Improving the Accuracy of Iodization of the Dietary Salt Supplies of Populations

Objectives: The mandate of this working group was to assess the importance of salt iodine quality in successful IDD prevention and control. Examine the role of salt iodine content in quality assurance, inspection, surveillance, and coalition oversight of IDD programs. Methods: Scientific literature, technical reports and a range of data and information sources were reviewed to determine whether accurate salt iodization was making a critical contribution toward safe and successful IDD programs. Results: Evidence and examples were collected on salt iodine data in quality assurance of iodization by salt industry, assessments of iodized salt quality by inspectors in factories and markets, surveillance of USI strategies and dietary iodine supplies by program managers, and in provision of coalition oversight by high-level officials. Conclusions: Because salt iodization is a supply-based strategy, reliable accuracy at the source is most critical. It is therefore vital that each salt factory should adopt a quality management system, with standard operating procedures at least for the manufacturing and packaging of iodized salt. Titration is preferred but other quantitative methods with e.g. the WYD Checker, i-Reader or Bioanalyt can also yield accurate data. Improved accuracy down the supply chain is desirable, especially in surveillance, but commonly points to the need for ensured accuracy at the source when quality failures are discovered. The need remains for an agreed approach to obtain reliable data of the use of iodized salt in the food manufacturing industry.