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The main reasons to start investigations on IDD in Poland as a nationwide project of the Ministry of Health and Welfare sponsored by the State Committee For Scientific Research and Foundation for Polish Science were: cessation of iodizing of kitchen salt in Poland in 1980, increase of the incidence of goitre in the population and hyperthyrotropinemia in newborns, results of the survey undertaken after Chernobyl disaster indicating an increase of goiter incidence (Nauman et al.) and results of the pilot study (Gutekunst, Gembicki, Kinalska and Rybakowa) indicating an increase of thyroid volume and diminishing of iodine excretion in urine of children in Kraków, Białystok ad Poznań regions. Therefore the main goals of the project were as follows: to evaluate IDD in Poland on the population basis, to map goiter incidence and iodine deficiency in geographic areas, to evaluate a voluntary model of iodine prophylaxis in Poland (20 mg of KI/kg of salt). The investigations were carried out in 19330 children (48.7% of boys and 51.3% for girls) in age group 6-13 years, attending 111 coeducational randomly selected schools from all the country. This number represents 0.35% of children subpopulation in the above age-groups. For practical purposes local coordinating centers at the relevant Departments of Endocrinology and Board of Coordinators were set up. The programme of survey included: filling the questionnaire by children's parents, thyroid palpation and classification according to WHO and ICCIDD criteria, thyroid volume determination by means of ultrasonograph Kontron Sigma 1 L with linear transducer 7.5 MHz, determination of iodine in casual morning urine sample using Sandell and Kalthoff method. Determination of iodine concentration in urine was performed in each case of goiter and in the same number of children without goiter. The results were segregated according to coordinating centers and according to 6 geographical areas of the country. The results were calculated according to the descriptive statistics using Student's test, Chi-square test F-test and Leven's test. The results segregated according to geographic areas were tested by means of analysis of variance using the linear model. The final results of the programme are presented in the next papers.

Low levels of iodine, observed in endemic goiter areas, decrease the synthesis of T3 and T4. This phenomenon is particularly dangerous during pregnancy when demand for thyroid hormones increases considerably. Iodine deficiency may cause brain tissue damage of varying degree, even cretinism in most severe cases. The aim of the study was to make an initial evaluation of TSH and thyroid hormone levels, thyroid volume, and urine iodine excretion in pregnant women. The group under study consisted of 46 women, inhabitants of Kraków region. Their mean age was 26.8 years, 18 were primiparas and 28 multiparas. All deliveries were physiologica, vaginal, within the biological norm of 281 +/- 22 days from the last menstrual period. The concentrations of T3, T4 and TSH were determined in maternal and umbilical blood. Urine iodine levels were measured in the patients. Mean body weight of the newborns was 3338 g, mean pregnancy duration 39.6 weeks, and mean Apgar score 9.9. The results for maternal blood were (mean, SD in parentheses): T3 1.5 ng/ml (0.4), T4 11.6 micrograms% (2.9), TSH 2.3 microU/ml (1.2), thyroid volume 27.8 ml (15.2), urine iodine level 34.99 micrograms/l (29.12), and for umbilical blood T3 0.59 ng/ml (0.1), T4 10.6 micrograms/dl (2.1), FT3 1.28 pm/l (1.1), FT4 15.6 pm/l (4.8), TSH 3.7 microU/ml (0.9). Urine iodine level in pregnant women was several times lower than normal. 80% of the women under study had enlarged thyroid glands. We conclude that investigations of the problem should be continued.

Thyroid size was evaluated by ultrasonography and palpation during a study performed in 1992 and 1993 by PCCIDD. Statistical analysis was carried out in 15774 cases with thyroid volume measured by trained teams of doctors. The results were evaluated in 5 age group: 6-8, 9-10, 11-12, and 13 years. The upper limit of the thyroid volume in each age group was defined as mean for stage 0 (WHO) + 1 SD. Our upper limits of thyroid volume in age groups were: 6.1, 7.2, 8.4 and 9.1 ml, respectively. The highest frequency of goitre (according to ultrasound criteria) were in the Sudeten endemia region (53.1%), the lowest in the Seaside area (14.3%). Significant influence of age, sex, height, weight, place of living, and thyroid hormone containing drugs on thyroid size was proved. The influence of iodine prophylaxis on thyroid volume was not significant.

The study included 4103 school children attending randomly selected schools localized in towns and villages of 3 geographically distinct regions: mountainous, (Carpathian endemia), upland, lowland. The children were divided into four age-related groups. The incidence of goiter as detected by palpation was 38.1% in all the children studied, the value being similar in all three regions (38.1, 37.3 and 38.6%, respectively). Goiter incidence differs slightly among urban and rural children, amounting to 40.5 and 34.5%, respectively, in the two groups. In about 60% of children urinary iodine excretion was lower than 50 micrograms/l, while in about 30% it was normal. In about 10% of children studied urinary iodine excretion was lower than 20 micrograms/l. The results obtained indicate the occurrence among children of the studied region of goiter endemy of moderate degree. It was found that the percentage of children excreting more than 50 micrograms/l of urinary iodine was higher among those consuming iodized salt as compared to those consuming non-iodized salt. The first effects of resumption of common salt fortification with iodide in southern Poland can already be noted. There is, however, a need for optimization and steady control over this prophylactic action.

Epidemiologic studies following the Czernobyl accident were performed in region Kraków, including Kraków, Nowy Sacz and Kielce district. 1426 males and 2495 females were selected according to the random sample on the whole population of Kraków and Nowy Sacz, as well as in some selected areas in Swietokrzyski Mountains, and in Kielcecity. The aim of the study was to assess the results of the prophylaxis with Kalium iodine after the radiation and the incidence of the goiter in the population. It was stated, that 19.2% of the population in Kraków district, 16.9% in Nowy Sacz and 20% in Kielce received the prophylactic dosis of K.J. 80% took mainly the Lugol solution, between May, the 1st and 5th, 1986. Among 18 of person showing side effects like gastrointestinal disturbances, 16 were of female sex. Goiter incidence according to WHO classification was 50.7%, 67.3% and 49.9% in Kraków, Nowy Sacz and Kielce respectively. The difference between the incidence of goiter in males and females was 1:3. In women it was rather Ist and IInd degree of goiter, in men OB and Ist. Nodules of thyroid gland in the rural region of Kraków, Nowy Sacz and Kielce were seen in women in 10.8%, 1.7%, add 12.3% consecutively. Hormonal studies i.e T3, T4, TSH serum concentration showed normal results in all groups studied. TSH concentration was the highest in the group OB. The microsomal and antithyroglobulin antibodies level was the same independently on the prophylactic dosis of Lugol solution. The high incidence of thyroid diseases not related to the accident was observed.(ABSTRACT TRUNCATED AT 250 WORDS)