed to examine a
potential association between Fukushima fallout and CH
risk is exposure levels. Estimates of emissions from Fu-
kushima are not precise; the
reactors are not stable and
are releasing radioactivity
. Worldwide measurements
show that 16,700 Peta-Becquerels of Xenon-133 were
emitted by fall 2011, about 2.5 times more than that re-
leased by the 1986 Chernobyl meltdown. [35] Other re-
ports place Fukushima emissions below Chernobyl’s.
In the US, the plume arrived
in the air above the west
coast states on March 15, just four days after the start of
the meltdowns [36]. US Environmental Protection Agen-
cy (EPA) measurements of I-131 in air, water, and milk
were relatively few in number, and thus it is not possible
to derive reliable geographic differences from these data.
The most I-131 readings in the US environment were
taken in precipitation, with 77 such measurements re-
ported from March 22 to April 12, 2011. Detectable lev-
els of I-131 in precipitation largely disappeared after this
period; of the 10 measurements on April 14, five were
“not detectable” and the others
were just slightly above
detectable levels of about 2.0 picocuries per liter [37].
Table 1.
Congenital hypothyroid rates countie
s closest to Indian point nuclea
r site compared to US, 1997-2007.
Area
Cases Live Births Cases/100,000 Live Births 95% CI % vs. US P value
*
Four Counties, 1997-2004 135 185,099
72.93
90.6 – 85.2 +70.7 <0.0001
*
Four Counties, 2005-2007 73
68,019
107.32
82.7 – 131.9 +151.2 <0.0001
*
Total 1997-2007
208 253,118
82.18
90.6 – 85.2 +92.4 <0.0001
US, 2001-2005
8569 20,060,577
42.72
*
Includes orange, putnam, rockland, and Westchester counties.

J. J. Mangano, J. D. Sherman / Open
Journal of Pediatrics 3 (2013) 1-9
Copyright © 2013 SciRes.
OJPed
3
Table 2
shows the distribution of the 77 measure-
ments of I-131, covering 30 sites. After Fukushima, only
7 of 77 readings produced a “not detectable” result. But
18 of 77 measurements were 40 pCi/l or greater, at least
20 times above normal. The greatest concentrations were
detected in Boise ID (242, 394, and 422), or 121-211
times above normal. Boise is
in the northwest U.S., but
the highest ten measurements included the East Coast
cities of Jacksonville FL (148) and Boston MA (92).
These data support the conclusion that I-131 from Fuku-
shima entered the environment across the entire nation.
The Pacific Northwest National Laboratory docu-
mented that airborne levels of Xenon-133 in Washington
State, on the Pacific coast,
were 10,000 to 100,000 times
greater than normal in the
week following the disaster
[38]. Xe-133 is a gas that travels more rapidly than other
isotopes, but frequently is a
tracer for future spatial pat-
terns of other radionuclides. Moreover, Washington State
was the site of radioactive “h
ot particles” soon after Fu-
kudhima [39].
A team from California State University-Long Beach
measured I-131 in kelp on the California coast on April
20, 2011 just over a month after the Fukushima melt-
downs. The highest levels in the dry seaweed were found
in Orange County in southern California (250 times
greater than before the accident
), Santa Cruz in northern
California (200 times greater), and Los Angeles County
(60 times greater) [40]. In New Hampshire, close to the
Atlantic coast, during the period March-May 2011 I-131
doubled from prior periods [41].
A national study conducted by the National Geological
Survey examined concentrations of wet depositions of
fission-produced isotopes in soil at sites across the US,
for several radioisotopes, between March 15 and April 5,
Table 2.
Measurements of I-131 in US precipitation March 22
to April 12, 2011.
Concentration I-131 (pCi/l) No. Measurements
N.D.
*
7
0.0 – 1.9
1
2.0 – 9.9
21
10.0 – 19.9
18
20.0 – 39.9
12
40.0 – 69.9
6
70.0 – 99.9
4
100.0- 8
TOTAL 77
*
Not detectable, or probably around normal levels of 2.0.
2011. Results showed that for I-131, the highest deposi-
tions, in becquerels per cubic meter, occurred in north-
west Oregon (5100), central California (1610), northern
Colorado (833), coastal California (211), and western
Washington (60.4). No other station recorded concentra-
tions above 13. Similar results were observed for Ce-
sium-134 and Cesium-137 [42]. All the cited locations
are on or near the Pacific
coast, with the exception of
Colorado, in the western US.
Thus, the data indicate the greatest concentrations of
environmental I-131 in the continental US after Fuku-
shima occurred on the west coast. While the excess is
difficult to quantify precisely, for purposes of this report
comparisons in airborne gross beta concentrations will be
made between the five Pacific and West Coast states
(Alaska, California, Hawaii,
Oregon, and Washington)
and the remainder of the nation. The source of data is the
US Environmental Protection Agency’s twice-weekly
measurements in nearly 100 US locations, creating a
large sample of hundreds of measurements in the weeks
after the arrival of Fukushima fallout.
