甲狀腺干擾物質(高氯酸鹽、硫氰酸鹽、硝酸鹽)具有高水溶性及穩定性，常用於軍事、農業及工業製造上，透過生產、儲存以及廢棄過程排放至環境中，易造成環境污染，常可在水體、空氣、土壤以及食物等介質中檢測出。因此，民眾可經由食入，吸入及皮膚接觸等途徑暴露高氯酸鹽、硫氰酸鹽、硝酸鹽，其中又以食物攝入為人體主要的暴露途徑。先前已有許多研究文獻指出碘離子為製造甲狀腺荷爾蒙之主要元素，當人體暴露高氯酸鹽、硫氰酸鹽、硝酸鹽三種甲狀腺干擾物質時，三者會競爭性抑制碘離子通過鈉碘轉運體，導致甲狀腺荷爾蒙分泌不足。在懷孕初期，胎兒需依靠母親提供甲狀腺荷爾蒙及碘，以確保正常的大腦神經發育，若甲狀腺荷爾蒙分泌不足，可能會影響新生兒生長、大腦發育及早期認知與動作發展，亦可能導致胎兒出生即患有先天性甲狀腺功能低下。2019年本研究團隊雖已探討暴露於高氯酸鹽、硫氰酸鹽、硝酸鹽對後代的生長及早期發育之相關性，但其樣本數少，且僅探討至嬰兒六個月時期的認知與動作發展，其發展能力尚未成型，難以看出顯著影響，故本研究繼續追蹤至一歲或較大之嬰兒以進行早期發展評估，探討產前與產後暴露於甲狀腺干擾物質之影響。
本研究自成大醫院婦產科門診招募224位懷孕婦女以及其生產之186位新生兒，於初步訪視時排除服用任何甲狀腺荷爾蒙藥物以及其他甲狀腺干擾物質相關之職業暴露、家族遺傳疾病者，簽署人體試驗同意書後，進行問卷調查、尿液、血液、臍帶血以及母乳及嬰兒配方奶樣本採集。尿液、臍帶血及母乳及嬰兒配方奶粉樣本皆進行高氯酸鹽、硫氰酸鹽、硝酸鹽、碘離子濃度檢測，血液及臍帶血樣本亦進行甲狀腺荷爾蒙濃度檢測，亦在嬰兒六個月及一歲時以貝萊嬰兒發展量表第三版進行早期發育評估，以探討產前懷孕婦女及產後新生兒與嬰兒時期暴露高氯酸鹽、硫氰酸鹽、硝酸鹽對後代之生長發育指標、認知與動作發展之影響。224位懷孕婦女平均年齡為34.8歲，各孕期(第一孕期:0-16週、第二孕期:17-29週、第三孕期:30週-分娩)之身體質量指數(Body Mass Index, BMI)分別為23.7、25.0及26.3，其尿液中高氯酸鹽濃度依孕期分別為7.03 vs. 9.04 vs. 8.89 µg/L、硫氰酸鹽濃度為1130.47 vs. 1530.53 vs. 1408.29 µg/L、硝酸鹽濃度為64.04 vs. 62.24 vs. 65.81 mg/L、尿碘濃度為87.00 vs. 94.02 vs. 91.33 µg/L；而新生兒尿液中高氯酸鹽濃度分別為11.69 vs. 6.74 vs. 7.22 µg/L、硫氰酸鹽濃度為265.59 vs. 124.62 vs. 475.59 µg/L、硝酸鹽濃度為10.23 vs.22.83 vs. 41.01 mg/L、尿碘濃度為141.85 vs.122.04 vs.143.29 µg/L，研究發現懷孕婦女尿碘濃度均低於WHO之建議值150 µg/L，表示懷孕婦女的碘攝取仍不足，而新生兒及嬰兒的尿碘濃度均高於WHO之建議值100 µg/L。在新生兒與嬰兒於出生至一歲時期，母乳中高氯酸鹽、硝酸鹽濃度顯著高於嬰兒配方奶粉中濃度(P<0.001)，硫氰酸鹽及碘離子濃度則顯著低於嬰兒配方奶粉中濃度(P<0.001)。母體尿液中硫氰酸鹽、硝酸鹽、碘離子濃度及PEC與臍帶血血清中甲狀腺干擾物質、甲狀腺荷爾蒙濃度之間呈統計上顯著相關(P<0.05)，表示高氯酸鹽、硫氰酸鹽、硝酸鹽及碘離子能主動運輸經由胎盤傳送給胎兒。在產前暴露的部分，以懷孕婦女尿液回推日暴露劑量分組，母體高氯酸鹽之高暴露組，其出生體重、頭圍均顯著低於低暴露組(P<0.05)；母體硝酸鹽之高暴露組，其出生身長、體重及頭圍均顯著低於低暴露組(P<0.05)。經校正干擾因子(母親教育程度、年齡、後代性別及出生胎齡)後之複迴歸結果發現，在第一孕期中，母體尿液中碘離子濃度與六個月及一歲嬰兒時之認知能力呈顯著負相關(P<0.05)；在第二孕期中，母體尿液中高氯酸鹽濃度與嬰兒一歲時之認知能力呈顯著負相關(P<0.05)，硫氰酸鹽濃度與嬰兒一歲時之動作能力呈顯著負相關(P<0.05)，PEC與嬰兒六個月時之認知能力呈顯著負相關(P<0.05)；在第三孕期中，母體尿液中高氯酸鹽濃度與嬰兒一歲的認知能力呈顯著負相關(P<0.05)，碘離子濃度與嬰兒一歲的認知、語言及動作能力呈顯著負相關(P<0.05)。懷孕婦女血液中T3、T4、FT3及FT4與後代生長指標呈統計上顯著負相關(P<0.05)，而TSH與生長指標呈顯著正相關(P<0.05)。在產後暴露的部分，新生兒及嬰兒尿液中高氯酸鹽、硫氰酸鹽、硝酸鹽及碘離子濃度與後代身長、體重及頭圍呈統計上顯著負相關(P<0.05)。校正干擾因子(性別及出生胎齡)後之複迴歸結果發現，在出生時期，新生兒尿液中高氯酸鹽濃度與嬰兒六個月及一歲的體重呈顯著負相關(P<0.05)；在六個月時期，嬰兒尿液中硫氰酸鹽濃度與嬰兒一歲的頭圍呈顯著負相關(P<0.05)，硝酸鹽濃度與嬰兒一歲的頭圍呈顯著負相關(P<0.05)；在一歲時期，則無統計上顯著相關性。亦發現在六個月時期，嬰兒尿液中碘離子濃度與其身長呈顯著負相關(P<0.05)，表示暴露越高濃度之甲狀腺干擾物質，將會影響其生長發育。母乳中碘離子濃度與嬰兒六個月的身長呈顯著正相關(P<0.05)，而高氯酸鹽濃度、PEC與嬰兒一歲的認知能力呈顯著負相關(P<0.05)。嬰兒配方奶粉中高氯酸鹽、硫氰酸鹽、碘離子濃度及PEC與嬰兒一歲的身長及體重呈顯著正相關(P<0.05)，碘離子濃度亦與嬰兒六個月的認知能力呈顯著正相關(P<0.05)。經校正干擾因子(母親教育程度、年齡、後代性別及出生胎齡)後之複迴歸結果發現，臍帶血血清中TSH與新生兒出生體重呈顯著負相關(P<0.05)，硫氰酸鹽濃度與嬰兒一歲的語言能力呈顯著負相關(P<0.05)，硝酸鹽濃度與嬰兒一歲的語言、動作能力呈顯著負相關(P<0.05)，FT4與嬰兒六個月的動作能力呈顯著正相關(P<0.05)。進一步探討產前及產後高氯酸鹽、硫氰酸鹽、硝酸鹽之共同暴露影響甲狀腺荷爾蒙、生長指標及認知與動作發展之貢獻，研究結果顯示產前懷孕婦女尿液中高氯酸鹽濃度對FT3及嬰兒六個月及一歲的認知能力之貢獻權重最高(60%、49.5%、82.7%)，硝酸鹽濃度對出生頭圍之貢獻權重最高(69.2%)；產後嬰兒尿液中高氯酸鹽濃度對一歲的語言能力之貢獻權重最高(45.8%)，母乳中硫氰酸鹽濃度對嬰兒六個月的體重之貢獻權重最高(53.1%)，母乳中硝酸鹽濃度對嬰兒六個月頭圍之貢獻權重最高(53.5%)，嬰兒配方奶粉中硫氰酸鹽濃度對嬰兒一歲語言能力之貢獻權重最高(62.7%)。使用混和線性模式分析重複量測懷孕婦女尿液中高氯酸鹽、硝酸鹽和硫氰酸鹽之暴露對尿碘濃度與甲狀腺荷爾蒙之影響，研究結果顯示懷孕婦女尿液中高氯酸鹽、硫氰酸鹽、硝酸鹽、PEC及日暴露劑量濃度增加時，尿碘濃度亦會隨之增加；而尿液中硫氰酸鹽濃度增加，會使血清中T3及T4濃度減少。
綜合上述結果，可知本研究懷孕婦女的碘攝取本就不足，當暴露於高氯酸鹽、硫氰酸鹽及硝酸鹽時，三者會抑制碘離子進入甲狀腺，進而導致甲狀腺荷爾蒙分泌不足，影響後代之生長指標及認知與動作發展。至於產後新生兒及嬰兒的碘若攝取充足，故對甲狀腺功能形成保護作用。兩者相比，產前暴露於甲狀腺干擾物質對新生兒及嬰兒之影響程度較高。本篇為首篇整合產前懷孕婦女與產後新生兒及嬰兒的暴露情況、生理指標及尿液、血液、乳製品濃度數據，並同時探討暴露於甲狀腺干擾物質對後代生長指標及認知與動作發展之影響。

