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BMJ. Sep 11, 1999; 319(7211): 659.
PMCID: PMC1116535

China moves to tackle iodine deficiency

China is aiming to eliminate iodine deficiency disorders by the end of the year 2000, although the government estimates that one third of its 1.3 billion people still live in areas where there is a low concentration of iodine in the local water supply.

Among the latest steps announced in the nationwide campaign was the opening this summer of the National Iodine Deficiency Disorders Reference Laboratory. The laboratory, which is housed at the Chinese Academy of Preventive Medicine in Beijing, will, as its primary task, provide China’s 31 provincial laboratories and its hundreds of local facilities with the reliable reference standards and quality control indicators that they need to monitor the problem.

According to Li Sumei, director of the national laboratory, the provincial and local facilities are sent samples of blood, urine, and salt twice yearly to see whether they can properly identify iodine levels. Among laboratories at the provincial level, 95%of the results fall within an “acceptable range of accuracy.”

But Dr Li admits that there are many problems with the local level laboratories because “the quality of the technicians is lower and they receive less training.” The new national laboratory’s other responsibilities include developing nationwide training programmes and teaching materials and reporting to the Chinese Ministry of Health on the progress of the campaign against iodine deficiency disorders.

In areas with sufficient concentrations of iodine in the water supply, locally produced meat, dairy products, and grain are expected to contain adequate amounts of dietary iodine. In many countries, especially those with coastlines, there is no need to add iodine to the diet.

Since 1995, China has banned the use of non-iodised salt and has succeeded in enforcing the ban in more and more areas of the country. The remote and impoverished province of Ningxia, for example, recently reported that iodised salt was available in 78%of its localities compared with 23%in 1995. However, iodised salt is slightly more expensive than non-iodised salt, which is often sold on the black market.

According to Dr Li, the incidence of “serious iodine deficiency” in children aged 8 to 10 years has been cut nationally from 20%in 1995 to less than 10%this year. Over the same period, the incidence of goitre dropped from 24%to under 11

Iodine deficiency can also cause hypothyroidism, complications in pregnancy, and cretinism in infants. China’s Ministry of Health estimates that iodine deficiency is a factor in more than 90%of the nation’s 11 million cases of mental disability.

Charles Rycroft, a Unicef official based in Beijing, said that iodine deficiency continued “to place a major social and economic burden on generations of Chinese.” Unicef is one of the laboratory’s sponsors.


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