2.2. Collecting Data on Congenital
Hypothyroidism Incidence
The other principal component in this dose-response
comparison involves CH incidence. Each of the 50 US
states maintains newborn screening program results, in-
cluding CH cases. Because only annual data is made
easily available on the internet, we conducted a tele-
phone survey of states, requesting monthly numbers of
CH cases, for each month in
2010 and 2011,
according to
the date of the baby’s birth. Cases from births of March 1
– 16 and March 17 – 31 were separated to define the pe-
riod after the arrival of Fukushima fallout in the US.
States were asked to provide only confirmed primary
CH cases; these are newborns who test positive for the
condition, and require therapeutic intervention to avoid
adverse health effects. Transient CH cases are mostly
newborns not confirmed to have CH, and secondary CH
cases are not recorded by all states. State programs were
also asked to confirm that there was no change in CH
definitions between 2010 and 2011 that would bias any
temporal comparison. State definitions vary by thyroxine
and TSH thresholds, so no valid intra-state comparisons
can be made.
Calculating CH rates of cases per live births is not
possible at this time, as final birth totals are not yet
available. Official preliminary data indicate that there
will be a 1 percent 2010-2011 decline in U.S. births [43];
thus, comparing the number of CH cases for large popu-
lations should prove highly accu
rate as a predictor of the
rate. In 2010, the five Pacific/West Coast States had a
total population of 49,880,102 (16.2% of the US total of

J. J. Mangano, J. D. Sherman / Open
Journal of Pediatrics 3 (2013) 1-9
Copyright © 2013 SciRes.
OJPed
4
308,745,538) [44], and accounted for 693,676 (16.8%) of
the 4,130,665 US births in 2009 [45].
CH cases for births in the periods March 17 to De-
cember 31 (2010 and 2011)
will be compared, for the
Pacific/West Coast States and the remainder of the US
Portions of this 290 day period will also be compared.
Significance testing will be conducted using a t test,
where n equals the number of Pacific/West Coast cases
in 2010 and 2011, the observed change will be the
change in the Pacific/West Coast, and the expected
change will be the change for the remainder of the US.
3. RESULTS
3.1. Largest US Radiation Increases after
Fukushima in Pacific/West Coast States
A review of US Environmental Protection Agency (EPA)
data measuring airborne levels of gross beta was con-
ducted, to compare 2010 and 2011 levels. The EPA uses
air filters to measure aerosols at points close to ground
level. The Agency typically does measurements about
twice a week for 69 US sites.
At the time of the analysis,
data were only available up to October 4, 2011, and thus
results for the periods January 1 to October 4 were com-
pared for 2010 and 2011 [46]. Beta measurements in-
clude a variety of radioisotopes, of which I-131 is a por-
tion, meaning gross beta as a proxy for relative expo-
sures to the thyroid gland.
The largest amounts of radioactive fallout in the US
environment from Fukushima occurred in late March and
all of April 2011, before declining to levels typically re-
corded in 2010. Thus, 2010-2011 comparisons were made
for two periods. The first was March 15-April 30, and
the second was the remainder of the period (January 1-
March 14 plus May 1-October 4).
To identify an “exposed” po
pulation, we selected 18
EPA stations in the five Pacific/West Coast States for
which at least 20 gross beta measurements were made
during both 2010 and 2011. Many stations had consid-
erably more, and thus a total of 1,043 and 1,083 meas-
urements were used in the two years for the 18 stations.
We identified a “control” group representing the re-
mainder of the US. Thus, 31 sites were selected, repre-
senting a wide geographic diversity. These sites recorded
59 to 79 airborne beta m
easurements each year for the
288-day period January 1-October 4, approximately twice-
weekly measurements for the
entire period. In all, 2,211
and 2,057 measurements were
included in each respect-
tive year for the 31 sites. Th
e list of these 18 exposed and
31 control sites is given in Appendix 1.
The “average” beta for each group was calculated by
dividing the arithmetic mean by the number of sites (18
or 31).
Table 3
presents the changes in average beta for
exposed and control groups, for the periods of higher and
lower/no exposure.
The data show that in the 18 sites in the Pacific/West
Coast (“exposed”) was 7.345 times higher in the March
15-April 30 period, compared to just 2.397 in the 31
other sites (“controls”), a ratio of 3.06. For the rest of the
year, the 2010-2011 change was very small (0.983 and
1.018, a ratio of 0.97), which is expected due to the ab-
sence of Fukushima fallout in both years.