SUMMARY

The objectives of present study are to investigate the association between prenatal and postnatal perchlorate, thiocyanate and nitrate exposure and early growth and development of neonates. 224 pregnant women and 186 neonates were recruited from obstetrics and gynecology clinics in NCKU Hospital in southern Taiwan. The mean maternal age is 34.8 years, and BMI of three trimesters are 23.7, 25.0, 26.3, respectively. The highest urinary concentrations of thyroid disrupting chemicals in pregnant women, neonates and infants was nitrate, followed by thiocyanate, and perchlorate was the lowest. The concentration of perchlorate and nitrate in breast milk is significantly higher than those in infant formula milk (P<0.001), while the concentrations of thiocyanate and iodide in breast milk were significantly lower than those in infant formula (P<0.001). The concentration of thiocyanate, nitrate, iodide ion and PEC in maternal urine was significantly positively associated with thyroid disrupting chemicals and thyroid hormones in cord blood (P<0.05). During the prenatal exposure, maternal urinary thyroid disrupting chemicals were significantly negatively associated with neonates’ growth (P<0.05). After adjusting for confounding factors, maternal urinary iodide, perchlorate, and thiocyanate were significantly negatively associated with ability of cognitive/motor (P<0.05). Maternal serum thyroid hormones were significantly positively associated with neonates’ growth (P<0.05). During the postnatal exposure, infant’s urinary thyroid disrupting chemicals were significantly negatively associated with growth and early development (P<0.05). Breast milk and formula milk iodide were significantly positively associated with neonates’ length (P<0.05). Weighted quantile sum regression results shows urinary perchlorate of pregnant women has the highest weight in reducing FT3 and ability of cognitive；and urinary nitrate of pregnant women have the highest weight in reducing birth head circumference in. WQS results also shows that thiocyanate in breast milk and formula milk has the highest weight in reducing infant’s weight and ability of language. In conclusion, the prenatal exposure to thyroid disrupting chemicals may affect neonate’s growth and development than those exposure of postnatal.

Agretti P, Dimida A, De Marco G, Ferrarini E, Gonzàlez JR, Santini F, et al. 2011. Study of potential inhibitors of thyroid iodide uptake by using cho cells stably expressing the human sodium/iodide symporter (hnis) protein. Journal of endocrinological investigation 34:170-174.
Amitai Y, Winston G, Sack J, Wasser J, Lewis M, Blount BC, et al. 2007. Gestational exposure to high perchlorate concentrations in drinking water and neonatal thyroxine levels. Thyroid 17:843-850.
Andersen SL, Olsen J, Wu CS, Laurberg P. 2013. Low birth weight in children born to mothers with hyperthyroidism and high birth weight in hypothyroidism, whereas preterm birth is common in both conditions: A danish national hospital register study. European Thyroid Journal 2:135-144.
