ThyroMobil: On the Road Again...

From ThyroWorld, Volume 1, No. 1, Autumn, 1997

That surely seems to be the motto of the Merck KGaA ThyroMobil as it trundles its way across Europe. On its 1994-1995 safari, it covered 30,000 km, visited twelve countries and tested over 7,000 schoolchildren. Its goal in aid of thyroid research was to obtain reliable data on the iodine supply in these countries - deficient or adequate.

The year 2000 is the target date set by the World Health organization (WHO) for the elimination of world-wide iodine deficiency. It is a goal shared by the United Nations International Children's Emergency fund (UNICEF) and the International Council of Iodine Deficiency Disorders (ICCIDD) and heartily endorsed by TFI.

The Federal Republic of Germany was among the 71 countries passing this resolution in 1990. To put the resolution into practice, a number of research studies were undertaken in Europe from 1990-1994. Among the most intriguing was Merck KGaA's European ThyroMobil Campaign.

The distinctive van visited these European countries: Austria, Belgium, the Czech Republic, France, Germany, Hungary, Italy, Luxembourg, Poland, Romania, Slovakia and The Netherlands.

To carry out the work, the van is especially equipped with a sonographic device, a computer for processing the thyroid measurements on the spot and facilities for collecting and storing urine samples.

Merck KGaA has developed a rapid urine test for iodine deficiency that gives results in ten minutes in the field without a lab being involved. The test results indicate a "yes" or "no" iodine deficiency but do not differentiate between mild or severe cases. It is a tremendous breakthrough in testing.

The target population was 7,599 schoolchildren between the ages of 7-15 tested in groups of 100 at the designated sites which were their school yards. The children's urine was measured ultrasonographically and the urinary iodine concentration determined. One can only imagine the excitement in the air as the children prepared to do their urinary duty for thyroid research and for science!

"The children were sonographed class by class. The urine samples were collected just before or after sonography. Height and weight were measured, allowing the calculation of body surface area (BSA). The results of the sonography were transferred immediately into the computer. In cases of abnormality in the clinical or echographic examination of the thyroid, the parents of the children received a written note directed to the home physician describing the abnormal results of the examination.

The investigation was approved by the ethical committee of the University of Brussels, the national Ministries of Health and Education and by representatives of the parents of the schoolchildren in the twelve countries."

To increase awareness of the public to iodine nutrition, the national investigators, the principal investigator of the ThyroMobil project (F D) as well as representatives of the academic bodies and of UNICEF national committees took part in a press conference in each country during the visit of the ThyroMobil van.

The study of the children and of earlier ones on adults generated tremendous press interest "and popular local support from physicians, pharmacists and health insurance groups."

In the 1992 adult campaign: "Press conferences were held in every large city where the examination van stopped.

During the campaign, numerous articles were published in scientific journals and lay magazines.

Approximately fifty press reports were published in different journals and magazines reaching a total of 21,229,000 readers.

Magazines were selected according to certain criteria in order to reach the target groups of iodine prophylaxis, i.e. parents of young children, pregnant women and nursing mothers.

A major part of these magazines were therefore women's magazines, magazines giving advice on how to raise children and booklets for pregnant mothers."

And what of the results? Good news. Since 1992, there has been a marked improvement in the status of iodine nutrition in many European countries. In schoolchildren in the Netherlands, Slovakia and France, results were entirely normal.

Improvement is probably due to implementation of salt iodization and improved diet. But in spite of improvement, there is room for much more.

Perhaps we should view the results with cautious optimism and with the proverbial "grain of salt."

In February 1998, the ThyroMobil will take to the road again with a visit planned to countries in southeast Asia (the area of the former Indochina). We look forward to that report.

Güte Reise!

This article has been adapted from an excellent presentation given at the Münich conference by Dr. Ulrike Hostalek and from the accompanying research study, published in the European Journal of Endocrinology. 136 180-187

For further information, please contact:

Dr. Ulrike Hostalek, Merck KGaA,
Darmstadt, Germany.
Telephone: (06151) 72 2024,
Fax: (06151) 727889