Observations for some sites showed especially large
increases. In the Pacific/West
Coast, the largest changes
were in the California citie
s of Eureka (increase of
38.264 times), Anaheim (14.941), and San Bernardino
(12.054). In the 31 control sites, the only increases above
4.2 times were observed in Tucson AZ (9.320) and Salt
Lake City UT (7.879), both located in the western US.
The lowest figures were found in the southeastern cities
of Baton Rouge LA (1.222) and Montgomery AL (1.212).
This shows that for all areas of the US, 2010-2011 gross
beta concentrations increased in the period March 15-
April 30. Thus, Fukushima fallout appeared to affect all
areas of the US, and was especially large in some, mostly
in the western part of the nation.
3.2. Congenital Hypothyroidism Incidence
Trends in US
With the greatest airborne gross beta increases docu-
mented on the west coast, we can assess any changes in
Table 3.
Change in average airborne gross beta concentration Paci
fic/West Coast sites (exposed) and other US sites (control)
2010-2011, periods of high and
low/no fallout from Fukushima.
2010 Average (n) 2011 Average (n) Change, 2010-2011
Period Exposed Control Exposed Control Exposed Control
High Fallout
March 15 – April 30 0.005112 (190) 0.008527 (401) 0.033016 (225) 0.020204 (378) 7.345 2.397
Low/No Fallout
Jan. 1-March 14 + May 1-Oct. 4 0.006027 (853) 0.009573 (1810) 0.005526 (858) 0.009670 (1679) 0.983 1.018
Figures are in picocuries of gross beta per cubic meter of air.

J. J. Mangano, J. D. Sherman / Open
Journal of Pediatrics 3 (2013) 1-9
Copyright © 2013 SciRes.
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5
CH incidence. All US newborns diagnosed with primary
CH born March 17-December 31, 2011 were exposed
in
utero
to radioactive fallout from the Fukushima melt-
downs. While these newborns were exposed at different
phases of pregnancy, effects of exposure is elevated dur-
ing the fetal period, compared to those during infancy,
childhood, and adulthood.
Phone calls to state newborn screening program coor-
dinators for monthly confirmed primary CH cases for
2010 and 2011 provided data for 41 of 50 states, repre-
senting 87% of all US births.
Included in the 41 states
were all five Pacific/West Coast States. Most of the other
states not sharing statistical data were small states with
under 10 cases per year, whose policies would not permit
release of small numbers of cases due to confidentiality
concerns. States reporting data are given in Appendix 2.
Table 4
presents the reported numbers of confirmed
primary CH cases for the fi
ve (5) Pacific/West Coast
States, along with cases fo
r the other 36 US States.
The 2010-2011 ratio representing the change in CH
cases was 1.16 for the five Pacific/West Coast States,
rising from 281 to 327 confirmed cases. The 1.16 ratio
exceeded the 0.97 ratio (dec
line in cases from 1208 to
1167) for the 36 control states; the difference is signifi-
cant at p < 0.03. Increases in
ratios were observed in the
exposed areas for the periods March 17-June 30 (1.28,
significant at p < 0.04) and
July 1-December 31 (1.10,
not significant at p < 0.21).
4. DISCUSSION
Congenital hypothyroidism (CH) incidence is rising in
various nations. Recent studies have examined patterns
of these increases; better detection and more liberal defi-
nitions of CH may explain some of this pattern, but there
is a general consensus that other factors are appearing to
affect temporal trends. A well-documented risk factor
affecting CH is exposure to the thyroid-seeking iodine
isotopes such as I-131. Previous sources have linked ele-
vated risk for hypothyroidism with nuclear weapons tests
and nuclear power inst
allations [22-34].
The meltdowns at the Fukushima-Daiichi nuclear
plant in Japan beginning March 11, 2011 present an op-
portunity to examine a recent e
xposure to radiation, not
just in Japan but in other nations that received the fallout.
In the US, government offici
als measured concentrations
of I-131 in precipitation up to 211 times above normal
during the weeks following the meltdowns. There were
increased concentrations of all beta-emitting radionu-
clides in the air during the six weeks following the be-
ginning of Fukushima fallout. Compared to the same
period a year earlier, the fallout increases were more than
seven times greater in the five Pacific/West Coast States,
compared to just over two times in the remainder of the
US.
For births March 17 to December 31, the 2010-2011
change in confirmed CH cases in the five Pacific/West
Coast States was significantly
greater than for 36 other
US States (p < 0.02). These 41 states represent 87% of
US births, meaning that this result likely represents the
pattern for the entire nation. The largest gap between the
two groups of states occurred in the period March 17 to
June 30, which represents fetuses exposed to environ-
mental radioiodine during the third trimester of preg-
nancy, after the thyroid gland is more fully developed
than in the first two trimesters.