Arzhanov I, Buniatov M, Ushakovа G. 2017. The thyroid status of a conditionally healthy adult population of prydniprovia. Regulatory Mechanisms in Biosystems 8:554–558-554–558.
Baier-Anderson C, Blount BC, LaKind JS, Naiman DQ, Wilbur SB, Tan S. 2006. Estimates of exposures to perchlorate from consumption of human milk, dairy milk, and water, and comparison to current reference dose. Journal of Toxicology and Environmental Health, Part A 69:319-330.
Ballabio M, Poshyachinda M, Ekins RP. 1991. Pregnancy-induced changes in thyroid function: Role of human chorionic gonadotropin as putative regulator of maternal thyroid. The Journal of Clinical Endocrinology & Metabolism 73:824-831.
Baranowska-Bik A, Bik W. 2020. The association of obesity with autoimmune thyroiditis and thyroid function-possible mechanisms of bilateral interaction. International Journal of Endocrinology 2020.
Barjaktarovic M, Korevaar T, Chaker L, Jaddoe V, De Rijke Y, Visser T, et al. 2017. The association of maternal thyroid function with placental hemodynamics. Human Reproduction 32:653-661.
Bassols J, Prats-Puig A, Soriano-Rodríguez P, García-González MM, Reid J, Martínez-Pascual M, et al. 2011. Lower free thyroxin associates with a less favorable metabolic phenotype in healthy pregnant women. The Journal of Clinical Endocrinology & Metabolism 96:3717-3723.
Batistuzzo A, Ribeiro MO. 2020. Clinical and subclinical maternal hypothyroidism and their effects on neurodevelopment, behavior and cognition. Archives of Endocrinology and Metabolism 64:89-95.
Bayley N. 2006. Bayley scales of infant and toddler development:PsychCorp, Pearson.
Ben FH, Soussia L, Guermazi F, Rebai T, Zeghal N. Propythiouracil and perchlorate effects on thyroid function in young and lactating mice. In: Proceedings of the Annales d'endocrinologie, 2001, Vol. 62, 446-453.
Bernieri T, Rodrigues D, Barbosa IR, Ardenghi PG, da Silva LB. 2019. Occupational exposure to pesticides and thyroid function in brazilian soybean farmers. Chemosphere 218:425-429.
Blount BC, Pirkle JL, Osterloh JD, Valentin-Blasini L, Caldwell KL. 2006. Urinary perchlorate and thyroid hormone levels in adolescent and adult men and women living in the united states. Environmental health perspectives 114:1865-1871.
Blount BC, Valentin-Blasini L, Osterloh JD, Mauldin JP, Pirkle JL. 2007. Perchlorate exposure of the us population, 2001–2002. Journal of exposure science & environmental epidemiology 17:400-407.
Blount BC, Rich DQ, Valentin-Blasini L, Lashley S, Ananth CV, Murphy E, et al. 2009. Perinatal exposure to perchlorate, thiocyanate, and nitrate in new jersey mothers and newborns. Environmental science & technology 43:7543-7549.
Blount BC, Rich DQ, Valentin-Blasini L, Lashley S, Ananth CV, Murphy E, et al. 2009. Perinatal exposure to perchlorate. Thiocyanate, and nitrate in new jersey mothers and newborns. Environ Sci Technol 43:7543-7549.
Borjan M, Marcella S, Blount B, Greenberg M, Zhang JJ, Murphy E, et al. 2011. Perchlorate exposure in lactating women in an urban community in new jersey. Science of the total environment 409:460-464.
Bruce GM, Corey LM, Mandel JH, Pleus RC. 2013. Urinary nitrate, thiocyanate, and perchlorate and serum thyroid endpoints based on nhanes 2001 to 2002. Journal of occupational and environmental medicine 55:52-58.
Burrow GN, Fisher DA, Larsen PR. 1994. Maternal and fetal thyroid function. New England Journal of Medicine 331:1072-1078.
Can O, Blount B, Valentin-Blasini L, Erdemgil Y, Uzunoglu D, Aksoy M, et al. 2016. Perchlorate exposure through water and milk in istanbul. Bulletin of environmental contamination and toxicology 97:439-445.
Cao Y, Blount BC, Valentin-Blasini L, Bernbaum JC, Phillips TM, Rogan WJ. 2010. Goitrogenic anions, thyroid-stimulating hormone, and thyroid hormone in infants. Environmental health perspectives 118:1332-1337.
Chapin FS, Matson PA, Mooney HA. 2002. Terrestrial nutrient cycling. Principles of Terrestrial Ecosystem Ecology:197-223.
Charatcharoenwitthaya N, Ongphiphadhanakul B, Pearce EN, Somprasit C, Chanthasenanont A, He X, et al. 2014. The association between perchlorate and thiocyanate exposure and thyroid function in first-trimester pregnant thai women. The Journal of Clinical Endocrinology & Metabolism 99:2365-2371.
Cheng Q, Liu F, Smith PN, Jackson WA, McMurry ST, Hooper MJ, et al. 2008. Perchlorate distribution, excretion, and depuration in prairie voles and deer mice. Water, air, and soil pollution 192:127-139.
Chevrier J, Harley KG, Kogut K, Holland N, Johnson C, Eskenazi B. 2011. Maternal thyroid function during the second half of pregnancy and child neurodevelopment at 6, 12, 24, and 60 months of age. Journal of thyroid research 2011.
Choi G, Keil AP, Villanger GD, Richardson DB, Daniels JL, Hoffman K, et al. 2021. Pregnancy exposure to common-detect organophosphate esters and phthalates and maternal thyroid function. Science of The Total Environment 782:146709.
Choi S, Kim MJ, Park YJ, Kim S, Choi K, Cheon GJ, et al. 2020. Thyroxine-binding globulin, peripheral deiodinase activity, and thyroid autoantibody status in association of phthalates and phenolic compounds with thyroid hormones in adult population. Environment International 140:105783.
Cianchetta S, di Bernardo J, Romeo G, Rhoden KJ. 2010. Perchlorate transport and inhibition of the sodium iodide symporter measured with the yellow fluorescent protein variant yfp-h148q/i152l. Toxicology and applied pharmacology 243:372-380.
Cignini P, Cafà EV, Giorlandino C, Capriglione S, Spata A, Dugo N. 2012. Thyroid physiology and common diseases in pregnancy: Review of literature. Journal of prenatal medicine 6:64.
