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This version published online on November 30, 2004
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1821
A more recent version of this article appeared on February 1, 2005
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Submitted on September 14, 2004
Accepted on November 17, 2004

The Effect of Perchlorate, Thiocyanate, and Nitrate on Thyroid Function in Workers Exposed to Perchlorate Long-Term

Lewis E. Braverman*, XueMei He, Sam Pino, Mary Cross, Barbarajean Magnani, Steven H. Lamm, Michael B. Kruse, Arnold Engel, Kenny S. Crump, and John P. Gibbs

Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston, MA, USA; Section of Endocrinology, Diabetes & Nutrition, Boston Medical Center, Boston, MA, USA; Section of Endocrinology, Diabetes & Nutrition, Boston Medical Center, Boston, MA, USA; Department of Radiology, Boston Medical Center, Boston, MA, USA; Department of Laboratory Medicine, Boston Medical Center, Boston, MA, USA; Consultants in Epidemiology and Occupational Health, Washington, DC, USA; Consultants in Epidemiology and Occupational Health, Inc., Washington, DC, USA; Consultants in Epidemiology and Occupational Health, Inc., Washington, DC, USA; Environ, Ruston, LA, USA; Health Management Division, Kerr-McGee Shared Services LLC, Oklahoma City, OK, USA

* To whom correspondence should be addressed.
Lewis E. Braverman, E-mail: Lewis.Braverman{at}bmc.org

Perchlorate (ClO4-) and thiocyanate (SCN-) are potent and nitrate (NO3-) a weak competitive inhibitor of the thyroid NIS. To determine the effects of long-term, high ClO4- exposure on thyroid function, we conducted a study of 29 workers employed for at least 1.7 yr (50% over 5.9 yr) in an ammonium ClO4- production plant in Utah. Serum ClO4-, SCN- and NO3-; serum T4, FTI, TT3, Tg and TSH; 14-hour thyroid radioactive iodine uptake (RAIU); and urine iodine (I) and ClO4- were assessed after three days off (Pre) and during the last of three, 12-hour night shifts in the plant (During) and in 12 volunteers (C) not working in the plant. Serum and urine ClO4- were not detected in C; urine ClO4- was not detected in 12 of 29 Pre workers and was 272 µg/L in 17; serum ClO4- was not detected in 27/29 Pre; and serum and urine ClO4- were markedly elevated during ClO4- exposure to 868 µg/L and 43 mg/g creatinine respectively. Serum SCN- and NO3- concentrations were similar in all groups. Thyroid RAIUs were markedly decreased in During compared with Pre (13.5 vs. 21.5%, P < 0.01, paired t) and were associated with an increase in urine I excretion (230 vs. 148 µgI/g Cr, P = 0.02, paired t) but were similar to those in the C group (14.4%). Serum TSH and Tg concentrations were normal and similar in the three groups. Serum T4 (8.3 vs. 7.7 µg/dl), FTI (2.4 vs. 2.2) and TT3 (147 vs. 134 ng/dl) were slightly, but significantly increased in the During vs. Pre workers (P < 0.01, paired t). Thyroid volumes and patterns by ultrasound were similar in the 29 workers and 12 community volunteers. Conclusion: High ClO4- absorption during three nights work exposure decreased the 14-hour thyroid RAIU by 38% in ClO4- production workers compared with the RAIU after three days off. However, serum TSH and Tg concentrations and thyroid volume by ultrasound were not affected by ClO4- suggesting that long-term, intermittent, high exposure to ClO4- does not induce hypothyroidism or goiter in adults.
Key words: perchlorate • thiocyanate • nitrate • RAIU • thyroid function • occupational




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