Possible explanations for this finding should be con-
sidered. Prior research has shown that certain demo-
graphic groups are at greater
risk for CH, including fe-
male births, Hispanics, Asians, and births to older moth-
ers. However, it is highly likely that distribution in gen-
der, race/ethnicity, or maternal age changed little from
2010 to 2011. As mentioned, including all 50 states
might have changed the comparison, but the sample of
87% of US births used in this report yields results very
similar to the total. Knowing the number of live births
and calculating CH rates could change the results, but the
official estimate that live births will decline just 1 per-
cent from 2010 to 2011 makes this unlikely to explain
the difference between the two groups of states. The sta-
tistical significance of the findings (p < 0.03 for March
17-December 31 births, and p
< 0.04 for March 17-June
30 births) make random yearly fluctuation unlikely as an
explanation for the observed differences.
The potential for Fukushima fallout to contribute to
rising CH in the Pacific/West Coast area of the US can
only be explained if evidence of harm from relatively
Table 4.
Confirmed primary congenital hypothyroid cases Ma
rch 17-December 31 (2010 and 2011), 41 US States.
5 Exposed States
P value 36 Control States
Period 2010 2011 Ratio 2010 2011 Ratio
P
value
March 17-December 31 281
327 1.16 <0.03 1208 1167 0.97
March 17-June 30
95
122 1.28 <0.04 399 378 0.96
July 1-December 30
186
205 1.10
695 662 0.97
Note: For March 17-June 30 and July 1-December 31, the control state group excludes Indiana.

J. J. Mangano, J. D. Sherman / Open
Journal of Pediatrics 3 (2013) 1-9
Copyright © 2013 SciRes.
OJPed
6
low-dose radiation exposures is understood. Numerous
reports have identified elevated disease risk from low
radiation doses previously be
lieved to be non-hazardous,
or at least not able to be calculated using standard re-
search methods. The first of
these discoveries from the
late 1950s showed prenatal abdominal X-rays nearly
doubled the chance of the irradiated fetus dying before
age ten [47,48]. US government officials estimated I-131
exposures from milk contaminated by Nevada above
ground nuclear weapons tests in the period 1951 to 1958
[49], as the basis for the projection that as many as
212,000 Americans developed thyroid cancer from Ne-
vada test fallout [50]. US officials also concluded (based
on several dozen published studies) that occupational
exposures received by worker
s in nuclear weapons plants
caused a variety of cancers [51]. The consensus from
results of these and other studies was that risks to health
of radiation exposure follows a linear no-threshold model,
even at the smallest doses [52]. Thus, while environ-
mental levels of Fukushima fallout were thousands of
times greater near the stricken
plant than those in the US,
these relatively low (but el
evated) exposures should be
analyzed for any potential links with diseases.
There are limitations to the data in this report that call
for future actions to address them. One of these actions is
to examine individual exposu
res to newborns with CH,
but the practical feasibility of calculating these data is
very low. Another is to obtain more precise temporal and
geographic data on environmen
tal levels of specific ra-
dionuclides in the US after Fukushima, including I-131.
Moreover, estimating specific exposures to humans as a
consequence of the fallout would also be helpful in any
future analyses of health risk. In addition, there are tech-
nical changes that may be made to data in this report,
such as using a period greater than just 2010 as a base-
line; including data on CH cases after 2011; and conver-
sion of trends in cases to ra
tes when official numbers of
2010-2011 live births by state and month become avail-
able. Review of CH changes in states with the highest
exposures other than the Pacific/West Coast, which may
include adjoining western states, can also be considered.
The data presented in this paper, including both expo-
sure levels and CH incidence, should be considered as
preliminary. They require
confirmation and expansion,
including long-term follow-up of infants and other chil-
dren. However, the current findings should be noted, and
encourage the conduct of futu
re analyses of health ef-
fects from exposures to Fukushima fallout.
Congenital hypothyroidism can be used as one meas-
ure to assess any potential changes in U.S. fetal and in-
fant health status after Fukus
hima because official data
was available relatively promptly. However, health de-
partments will soon have available for other 2010 and
2011 indicators of fetal/infant health, including fetal
deaths, premature births, low weight births, neonatal
deaths, infant deaths, and birth defects. While any ad-
verse effects would first be ex
pected to affect the suscep-
tible fetus and infant, subsequent review of any changes
in health status of older children and adults can be pro-
ceed.
Understanding why CH rates have risen in developed
nations such as the U.S. is a complex task, as multiple
factors are likely involved. Exposure to radiation, espe-
cially the thyroid-seeking radioiodine isotopes, should be
considered as one of these fa
ctors. The meltdown at Fu-
kushima Dai-ichi presents an opportunity to analyze this
factor, and studies such as this one should continue.
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