Ensuring effective prevention of iodine-deficiency disorders

Background Programs initiated to prevent iodine-deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors and human behaviour that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies are needed to optimize the effectiveness of IDD prevention. Summary Although the need for monitoring is compelling, the current reality in Europe is less than optimal. Regular and systematic monitoring surveys have only been established in a few countries and comparability across the studies is hampered by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency. Conclusion Monitoring studies can be optimized by including centralized standardization procedures that improve the comparison between studies. No study of iodine consumption can replace the direct measurement of health outcomes and the evaluation of the costs and benefits of the program. It is particularly important that health-economic evaluation should be conducted in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic and cultural backgrounds.