Citterio CE, Rivolta CM, Targovnik HM. 2021. Structure and genetic variants of thyroglobulin: Pathophysiological implications. Molecular and Cellular Endocrinology:111227.
Cleary-Goldman J, Malone FD, Lambert-Messerlian G, Sullivan L, Canick J, Porter TF, et al. 2008. Maternal thyroid hypofunction and pregnancy outcome. Obstetrics and gynecology 112:85.
Council NR. 2005. Health implications of perchlorate ingestion:National Academies Press.
Crump C, Michaud P, Téllez R, Reyes C, Gonzalez G, Montgomery EL, et al. 2000. Does perchlorate in drinking water affect thyroid function in newborns or school-age children? Journal of Occupational and Environmental Medicine 42:603-612.
Dewey KG, Heinig MJ, Nommsen LA, Peerson JM, Lönnerdal B. 1992. Growth of breast-fed and formula-fed infants from 0 to 18 months: The darling study. Pediatrics 89:1035-1041.
Dineva M, Fishpool H, Rayman MP, Mendis J, Bath SC. 2020. Systematic review and meta-analysis of the effects of iodine supplementation on thyroid function and child neurodevelopment in mildly-to-moderately iodine-deficient pregnant women. The American journal of clinical nutrition 112:389-412.
Dohan O, De la Vieja A, Paroder V, Riedel C, Artani M, Reed M, et al. 2003. The sodium/iodide symporter (nis): Characterization, regulation, and medical significance. Endocrine reviews 24:48-77.
Dohán O, De la Vieja A, Paroder V, Riedel C, Artani M, Reed M, et al. 2003. The sodium/iodide symporter (nis): Characterization, regulation, and medical significance. Endocr Rev 24:48-77.
Donadio-Andréi S, Chikh K, Iss C, Kuczewski E, Gauchez A-S, Ronin C, et al. 2013. Quelle pertinence accorder au taux circulant de tsh? Immuno-analyse & Biologie Spécialisée 28:223-239.
dos Santos Pinheiro V, Volino-Souza M, de Oliveira GV, Conte-Junior CA, Alvares TS. 2021. Effect of high-nitrate beetroot juice consumption on thyroid gland hormones and iodine levels in adults. Food Bioscience 40:100869.
Dusdieker LB, Stumbo PJ, Kross BC, Dungy CI. 1996. Does increased nitrate ingestion elevate nitrate levels in human milk? Archives of pediatrics & adolescent medicine 150:311-314.
Eder S, Hermann C, Lamkowski A, Kinoshita M, Yamamoto T, Abend M, et al. 2020. A comparison of thyroidal protection by stable iodine or perchlorate in the case of acute or prolonged radioiodine exposure. Archives of Toxicology 94:3231-3247.
Ellis G, Adatia I, Yazdanpanah M, Makela SK. 1998. Nitrite and nitrate analyses: A clinical biochemistry perspective. Clinical biochemistry 31:195-220.
Ellsworth L, McCaffery H, Harman E, Abbott J, Gregg B. 2020. Breast milk iodine concentration is associated with infant growth, independent of maternal weight. Nutrients 12:358.
EPA. 1998. Contaminant candidate list 1 - ccl 1.
EPA. 2005. Perchlorate (clo4-) and perchlorate salts.
EPA. 2006. National primary drinking water regulations. Available: https://www.epa.gov/ground-water-and-drinking-water/national-primary-drinking-water-regulations.
Eroglu A, Kucuk A. 2020. Congenital hypothyroidism. Anästh Intensivmed 61:S125-S132.
Evans KA, Rich DQ, Weinberger B, Vetrano AM, Valentin-Blasini L, Strickland PO, et al. 2015. Association of prenatal perchlorate, thiocyanate, and nitrate exposure with neonatal size and gestational age. Reproductive Toxicology 57:183-189.
Fiore M, Oliveri Conti G, Caltabiano R, Buffone A, Zuccarello P, Cormaci L, et al. 2019. Role of emerging environmental risk factors in thyroid cancer: A brief review. International journal of environmental research and public health 16:1185.
Folio M, Fewell R. 2000. Peabody developmental motor scales: Examiner’s manual, 2nd edn. Austin: Pro-ed. Inc[Google Scholar].
Forhead AJ, Fowden AL. 2014. Thyroid hormones in fetal growth and prepartum maturation. Journal of endocrinology 221:R87-R103.
Foster G, Baghdiantz A, Kumar M, Slack E, Soliman H, MacIntyre I. 1964. Thyroid origin of calcitonin. Nature 202:1303-1305.
Frankenburg W, Dodds J, Archer P, Bresnick B, Maschka P, Edelman N, et al. 1992. Denver ii training manual. Denver developmental materials. Inc, Denver, CO.
FUSE Y, WAKAE E, NEMOTO Y, UGA N, TANAKA M, MAEDA M, et al. 1991. Influence of perinatal factors and sampling methods on tsh and thyroid hormone levels in cord blood. Endocrinologia japonica 38:297-302.
Gan Z, Pi L, Li Y, Hu W, Su S, Qin X, et al. 2015. Occurrence and exposure evaluation of perchlorate in indoor dust and diverse food from chengdu, china. Science of the Total Environment 536:288-294.
Gao X-Q, Fei F, Huo HH, Huang B, Meng XS, Zhang T, et al. 2019. Exposure to nitrite alters thyroid hormone levels and morphology in takifugu rubripes. Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology 225:108578.
Gasparoni A, Autelli M, Ravagni Probizer MF, Bartoli A, Regazzi Bonora M, Chirico G, et al. 1998. Effect of passive smoking on thyroid function in infants. European Journal of Endocrinology 138:379-382.
Ghasemi A, Mehrazin F, Zahediasl S. 2013. Effect of nitrate and l-arginine therapy on nitric oxide levels in serum, heart, and aorta of fetal hypothyroid rats. Journal of physiology and biochemistry 69:751-759.
Ghorbel H, Fetoui H, Mahjoubi A, Guermazi F, Zeghal N. 2008. Thiocyanate effects on thyroid function of weaned mice. Comptes rendus biologies 331:262-271.
Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, et al. 1999. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. New England Journal of Medicine 341:549-555.
Hadlow NC, Rothacker KM, Wardrop R, Brown SJ, Lim EM, Walsh JP. 2013. The relationship between tsh and free t4 in a large population is complex and nonlinear and differs by age and sex. The Journal of Clinical Endocrinology & Metabolism 98:2936-2943.
