title: Occupational exposure to ionizing radiation is associated with autoimmune thyroid disease.
abstract: BACKGROUND
  The thyroid gland is a potential target organ for radiation-related damage.
  
  
  OBJECTIVE
  The aim of the analysis was to investigate the association between occupational exposure to ionizing radiation and autoimmune thyroid disease (AITD).
  
  
  METHODS
  Our design was the cross-sectional Study of Health in Pomerania.
  
  
  METHODS
  The setting was the general community.
  
  
  METHODS
  Analyses were performed in a population-based sample of 4299 subjects. Among them, 160 persons reported a history of occupational exposure to ionizing radiation.
  
  
  METHODS
  AITD was defined as the combined presence of hypoechogenicity in thyroid ultrasound and antithyroxiperoxidase antibodies greater than 200 IU/ml.
  
  
  RESULTS
  Females with occupational exposure to ionizing radiation had more often AITD than nonexposed females (10.0 vs. 3.4%; P < 0.05). This association persisted after adjustment for relevant confounders (odds ratio, 3.46; 95% confidence interval, 1.16-10.31; P < 0.05). In males, there were too few subjects who fulfilled the criteria of AITD, but the association between the exposure to radiation and hypoechogenicity of the thyroid gland barely missed statistical significance (odds ratio, 2.20; 95% confidence interval, 0.92-5.26; P = 0.08). In both females and males, subjects who reported a length of exposure of more than 5 yr exhibited the highest risk of the endpoints.
  
  
  CONCLUSIONS
  We conclude that occupational exposure to ionizing radiation is related to the risk of AITD. The usage of thyroid protection shields by radiation workers is strongly recommended.
authors.affiliation: Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Greifswald, Germany. voelzke@uni-greifswald.de
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: André
authors.initials: A
authors.lastname: Werner
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Nele
authors.initials: N
authors.lastname: Friedrich
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Robinson
authors.forename: Stefan
authors.initials: S
authors.lastname: Kindler
authors.forename: Matthias
authors.initials: M
authors.lastname: Kraft
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure; D011481:Protective Clothing; D011832:Radiation Injuries / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011839:Radiation, Ionizing; D012307:Risk Factors; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology* / Q000209:etiology