Endemic Goiter in Greece: Some New Epidemiologic Studies1

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Abstract
A study is presented of some environmental factors associated with endemic iodine deficiency goiter. A preliminary geologic survey showed that villages with endemic goiter were situated on soil from noncalcareous rocks (flysch, schist, etc.) with considerable erosion and that the drinking water came from superficial sources, whereas villages without endemic goiter were mainly on soil from calcareous rocks (limestone) with drinking water coming from deeper layers. Drinking water from calcareous soils contained significantly more iodine. These general findings were confirmed in a detailed soil survey of three villages, a lowland goitrous vilage, a mountainous goitrous village, and a lowland goiter-free village. A study of the chemical composition of the soil revealed that the soil from villages with endemic goiter contained significantly less calcium carbonate and less exchangeable cations (Ca++, Mg++, K+, Na+). Chemical analysis of the drinking water showed several significant differences. Drinking water from villages with endemic goiter contained significantly less total salts, iodine, chloride, carbonate, bicarbonate, sodium and zinc, and had a lower electrical conductivity and pH. Bacteriologic studies revealed that the drinking water from the goitrous villages was significantly more often polluted with Escherichia coli I and coli like organisms. Finally, the capacity of the soil to adsorb iodine was significantly higher in the villages with endemic goiter. It is concluded that iodine deficiency is not an isolated epidemiologic phenomenon, but that it correlates with several geologic characteristics. Whether these contribute directly to the development of endemic goiter or correlate with it simply because they condition iodine deficiency remains a subject for future research.

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