Health Promotion Administration M. 2018. National dietary nutrient reference intake.
Her N, Kim J, Yoon Y. 2010. Perchlorate in dairy milk and milk-based powdered infant formula in south korea. Chemosphere 81:732-737.
Honikel K-O. 2008. The use and control of nitrate and nitrite for the processing of meat products. Meat science 78:68-76.
Horton MK, Blount BC, Valentin-Blasini L, Wapner R, Whyatt R, Gennings C, et al. 2015. Co-occurring exposure to perchlorate, nitrate and thiocyanate alters thyroid function in healthy pregnant women. Environmental research 143:1-9.
Hospital BTCMFHTC. 2020. Anti-thyroglobulin ab
Hospital MM. 2016. Congenital hypothyroidism.
Howdeshell KL. 2002. A model of the development of the brain as a construct of the thyroid system. Environmental health perspectives 110:337-348.
Huang P-C, Kuo P-L, Chang W-H, Shih S-F, Chang W-T, Lee C-C. 2021. Prenatal phthalates exposure and cord thyroid hormones: A birth cohort study in southern taiwan. International Journal of Environmental Research and Public Health 18:4323.
Huber DR, Blount BC, Mage DT, Letkiewicz FJ, Kumar A, Allen RH. 2011. Estimating perchlorate exposure from food and tap water based on us biomonitoring and occurrence data. Journal of exposure science & environmental epidemiology 21:395-407.
Jackson WA, Joseph P, Laxman P, Tan K, Smith PN, Yu L, et al. 2005. Perchlorate accumulation in forage and edible vegetation. Journal of Agricultural and Food Chemistry 53:369-373.
Janssen BG, Saenen ND, Roels HA, Madhloum N, Gyselaers W, Lefebvre W, et al. 2017. Fetal thyroid function, birth weight, and in utero exposure to fine particle air pollution: A birth cohort study. Environmental health perspectives 125:699-705.
Javidi A, Rafiei N, Amin MM, Hovsepian S, Hashemipour M, Kelishadi R, et al. 2015. The relationship between perchlorate in drinking water and cord blood thyroid hormones: First experience from iran. International journal of preventive medicine 6.
Johns LE, Ferguson KK, Cantonwine DE, Mukherjee B, Meeker JD, McElrath TF. 2018. Subclinical changes in maternal thyroid function parameters in pregnancy and fetal growth. The Journal of Clinical Endocrinology & Metabolism 103:1349-1358.
Jones JA, Ninnis JR, Hopper AO, Ibrahim Y, Merritt TA, Wan KW, et al. 2014. Nitrite and nitrate concentrations and metabolism in breast milk, infant formula, and parenteral nutrition. Journal of Parenteral and Enteral Nutrition 38:856-866.
Junge B. 1985. Changes in serum thiocyanate concentration on stopping smoking. British medical journal (Clinical research ed) 291:22.
Karthikprabu B, Palanimurugan A, Dhanalakshmi A, Kannan K, Thangadurai S. 2020. Perchlorate contamination assessment and hypothyroidism in rat studies using water samples collected around kovil patti, tuticorin district of tamil nadu, india. Microchemical Journal 154:104570.
Kawasaki T, Uezono K, Itoh K, Ueno M. 1991. Prediction of 24-hour urinary creatinine excretion from age, body weight and height of an individual and its application. [Nihon koshu eisei zasshi] Japanese journal of public health 38:567.
Khalil AM, Hammad S. 2019. Effects of nitrate toxicity on vitamin a concentration and the thyroid gland status in albino rats. Ophthalmology Case Reports 3:34.
Kilfoy BA, Zheng T, Holford TR, Han X, Ward MH, Sjodin A, et al. 2009. International patterns and trends in thyroid cancer incidence, 1973–2002. Cancer Causes & Control 20:525-531.
Kirk AB, Smith EE, Tian K, Anderson TA, Dasgupta PK. 2003. Perchlorate in milk. Environmental Science & Technology 37:4979-4981.
Kirk AB, Martinelango PK, Tian K, Dutta A, Smith EE, Dasgupta PK. 2005. Perchlorate and iodide in dairy and breast milk. Environmental Science & Technology 39:2011-2017.
Kirk AB, Dyke JV, Martin CF, Dasgupta PK. 2007. Temporal patterns in perchlorate, thiocyanate, and iodide excretion in human milk. Environmental Health Perspectives 115:182-186.
Kışlal F, Çetinkaya S, Dilmen U, Yaşar H, Teziç T. 2010. Cord blood thyroid‐stimulating hormone and free t4 levels in turkish neonates: Is iodine deficiency still a continuing problem? Pediatrics International 52:762-768.
Knight BA, Shields BM, He X, Pearce EN, Braverman LE, Sturley R, et al. 2018. Effect of perchlorate and thiocyanate exposure on thyroid function of pregnant women from south-west england: A cohort study. Thyroid research 11:1-7.
Kolmykova L, Korobova E. 2019. Iodine and selenium in natural waters as a risk factor in manifestation of endemic thyroid diseases (review. Теоретическая и прикладная экология:5-13.
Kooistra L, Crawford S, van Baar AL, Brouwers EP, Pop VJ. 2006. Neonatal effects of maternal hypothyroxinemia during early pregnancy. Pediatrics 117:161-167.
Korevaar TI, de Rijke YB, Chaker L, Medici M, Jaddoe VW, Steegers EA, et al. 2017. Stimulation of thyroid function by human chorionic gonadotropin during pregnancy: A risk factor for thyroid disease and a mechanism for known risk factors. Thyroid 27:440-450.
Kota SK, Gayatri K, Jammula S, Meher LK, Kota SK, Krishna S, et al. 2013. Fetal endocrinology. Indian journal of endocrinology and metabolism 17:568.
Kwon SR, Dawson DV, Wertz PW. 2016. Time course of potassium nitrate penetration into the pulp cavity and the effect of penetration levels on tooth whitening efficacy. Journal of Esthetic and Restorative Dentistry 28:S14-S22.
LaFRANCHI S. 1999. Congenital hypothyroidism: Etiologies, diagnosis, and management. Thyroid 9:735-740.
Lania A, Persani L, Beck-Peccoz P. 2008. Central hypothyroidism. Pituitary 11:181-186.
