Thyrotoxicosis among Hanford, Washington, Downwinders: a community-based health survey

Sixty cases of thyrotoxicosis (including hyperthyroidism, Graves' disease, and toxic goiter), an unexpectedly large number compared with general population data, were reported in a voluntary health survey that included a period of approximately 50 yr, with 801 self-defined "Downwinders" who had lived near the Hanford, Washington, nuclear facility. In another self-selected group of medical patients (n = 423) who were examined over the same time period, only 2 cases of thyrotoxicosis were identified. Evidence is presented that suggests that the effects of bias from self-selection likely did not account for the magnitude of the apparent excess of thyrotoxicosis cases in the present study population. The findings are consistent with those of other studies, as well as with the hypothesis of an association of thyrotoxicosis with exposures to radioiodine.