江苏丰县地方性氟中毒现况研究

目的了解丰县地方性氟中毒现况及病因。方法采用整群随机抽样的方法，对1个城区和2个乡镇900余人进行调查。采用Dean法进行氟斑牙诊断。结果丰县氟斑牙患病率为77．0％，氟骨症患病率为23．7％。饮用浅层地下水的居民氟斑牙患病率为84．8％，饮用自来水的人群其患病率是74．2％，二者有差异（P〈0．01）。改水前后出生的人群氟斑牙患病率分别是78．0％、63．9％。2组人群氟斑牙患病率有差异（P〈0．01）。吸烟的人群氟斑牙患病率为85．4％，非吸烟人群患病率是73．8％，吸烟人群氟斑牙患病率高于非吸烟的人群（P〈0．01）。常食高钙食物者氟斑牙患病率是72．2％，不常食高钙食物者患病率为84．7％，两者比较有统计学意义（P〈0．01）。以柴为主要燃料的居民氟斑牙患病率（84．3％）高于其他人群（煤：74．2％；气：70．1％）。专科及以上文化程度人群氟中毒患病率（60．3％）最低，与其他人群相比有差异（文盲：84．3％；小学：87．3％；初中：74．0％；高中：71．6％）。地方性氟中毒患病率城市明显低于乡村。结论改水取得了一定效果，但丰县地方性氟中毒病情仍然较重，该地区地方性氟中毒不仅与饮用水有关，也与饮食结构、行为生活方式、文化程度、卫生服务等有关，防治工作需多方位进行。

Research on the status quo of endemic fluorosis of Feng County of Jianghsu Province

Objective To investigate the status quo of endemic fiuorosis in Feng County, Jiangsu Province and discuss its etiology. Methods A survey was conducted by cluster random sampling on over 900 residents from one urban and two rural townships. Dental fluorosis was determined by Dean classification. Results The prevalence of dental and skeletal fluorosis in Feng County was 77.0% and 23.7% , respectively. The rate of dental fluorosis in residents drinking shallow groundwater and tap water was 84.8% and 74.2%, respectively, which indicated a significant difference （P 〈 0.01 ）. The prevalence of dental fluorosis in people born before and after Water improvement was 78.0% and 63.9% , respectively, with a significant difference （P 〈 0.01 ）. The observation of the prevalence of the dental fluorosis in smokers （85.4%） and nonsmokers （73.8%） bad a significant difference （P 〈 0.01 ）. Statistical significance was obtained between the group with calcium - rich diet and the group without, whose prevalence of dental fluorosis was 72.2% , and 84.7% , respectively. People using the firewood as the main fuel had a higher prevalence of dental fluorosis （ 84.3% ） than those using other fuels （coal： 74.2%, gas： 70.1% ）. The lowest prevalence （60.3%） was obtained in the people with junior college education or above, which is obviously different from other groups （ illiteracy： 84.3% ; primary school： 87.3% ; junior high school： 74.0% and senior high school： 71.6% ）. The prevalence of endemic fluorosis in urban areas was significantly lower than that in rural areas. Conclusions Despite the achievements in Water improvement, the status of endemic fluorosis is still serious in Feng County. The fluorosis in Feng County is not only correlated with drinking water, but also with dietary structure, life style, education, and health service, etc., and therefore, muhi- dimensional prevention and treatment are required.