León G, Murcia M, Rebagliato M, Álvarez‐Pedrerol M, Castilla AM, Basterrechea M, et al. 2015. Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The infancia y medio ambiente cohort, s pain. Paediatric and perinatal epidemiology 29:113-122.
Leung AM, Pearce EN, Hamilton T, He X, Pino S, Merewood A, et al. 2009. Colostrum iodine and perchlorate concentrations in boston‐area women: A cross‐sectional study. Clinical endocrinology 70:326-330.
Leung AM, Braverman LE, He X, Schuller KE, Roussilhes A, Jahreis KA, et al. 2012. Environmental perchlorate and thiocyanate exposures and infant serum thyroid function. Thyroid 22:938-943.
Liao Z, Cao D, Gao Z, Zhang S. 2020. Occurrence of perchlorate in processed foods manufactured in china. Food Control 107:106813.
Lisco G, De Tullio A, Giagulli VA, De Pergola G, Triggiani V. 2020. Interference on iodine uptake and human thyroid function by perchlorate-contaminated water and food. Nutrients 12:1669.
Mage DT, Allen RH, Kodali A. 2008. Creatinine corrections for estimating children's and adult's pesticide intake doses in equilibrium with urinary pesticide and creatinine concentrations. Journal of exposure science & environmental epidemiology 18:360-368.
Malik AQ. 2017. Investigation of the thermal decomposition of magnesium–sodium nitrate pyrotechnic composition (sr-524) and the effect of accelerated aging. Journal of Saudi Chemical Society 21:262-269.
Manglik AK, Chatterjee N, Ghosh G. 2005. Umbilical cord blood tsh levels in term neonates: A screening tool for congenital hypothyroidism. Indian Pediatr 42:1029-1032.
Männistö T, Vääräsmäki M, Pouta A, Hartikainen A-L, Ruokonen A, Surcel H-M, et al. 2009. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: A prospective population-based cohort study. The Journal of Clinical Endocrinology & Metabolism 94:772-779.
Marwaha R, Chopra S, Gopalakrishnan S, Sharma B, Kanwar R, Sastry A, et al. 2008. Establishment of reference range for thyroid hormones in normal pregnant indian women. BJOG: An International Journal of Obstetrics & Gynaecology 115:602-606.
McLanahan ED, White P, Flowers L, Schlosser PM. 2014. The use of pbpk models to inform human health risk assessment: Case study on perchlorate and radioiodide human lifestage models. Risk analysis 34:356-366.
McMahon MJ, Brown HL, Dean RA. 1997. Umbilical cord thiocyanate and thyroid function in intrauterine growth-restricted infants of the smoking gravida. Journal of Perinatology 17:370-374.
Mehrnejat N, Yazdanpanah H, Nobari RF, Hashemipour M, Maracy M, Moafi M, et al. 2015. Spatial analysis of neonatal congenital hypothyroidism and nitrate as an environmental pollutant in isfahan province during 2010-2013. International journal of preventive medicine 6.
Meinhold C, Park Y, Stolzenberg-Solomon R, Hollenbeck A, Schatzkin A, De Gonzalez AB. 2009. Alcohol intake and risk of thyroid cancer in the nih-aarp diet and health study. British journal of cancer 101:1630-1634.
Mendiratta SK, Dotson RL, Brooker RT, Staff Ub. 2000. Perchloric acid and perchlorates. Kirk‐Othmer Encyclopedia of Chemical Technology.
Mensinga TT, Speijers GJ, Meulenbelt J. 2003. Health implications of exposure to environmental nitrogenous compounds. Toxicological reviews 22:41-51.
Mervish NA, Pajak A, Teitelbaum SL, Pinney SM, Windham GC, Kushi LH, et al. 2016. Thyroid antagonists (perchlorate, thiocyanate, and nitrate) and childhood growth in a longitudinal study of us girls. Environmental health perspectives 124:542-549.
Moleti M, Trimarchi F, Tortorella G, Candia Longo A, Giorgianni G, Sturniolo G, et al. 2016. Effects of maternal iodine nutrition and thyroid status on cognitive development in offspring: A pilot study. Thyroid 26:296-305.
Mondal C, Chandra AK. 2019. Goitrogenic/antithyroidal potential of moringa leaves (moringa oleifera) and spinach (spinacia oleracea) of indian origin on thyroid status in male albino rats. Brazilian Journal of Pharmaceutical Sciences 55.
Mortensen ME, Birch R, Wong L-Y, Valentin-Blasini L, Boyle EB, Caldwell KL, et al. 2016. Thyroid antagonists and thyroid indicators in us pregnant women in the vanguard study of the national children's study. Environmental research 149:179-188.
Mullur R, Liu Y-Y, Brent GA. 2014. Thyroid hormone regulation of metabolism. Physiological reviews 94:355-382.
Naafs JC, Vendrig LM, Limpens J, van der Lee H, Duijnhoven RG, Marchal J, et al. 2020. Cognitive outcome in congenital central hypothyroidism: A systematic review with meta-analysis of individual patient data. European journal of endocrinology 182:351-361.
Narkowicz S, Jaszczak E, Polkowska Ż, Kiełbratowska B, Kotłowska A, Namieśnik J. 2018. Determination of thiocyanate as a biomarker of tobacco smoke constituents in selected biological materials of human origin. Biomedical Chromatography 32:e4111.
Nazeri P, Shab-Bidar S, Pearce EN, Shariat M. 2020. Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis. Nutrition reviews 78:747-763.
Oghbaei H, Alipour MR, Hamidian G, Ahmadi M, Ghorbanzadeh V, Keyhanmanesh R. 2018. Two months sodium nitrate supplementation alleviates testicular injury in streptozotocin‐induced diabetic male rats. Experimental physiology 103:1603-1617.
Organization WH. 2007. Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers.
Patel J, Landers K, Li H, Mortimer RH, Richard K. 2011. Delivery of maternal thyroid hormones to the fetus. Trends in Endocrinology & Metabolism 22:164-170.
Pearce EN, Leung AM, Blount BC, Bazrafshan HR, He X, Pino S, et al. 2007. Breast milk iodine and perchlorate concentrations in lactating boston-area women. The Journal of Clinical Endocrinology & Metabolism 92:1673-1677.
Pearce EN, Braverman LE. 2009. Environmental pollutants and the thyroid. Best Practice & Research Clinical Endocrinology & Metabolism 23:801-813.
