Perchlorate exposure and thyroid function in ammonium perchlorate workers in Yicheng, China

Environmental exposure to perchlorate, nitrate and thiocyanate, and thyroid function in Chinese adults: A community-based cross-sectional study

BACKGROUND

Evidence on environmental exposure to perchlorate, nitrate, and thiocyanate, three thyroidal sodium iodine symporter (NIS) inhibitors, and thyroid function in the Chinese population remains limited.

OBJECTIVE

To investigate the associations of environmental exposure to perchlorate, nitrate, and thiocyanate with markers of thyroid function in Chinese adults.

METHODS

A total of 2441 non-pregnant adults (mean age 50.4 years and 39.1% male) with a median urinary iodine of 180.1 μg/L from four communities in Shenzhen were included in this cross-sectional study. Urinary perchlorate, nitrate, thiocyanate, and thyroid profiles, including serum free thyroxine (FT4), total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), and thyroid stimulating hormone (TSH), were measured. Generalized linear model was applied to investigate the single-analyte associations. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were used to examine the association between the co-occurrence of three anions and thyroid profile.

RESULTS

The median levels of urinary perchlorate, nitrate, and thiocyanate were 5.8 μg/g, 76.4 mg/g, and 274.1 μg/g, respectively. After adjusting for confounders, higher urinary perchlorate was associated with lower serum FT4, TT4, and TT3, and higher serum FT3 and TSH (all P < 0.05). Comparing extreme tertiles, subjects in the highest nitrate tertile had marginally elevated TT3 (β: 0.02, 95% CI: 0.00-0.04). Each 1-unit increase in log-transformed urinary thiocyanate was associated with a 0.04 (95% CI: 0.02-0.06) pmol/L decrease in serum FT3. The WQS indices were inversely associated with serum FT4, TT4, and FT3 (all P < 0.05). In the BKMR model, the mixture of three anions was inversely associated with serum FT4, TT4, and FT3.

CONCLUSIONS

Our study provides evidence that individual and combined environmental exposure to perchlorate, nitrate, and thiocyanate are associated with significant changes in thyroid function markers in the Chinese population with adequate iodine intake.

Perchlorate - properties, toxicity and human health effects: an updated review

Interest in perchlorate as environmental pollutant has increased since 1997, when high concentrations have been found in the waters of the Colorado River, USA. Perchlorate is very persistent in nature and it is slowly degraded. Although harmful effects of large doses of perchlorate on thyroid function have been proven, the environmental effects are still unclear. The primary objective of the present review is to collect prevailing data of perchlorate exposure and to discuss its impact on human health. The results show that more than 50% of reviewed works found significant associations of perchlorate exposure and human health. This review consists of the following sections: general information of perchlorate sources, its properties and determination methods, role and sources in human body including food and water intake, overview of the scientific literature on the research on the effect of perchlorate on human health from 2010 to 2020. Finally, conclusions and recommendations on future perchlorate studies concerning human exposure are presented.

Possible Effects of Perchlorate Contamination of Drinking Water on Thyroid Health

Background

Perchlorate is an anion that occurs as a contaminant in groundwater. It originates from the improper disposal of ammonium perchlorate, a component of rocket fuel. The objective of this study was to explore whether the exposure to perchlorate in drinking water had an impact on the thyroid function of the population residing near an ammonium perchlorate plant in Kerala. Methodology. Using an ecological study design, we compared the serum levels of thyroid-stimulating hormone, thyroxine, and thyroid peroxidase antibodies among a representative sample of 289 study subjects from the area surrounding the ammonium perchlorate enrichment plant to 281 study subjects in a control area.

Results

The perchlorate concentration in the groundwater varied from 1600 ppb to 57,000 ppb in the 10 samples from the contaminated area and was below 24 ppb in all locations in the control area. No significant differences were found in the mean serum TSH concentration and mean T4 levels between the subjects from the contaminated area and the control area. On regression analysis, perchlorate contamination was not found to be a significant predictor of TSH.

Conclusion

This study did not find any significant association between perchlorate in drinking water and changes in thyroid hormone levels. Our findings indicate the need for further investigation of this hypothesis using urinary perchlorate as a measure of individual exposure.

Evaluation of hypothalamus-pituitary-thyroid axis function by chronic perchlorate exposure in male rats

Perchlorate is a widespread endocrine disruptor that was previously correlated with increased serum TSH levels and decreased thyroid hormones production both in animals and humans. Even so, the regulation of gene/protein expression in the hypothalamus, pituitary and thyroid by chronic perchlorate exposure was not completely elucidated. Therefore, this study aimed to investigate the underlying mechanisms involved in the disruption of hypothalamus-pituitary-thyroid axis by chronic perchlorate exposure. Male Wistar rats were treated or not with NaClO₄ in the drinking water (35 mg/Kg/day) for 60 days. Thereafter, hormone/cytokines serum levels were measured through multiplex assays; genes/proteins expression were investigated by qPCR/Western Blotting and thyroid morphology was evaluated through histological analysis. Serum TSH levels were increased and serum T₄ /T₃ levels were decreased in perchlorate-treated animals. This treatment also altered the thyrotropin-releasing hormone mRNA/protein content in the hypothalamus. Additionally, the expression of both subunits of TSH were increased in the pituitary of perchlorate-treated rats, which also presented significant alterations in the thyroid morphology/gene expression. Furthermore, perchlorate exposure reduced liver Dio1 mRNA expression and increased the content of pro-inflammatory cytokines in the thyroid and the serum. In conclusion, our study adds novel findings about the perchlorate-induced disruption of the hypothalamus-pituitary-thyroid axis gene/protein expression in male rats. The data presented herein also suggest that perchlorate induces thyroid and systemic inflammation through the increased production of cytokines. Taken together, our results suggest that perchlorate contamination should be monitored, especially in the individuals most susceptible to the deleterious effects of reduced levels of thyroid hormones.

Assessing the potential impact on the thyroid axis of environmentally relevant food constituents/contaminants in humans

Occurrence and mode of action of potentially relevant goitrogens in human nutrition and their mode of action (MOA) are reviewed, with special focus on the anionic iodine uptake inhibitors perchlorate (PER), thiocyanate (SCN) and nitrate (NO3). Epidemiological studies suggest persistent halogenated organic contaminants and phthalates as well as certain antimicrobials to deserve increased attention. This also applies to natural goitrogens, including polyphenols and glucosinolates, food constituents with limited data density concerning human exposure. Glucosinolates present in animal feed are presumed to contribute to SCN transfer into milk and milk products. PER, SCN and NO3 are well-investigated environmental goitrogens in terms of MOA and relative potency. There is compelling evidence from biomarker monitoring that the exposure to the goitrogens SCN and NO3 via human nutrition exceeds that of PER by orders of magnitude. The day-to-day variation in dietary intake of these substances (and of iodide) is concluded to entail corresponding variations in thyroidal iodide uptake, not considered as adverse to health or toxicologically relevant. Such normal variability of nutritional goitrogen uptake provides an obvious explanation for the variability in radioactive iodine uptake (RAIU) measurements observed in healthy individuals. Based on available data, a 20 % change in the thyroidal uptake of iodide is derived as threshold value for a biologically meaningful change induced by perchlorate and other goitrogens with the same MOA. We propose this value to be used as the critical effect size or benchmark response in benchmark dose analysis of human RAIU data. The resulting BMDL20 is 0.0165 mg/kg bw/day or 16.5 μg/kg bw/day. Applying a factor of 4, to allow for inter-human differences in toxicokinetics, leads to a TDI for perchlorate of 4 μg/kg bw/day.