山东省黄河下游冲积平原地区地方性氟中毒流行病学调查

目的 了解山东省黄河下游冲积平原地区地方性氟中毒流行现状.方法 按照国家<2008年地方病防治项目技术实施方案>要求,选择16个县,每个县选择3个村,测定饮用水含氟量,检查8～12岁儿童氟斑牙和＞16岁人群氟骨症,并抽查尿氟含量.水、尿氟含量测定采用氟离子选择电极法,8～12岁儿童氟斑牙诊断采用Dean's法,氟骨症诊断执行<地方性氟骨症诊断>标准(WS 192-2008).结果 调查26个改水村,其中水氟均值≤1.00mg/L的村19个(73.08%),＞1.00 mg/L的村7个(26.92%);水氟最大值为3.73 mg/L.调查22个未改水村,其中水氟均值≤1.00 mg/L的村5个(22.73%),＞1.00 mg/L的村17个(77.27%);水氟最大值为3.38 mg/L.8～12岁儿童氟斑牙总患病率为52.18%(1042/1997),氟斑牙指数为1.17,缺损率为8.01%(160/1997);儿童尿氟均值＞1.40mg/L的人数占65.00%(845/1300),最高值为18.53mg/L;＞16岁人群氟骨症临床和X线检出率分别为4.35%(1121/25 781)和11.36%(5/44).成年人尿氟均值＞1.60mg/L的人数占63.92%(606/948),最高值为21.35 mg/L.结论 山东省黄河下游冲积平原地区地方性氟中毒尚未得到有效控制.

Epidemiological investigation on endemic fluorosis along the Yellow River alluvial plain of Shandong province

Objective To investigate the current prevalent status of endemic fluorosis in the floodplain area of the lower Yellow River in Shandong province. Methods According to "The National Technical Scheme for Endemic Disease Control in 2008", 16 counties were chosen to carry out the epidemiological survey of endemic fluorosis. Three villages were chosen in each county, to determine the fluoride content of drinking water and to check the dental fluorosis of children aged 8 to 12 year old, the skeletal fluorosis of adults over 16 years of age. Both children and adults were tested for urine fluoride. The content of fluoride in drinking water and urine was determined by F-ion selective electrode while dental fiuorosis of children aged 8 to 12 years old was diagnosed by Dean's method and adults skeletal fluorosis by the National Standard for "Diagnosis of endemic skeletal quality' villages in 16 counties, among which 19 villages had water fluoride content ≤ 1.00 mg/L and accounted for 73.08% ( 19/26), 7 villages had water fluoride content ＞ 1.00 mg/L and accounted for quality' villages in 16 counties, 5 villages had water fluoride content ≤ 1.00 mg/L (accounted for 22.73% ), 17 villages had water fluoride content ＞1.00 mg/L(accounted for 77.27% ), with the highest water fluoride content as 3.38 mg/L. The overall rate of dental fluorosis among children aged 8to 12 years old was 52.18% (1042/1997), with the index of dental fluorosis as 1.17 and the rate of dental damage as 8.01% (160/1997). The urinary fluoride values above 1.40 mg/L were found in 65.00% (845/1300) of children aged 8 to 12 years old, with the highest urinary fluoride concentrations as 18.53 mg/L. The rate of skeletal fiuorosis by clinic and X-rays in adults older than 16 years old were 4.35% ( 1121/25 781 ) and 11.36%(5/44), respectively. The urinary fluoride values above 1.60 mg/L were found as 63.92%(606/948) in adults older than 16 years old, with the highest urinary fluoride concentrations as 21.35 mg/L. Conclusion The status of endemic fluorosis had not been effectively controlled and the situation for endemic fluorosis control was still critical in the floodplain area of the lower Yellow River in Shandong province, suggesting that the preventive approaches on endemic fluorosis control should be strengthened.