人体总摄氟量与氟骨症的剂量-效应关系

目的 探讨人体总摄氟量和氟骨症患病情况间的确切剂量-效应关系,为地方性氟中毒防治提供参考依据.方法 根据家庭手压井饮水含氟量的不同,分别从江苏省地方性氟中毒重病区村瓦庙村和非病区村新淮村抽取调查对象,观察日均总摄氟量和氟骨症患病情况,并把两村的调查对象作为一个整体,根据每个调查对象日均总摄氟量分为5个剂量组(＜2.00、2.00～、3.00～、4.00～、≥5.00 mg/d),分析日均总摄氟量和氟骨症患病情况的关系.结果 瓦庙村氟骨症检出率为31.06%(41/132),新淮村未发现氟骨症患者(0/35).调查对象随着日均总摄氟量的升高,氟骨症的检出率明显增加,有显著的剂量-效应关系(Quadriatic fit模型拟合曲线的回归方程为:y=2.624-6.855x+3.424x2,r=0.997).根据剂量-效应关系计算的总摄氟量的基准剂量95%可信限的下限值为2.50 mg/d,由此可得日均总摄氟量的参考剂量为2.50 mg/d.瓦庙村氟骨症患者[(5.09±1.20)mg/d]和非氟骨症者[(3.08±1.12)mg/d]的日均总摄氟量比较,差异有统计学意义(t=-9.32,P＜0.01).结论 在饮水型地方性氟中毒病区,日均总摄氟量和氟骨症检出率间呈正相关剂量-效应关系,日均总摄氟量的参考剂量(2.50 mg/d)低于<人群总摄氟量卫生标准>(WS/T 87-1996)的要求(3.50 mg/d).

Dose-respones relationship between daily total fluoride intake and prevalence of osteofluorosis

Objective To investigate the daily total fluoride intake in relating to the prevalence of skeletal fluorosis in two villages in Jiangsu Province,in order to provide the scientific evidences for the control and prevention of endemic fluorosis.Methods Adults sampled from a high-fluoride Village,Wamiao,and a low-fluoride Village,Xinhuai,were surveyed in this study according to the fluoride concentration in their household shallow well.The average daily total fluoride intake from difierent sources and the skeletal fluorosis were investigated in each subject.Then the subjects from two villages were allocated into five subgroups(＜2.00,2.00～,3.00～,4.00～,≥5.00 mg/d),the relation fluoride intake and prevalence of osteofluorosis was analyzed.Results The prevalence of skeletal fluorosis in Wamiao Village was 31.06%(41/132),but no skeletal fluorosis case(0/35)was found in Xinhuai Village.According to the daily total fluoride intake,subjects with higher daily total fluoride intake tended to associated with a higher prevalence of skeletal fluorosis in a significant dose-response relationship(regression equation:y=2.624-6.855x+3.424x2:r=0.997).The benchmark dose lower limitation of daily total fluoride intake with 95% confidencewas 2.50 mg/d calculated according to this dose-response relationship,the reference dose(RfD)was 2.50 mg/d.In Wamiao Village a significant difference was also found between daily total fluoride intake in 41 subjects[(5.09±1.20)mg/d]with X-ray detectable skeletal fluorosis and in 91 subjects[(3.08±1.12)mg/d]without X-ray detectable skeletal fluorosis(t=-9.32,P＜0.01).Conclusions These findings indicate that the daily total fluoride intake has a significant dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water;and the RfD in this study was lower than that in the national standard of"Chinese hygienic standard for daily total fluoride intake(WS/T 87-1996)"(3.50 mg/d).