Residents of petrochemical area have high incidence of thyroid disease

The appearance of atypical cases of chronic autoimmune thyroiditis at the clinic of endocrinologist Maria Angela Zaccarelli-Marino in Santo André raised the specialist’s suspicions that incidence of the disease was highest in the area neighboring the Capuava Petrochemical Complex. After 15 years researching the subject, the professor at the ABC’s Faculty of Medicine has concluded that the area’s residents have a fivefold incidence of the disease.

The complex, which lies on the border separating Santo André, Mauá and São Paulo, includes 14 plants manufacturing petroleum subproducts. Between 1989 and 2004, the researcher identified 6,306 patients seeking endocrinological screening at her clinic. She divided these into two groups based on where they lived.

The first, containing 3,356 patients, includes those from the vicinity of the Petrochemical Complex while the second, containing 2,950 patients, includes those from another industrial area 8.5 km from the former, but without any petrochemicals. At the end of the study, 905 patients in the first group (or 26.9%) were diagnosed with the disease, while 173 (or 5.1%) of the second group received a diagnosis. Chronic autoimmune thyroiditis is the principal cause of hypothyroidism.

The results were published in the May issue of the Journal of Clinical Immunology. Over the course of the study, the researcher sent reports on the situation to the municipal health authorities and to the Centro de Vigilância Epidemiológica [Center for Epidemiological Control — CVE] of the State Secretary of Health.

At the request of Santo André Environment leader José Luiz Saikali, the CVE carried out its own study to verify the problem. That body analyzed 1,533 volunteers in the two regions. Whereas 9.3% of the first group had thyroiditis, just 3.9% of the second group had the illness. The details were published in the journal Environmental Research.

Aside from the tests already contained in Maria Angela’s study, the CVE performed iodine dosage tests on those volunteers. There was a possibility that the increase in the number of cases of the disease was linked to higher consumption of iodine. “The CVE verified that it was not the iodine. That gave me a certain peace of mind since the study had proved very controversial,” said Maria Angela.

“Previously, no one had ever said that chronic autoimmune thyroiditis might be caused by the environment. I’m suggesting a new name: autoimmune chemical thyroiditis,” says the researcher, who is now embarking on a study to identify the chemical agents responsible for the disease.

For the immunologist Eduardo Finger, who has a postdoctoral degree in this discipline from the Harvard School of Medicine and is head of the research department at SalomãoZoppi Diagnósticos, it is still necessary to establish what causes the disease. “We must find the chemical pollutant with a proven link to the disease.”

Consequences

Chronic autoimmune thyroiditis only begins to exhibit symptoms with the onset of hypothyroidism, which is a reduction in the production of thyroid hormones. The symptoms are tiredness, hair loss, dry skin and slower heartbeat. Children could suffer from stunted growth and even develop mental retardation. However, the treatment is simple and involves daily replacement of thyroid hormones.

IT professional Noemi Lucena Silva, age 21, discovered she had the disease at age 9. She lives beside one of the petrochemical plants. “My house is literally next door to the factory.” Noemi’s mother was recently diagnosed with thyroid problems as well.

Petrobras made no comment on the conclusions of the study when approached in connection with this report.

Sisters Gilda Buccini Martins, age 58, and Sueli Buccini de Oliveira, 52, live next door to each other in row houses in Jardim Santo Alberto, in Santo André, near the Capuava Petrochemical Complex. Both are victims of the environmental pollution.

Gilda discovered she had chronic autoimmune thyroiditis at age 50. Sueli discovered she had the disease at the same age. In the case of Sueli’s daughter, who is just 23, the disease manifested itself sooner: less than a month ago she had to undergo an operation to remove a thyroid nodule.

Fatigue

Gilda explains how she began to feel more tired, had finer hair and dry skin, but she attributed all of the symptoms to menopause. That’s when her gynecologist ordered a series of tests and discovered a thyroid anomaly in one of them.

“I was exhausted, I wanted to know what the cause of that problem was, I wanted to find out where that disease came from. That was when I discovered they were conducting research right here that was linking the problem to the pollution.”

The homemaker explains that the yard is always covered in black powder because of the plant. “Sometimes it releases towering flames. A really dark pall of smoke rises, then it turns light gray. People can’t even breathe properly. But I’m not going to move away from here. When you build your house, you build it with love and care.”

The diagnosis of nursing assistant Nadia Fachini, age 56, came when she was 44. She decided to visit the doctor because she was obese.

“People have always been scared of this pollution. There are days when foam starts to fall from the sky. When we’re nearby, our noses start to burn,” she says. She is currently undergoing hormone treatment and is monitored with tests every three months. 

Original article published in Portuguese in O Estado de S. Paulo.