江西省宜春市燃煤污染型氟中毒流行病学调查及分析

目的调查掌握宜春市燃煤型氟中毒流行病学现状,为今后合理规划和改进防制措施提供科学依据。方法儿童氟斑牙用丁氏法进行判定;玉米、辣椒、生活用煤、室内空气、生活饮用水及尿氟采用氟离子电极法测定,按GB/T5009-1996判定;逐户调查病区村燃煤情况、房屋结构、燃烧方式;氟骨症诊断执行地方性氟骨症临床分度诊断标准和氟骨症X线诊断标准。结果总计调查3个县市区,71个乡镇,919个行政村;调查8~12岁儿童137 277人,查出氟斑牙人数8 021人,氟斑牙平均患病率为5.84%;袁州区、万载县煤氟低于全国煤氟水平,水氟低于国家卫生标准,玉米、辣椒、旺火期空气含量都超过国家卫生标准;检测了647份小学生尿样,均值为0.71 mg/L;调查了52个病区村,总计33 278户;对89 212人进行了氟骨症调查,未发现氟骨症患者。结论 8~12岁儿童氟斑牙患病率呈较大幅度地下降,未发现有氟骨症患者,调查结果说明燃煤污染型氟中毒病情得到了一定程度的控制。

Epidemiological investigation of coal burning related endemic fluorosis in Yichun,Jiangxi

Objective To investigate the epidemiological situation of endemic fluorosis related to air pollution caused by burning coal in Yichun and provide a scientific basis for rational planning and improvement measures in future.Methods The prevalence of dental fluorosis was investigated among children aged 8-12 years by Dean Classification in the areas of Yuanzhou district,Wanzai county and Fengcheng City.Each family was surveyed for bunker coal use situation,house structure and combustion mode for the villages of survey areas.The contents of fluoride were analyzed for corn,pepper,urinary,drinking water and air collected from the villages of endemic areas.The prevalence of skeletal fluorosis was determined with the standards of GB/T16396-1996 and WS192-2008 for residents aged over 16 years.Results The investigation included 71 townships and 919 administrative villages.The prevalence rate of dental fluorosis was 5.84% for 137 277 children aged 8-12 years.The fluorosis content in coal was higher than the national level,the water fluorosis was lower than the national hygienic level,but the fluorosis content in corn,pepper and air of high-temperature fire were higher than the national hygienic level in Yuanzhou district and Wanzai county.The mean urinary fluoride of 647 samples was 0.71 mg/L;There was no skeletal fluorosis patient confirmed among the 89 212 residents of 33 278 families.Conclusion The prevalence of dental fluorosis decreased significantly among children aged 8-12 years and no skeletal fluorosis patient was confirmed.The results indicated that the measures of decreasing coal burning fluoride pollution were effective.