2010年山东省地方性氟中毒病情调查

目的了解山东省地方性氟中毒的病情现状,为制定防制策略提供科学依据。方法按照国家《2009年地方病防治项目技术实施方案》和《饮水型地方性氟中毒监测方案(试行)》的要求,选择10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≥25岁成人氟骨症。水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)。结果在10个县中,共调查26个已改水村和4个未改水村。在26个已改水村中,水氟均值≤1.20 mg/L的村15个,占57.69%;>1.20 mg/L的村11个,占42.31%,水氟最大值为5.58 mg/L。在4个未改水村中,水氟均值≤1.20 mg/L的村1个,占25.00%,>1.20 mg/L的村3个,占75.00%,水氟最大值为2.92 mg/L。检查已改水村8～12岁儿童1 331人,氟斑牙检出率为59.73%,氟斑牙指数为1.17,缺损率为10.14%。检查未改水村8～12岁儿童138人,氟斑牙检出率为51.45%,氟斑牙指数为0.95,缺损率为0.72%。已改水村和未改水村≥25岁成人的氟骨症X线检出率分别为8.80%和3.05%。结论山东省改水降氟工程水氟超标严重,地方性氟中毒病情尚未得到有效控制,须进一步加大防制力度。

Investigation on endemic fluorosis condition of Shandong province in 2010

Objectives To investigate the status of endemic fluorosis condition in Shandong province at present,and to provide the scientific evidence for making strategies for the prevention and control.Methods In accordance with the national "Technology Implementation Plan for Endemic Disease Control Project in 2009" and "drinking water endemic fluorosis monitoring program(trial)",Ten counties were chosen to carry out the investigation,three villages were chosen in each county,to determine fluoride content of drinking water,check the 8 to 12 years old children’s dental fluorosis and ≥ 25-year-old adult skeletal fluorosis.Water fluoride content was determined by fluoride ion selective electrode method,children aged 8 to 12 were diagnosed with dental fluorosis Dean’s method and adults skeletal fluorosis by the National Standard for "Diagnosis of endemic skeletal fluorosis"(WS 192-2008).Results Twenty-six improved water quality villages and four yet no improve-water quality villages were investigated in 10 counties.In the 26 improved water quality villages,15 villages had water fluoride mean ≤1.20 mg / L and accounted for 57.69%,11 villages had water fluoride mean > 1.20 mg / L and accounted for 42.31%,with the maximum water fluoride mean as 5.58 mg/L.In the 4 yet no improve-water quality villages,1 village had water fluoride mean ≤ 1.20 mg / L and accounted for 25.00%,3 villages had water fluoride mean > 1.20 mg / L and accounted for 75.00%,with the maximum water fluoride mean as 2.92 mg/L.1 331 children aged 8 to 12 years old were checked in the 26 improved water villages,with the detection rate of dental fluorosis among children aged 8 to 12 years old was 59.73%,the index of dental fluorosis as 1.17 and the rate of dental damage as 10.14%.138 children aged 8 to 12 years old were checked in 4 yet no improve-water quality villages,with the detection rate of dental fluorosis among children aged 8 to 12 years old was 51.45%,with the index of dental fluorosis as 0.95 and the rate of dental damage as 0.72%.In improved water quality villages and yet no improve-water quality villages,X-rays detection rates of skeletal fluorosis ≥ 25-year-old of adult were 8.80% and 3.05%,respectively.Conclusions The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.So preventive measures for endemic fluorosis should be strengthened.