Pearce EN, Lazarus JH, Smyth PP, He X, Dall'Amico D, Parkes AB, et al. 2010. Perchlorate and thiocyanate exposure and thyroid function in first-trimester pregnant women. The Journal of Clinical Endocrinology & Metabolism 95:3207-3215.
Pearce EN, Spencer CA, Mestman JH, Lee RH, Bergoglio LM, Mereshian P, et al. 2011. Effect of environmental perchlorate on thyroid function in pregnant women from córdoba, argentina, and los angeles, california. Endocrine Practice 17:412-417.
Pearce EN, Alexiou M, Koukkou E, Braverman LE, He X, Ilias I, et al. 2012. Perchlorate and thiocyanate exposure and thyroid function in first‐trimester pregnant women from g reece. Clinical endocrinology 77:471-474.
Pleus RC, Corey LM. 2018. Environmental exposure to perchlorate: A review of toxicology and human health. Toxicology and applied pharmacology 358:102-109.
Pop VJ, Kuijpens JL, van Baar AL, Verkerk G, van Son MM, de Vijlder JJ, et al. 1999. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clinical endocrinology 50:149-155.
Pop VJ, Brouwers EP, Vader HL, Vulsma T, Van Baar AL, De Vijlder JJ. 2003. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: A 3‐year follow‐up study. Clinical endocrinology 59:282-288.
Poulsen S, Errboe M, Hovgaard O, Worthington HV. 2000. Potassium nitrate toothpaste for dentine hypersensitivity. Cochrane Database of Systematic Reviews.
Preston EV, Webster TF, Henn BC, McClean MD, Gennings C, Oken E, et al. 2020. Prenatal exposure to per-and polyfluoroalkyl substances and maternal and neonatal thyroid function in the project viva cohort: A mixtures approach. Environment international 139:105728.
Qiaofan Q. 2017. Congenital hypothyroidism.
Quigley M, Embleton ND, McGuire W. 2019. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database of systematic reviews.
Rastogi MV, LaFranchi SH. 2010. Congenital hypothyroidism. Orphanet journal of rare diseases 5:1-22.
Reichert L, De Rooy H. 1989. Treatment of amiodarone induced hyperthyroidism with potassium perchlorate and methimazole during amiodarone treatment. BMJ 298:1547-1548.
Ringwalt S. 2008. Developmental screening and assessment instruments with an emphasis on social and emotional development for young children ages birth through five. National Early Childhood Technical Assistance Center (NECTAC).
Rocha BS, Laranjinha J. 2020. Nitrate from diet might fuel gut microbiota metabolism: Minding the gap between redox signaling and inter-kingdom communication. Free Radical Biology and Medicine 149:37-43.
Roef G, Taes Y, Toye K, Goemaere S, Fiers T, Verstraete A, et al. 2013. Heredity and lifestyle in the determination of between-subject variation in thyroid hormone levels in euthyroid men. Eur J Endocrinol 169:835-844.
Roland MCP, Friis CM, Voldner N, Godang K, Bollerslev J, Haugen G, et al. 2012. Fetal growth versus birthweight: The role of placenta versus other determinants. PloS one 7:e39324.
Rubin R, Pearl M, Kharrazi M, Blount BC, Miller MD, Pearce EN, et al. 2017. Maternal perchlorate exposure in pregnancy and altered birth outcomes. Environmental research 158:72-81.
Ruggeri RM, Giovinazzo S, Barbalace MC, Cristani M, Alibrandi A, Vicchio TM, et al. 2021. Influence of dietary habits on oxidative stress markers in hashimoto's thyroiditis. Thyroid 31:96-105.
Schier JG, Wolkin AF, Valentin-Blasini L, Belson MG, Kieszak SM, Rubin CS, et al. 2010. Perchlorate exposure from infant formula and comparisons with the perchlorate reference dose. Journal of exposure science & environmental epidemiology 20:281-287.
Sellitti DF, Suzuki K. 2014. Intrinsic regulation of thyroid function by thyroglobulin. Thyroid 24:625-638.
Seth A, Sekhri Τ, Agarwal A. 2007. Effect of perinatal factors on cord blood thyroid stimulating hormone levels. Journal of Pediatric Endocrinology and Metabolism 20:59-64.
Shi Y, Zhang P, Wang Y, Shi J, Cai Y, Mou S, et al. 2007. Perchlorate in sewage sludge, rice, bottled water and milk collected from different areas in china. Environ Int 33:955-962.
Siglin JC, Mattie DR, Dodd DE, Hildebrandt PK, Baker WH. 2000. A 90-day drinking water toxicity study in rats of the environmental contaminant ammonium perchlorate. Toxicological Sciences 57:61-74.
Smith PN, Theodorakis CW, Anderson TA, Kendall RJ. 2001. Preliminary assessment of perchlorate in ecological receptors at the longhorn army ammunition plant (lhaap), karnack, texas. Ecotoxicology 10:305-313.
Soto-Blanco B, Górniak SL. 2003. Milk transfer of cyanide and thiocyanate: Cyanide exposure by lactation in goats. Veterinary research 34:213-220.
Srinivasan A, Viraraghavan T. 2009. Perchlorate: Health effects and technologies for its removal from water resources. International Journal of Environmental Research and Public Health 6:1418-1442.
Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. 2011. Guidelines of the american thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21:1081-1125.
Stagnaro-Green A, Pearce E. 2012. Thyroid disorders in pregnancy. Nature Reviews Endocrinology 8:650-658.
Steinmaus C, Miller MD, Smith AH. 2010. Perchlorate in drinking water during pregnancy and neonatal thyroid hormone levels in california. Journal of occupational and environmental medicine 52:1217-1524.
Téllez RT, Chacón PM, Abarca CR, Blount BC, Landingham CBV, Crump KS, et al. 2005. Long-term environmental exposure to perchlorate through drinking water and thyroid function during pregnancy and the neonatal period. Thyroid 15:963-975.
Taylor PN, Okosieme OE, Murphy R, Hales C, Chiusano E, Maina A, et al. 2014. Maternal perchlorate levels in women with borderline thyroid function during pregnancy and the cognitive development of their offspring: Data from the controlled antenatal thyroid study. The Journal of Clinical Endocrinology & Metabolism 99:4291-4298.technologyMmhi.2016.Congenitalhypothyroidism.Available:http://www.mmh.org.tw/taitam/pedend/index4/index4_2_3.html.
Tonacchera M, Pinchera A, Dimida A, Ferrarini E, Agretti P, Vitti P, et al. 2004. Relative potencies and additivity of perchlorate, thiocyanate, nitrate, and iodide on the inhibition of radioactive iodide uptake by the human sodium iodide symporter. Thyroid 14:1012-1019.
Tran N, Valentin-Blasini L, Blount BC, McCuistion CG, Fenton MS, Gin E, et al. 2008. Thyroid-stimulating hormone increases active transport of perchlorate into thyroid cells. American Journal of Physiology-Endocrinology and Metabolism 294:E802-E806.
Trumpolt CW, Crain M, Cullison GD, Flanagan SJ, Siegel L, Lathrop S. 2005. Perchlorate: Sources, uses, and occurrences in the environment. Remediation Journal: The Journal of Environmental Cleanup Costs, Technologies & Techniques 16:65-89.
TWHPA. 2018. 國人膳食營養素參考攝取量. Available: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=544&pid=725.
Ucal Y, Sahin ON, Serdar M, Blount B, Kumru P, Muhcu M, et al. 2018. Exposure to perchlorate in lactating women and its associations with newborn thyroid stimulating hormone. Frontiers in endocrinology 9:348.
USEPA.2021a.Potassiumperchlorate.Available:https://comptox.epa.gov/dashboard/dsstoxdb/results?search=DTXSID3047003#product-use-categories.
USEPA. 2021b. Magnesium perchlorate.
Valentín-Blasini L, Blount BC, Otero-Santos S, Cao Y, Bernbaum JC, Rogan WJ. 2011. Perchlorate exposure and dose estimates in infants. Environmental science & technology 45:4127-4132.
Vejdovszky K, Grossgut R, Unterluggauer H, Inreiter N, Steinwider J. 2018. Risk assessment of dietary exposure to perchlorate for the austrian population. Food Additives & Contaminants: Part A 35:624-632.
Villanger GD, Drover SS, Nethery RC, Thomsen C, Sakhi AK, Øvergaard KR, et al. 2020. Associations between urine phthalate metabolites and thyroid function in pregnant women and the influence of iodine status. Environment International 137:105509.
Wang B, Song R, He W, Yao Q, Li Q, Jia X, et al. 2018. Sex differences in the associations of obesity with hypothyroidism and thyroid autoimmunity among chinese adults. Frontiers in physiology 9:1397.
Wang Z, Sparling M, Wang KC, Arbuckle TE, Fraser W. 2019. Perchlorate in human milk samples from the maternal-infant research on environmental chemicals study (mirec). Food Additives & Contaminants: Part A 36:1837-1846.
Weitzberg E, Lundberg JO. 2013. Novel aspects of dietary nitrate and human health. Annual review of nutrition 33:129-159.
WHO U. 2007. Iccidd: Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers. Geneva: World Health Organization:1-94.
Winther KH, Rayman MP, Bonnema SJ, Hegedüs L. 2020. Selenium in thyroid disorders—essential knowledge for clinicians. Nature Reviews Endocrinology:1-12.
Wirojsaengthong S, Aryuwananon D, Aeungmaitrepirom W, Pulpoka B, Tuntulani T. 2021. A colorimetric paper-based optode sensor for highly sensitive and selective determination of thiocyanate in urine sample using cobalt porphyrin derivative. Talanta 231:122371.
Xueyu W. 2005. The diagnostic accuracy of the "comprehensive infant and toddler development test" action subtest and the "peabody motor development scale 2nd edition".
YEH TS, LIAO SF, KUO CY, HWANG WI. 2013. Investigation of the nitrate and nitrite contents in milk and milk powder in taiwan. Journal of food and drug analysis.
Yoo YG, Boas JY, Choi E-H. 2018. A comparison study: The risk factors in the lifestyles of thyroid cancer patients and healthy adults of south korea. Cancer nursing 41:E48-E56.
York RG, Brown WR, Girard MF, Dollarhide JS. 2001. Two-generation reproduction study of ammonium perchlorate in drinking water in rats evaluates thyroid toxicity. International Journal of Toxicology 20:183-197.
York RG, Funk KA, Girard MF, Mattie D, Strawson JE. 2003. Oral (drinking water) developmental toxicity study of ammonium perchlorate in sprague-dawley rats. International journal of toxicology 22:453-464.
Yu J, Dong H-W, Shi L-T, Tang X-Y, Liu J-R, Shi J-H. 2019. Reproductive toxicity of perchlorate in rats. Food and Chemical Toxicology 128:212-222.
Zaki A, Chaoui AA, Talibi A, Derouiche A, Aboussaouira T, Zarrouck K, et al. 2004. Impact of nitrate intake in drinking water on the thyroid gland activity in male rat. Toxicology letters 147:27-33.
Zhang T, Ma Y, Wang D, Li R, Chen X, Mo W, et al. 2016. Placental transfer of and infantile exposure to perchlorate. Chemosphere 144:948-954.
Zhu F, Huang M, Jiao J, Zhuang P, Mao L, Zhang Y. 2019. Environmental exposure to perchlorate, nitrate, and thiocyanate in relation to obesity: A population-based study. Environment international 133:105191.
Zhu F, Jiao J, Zhuang P, Huang M, Zhang Y. 2021. Association of exposures to perchlorate, nitrate, and thiocyanate with allergic symptoms: A population-based nationwide cohort study. Environmental Pollution:117068.
Zimmermann MB, Jooste PL, Pandav CS. 2008. Iodine-deficiency disorders. The Lancet 372:1251-1262.
Zimmermann MB. 2012. The effects of iodine deficiency in pregnancy and infancy. Paediatric and perinatal epidemiology 26:108-117.
Zygmunt B, Buczkowski D. 2012. Agriculture grade ammonium nitrate as the basic ingredient of massive explosive charges. Propellants, Explosives, Pyrotechnics 37:685-690.
張毓文. 2019. 新生兒高氯酸鹽, 硝酸鹽及硫氰酸鹽暴露與早期發育之相關性研究.
傅玉萍. 2018. 懷孕婦女高氯酸鹽, 硝酸鹽及硫氰酸鹽暴露評估及其對甲狀腺功能之影響. 成功大學環境醫學研究所學位論文:1-25.