三峡工程对开县人群健康可能发生的潜在影响的预测评估

背景三峡库区历史上曾为传染病、自然疫源性疾病和地方病的高发地区,其淹没面积大、人口密集,水库形成后的污染可能会造成对人群健康的危害.目的通过分析开县地区人群的主要健康指标以及影响因素,对三峡水库形成后可能产生的对人群健康造成的影响因素进行预测性评估.设计横断面调查.单位重庆医科大学公共卫生学院及重庆市开县疾病控制中心.对象调查于2004-02/05在重庆市开县完成,调查对象为该县所有人口的疾病监测资料,选择三峡库区重庆段其他库区县及非库区县人群的疾病监测资料作为对照.方法收集有关社会发展、人群健康和与公共卫生体系的有关指标,深入有代表性的重点乡镇现场调查.对相关资料数据进行比较分析,并利用定量与定性相结合的方法对三峡工程对人群健康的潜在影响做出全面预测评估.主要观察指标①开县、重庆市和全国1999～2001年一般人群的健康状况比较.②开县、重庆市和全国1999～2003年传染病发病率比较.③水库形成后对人群健康产生的潜在影响.结果①开县、重庆市和全国1999～2001年一般人群的健康状况比较开县孕产妇病死率、婴儿以及5岁以下儿童病死率高于全国和重庆市的平均水平,多项指标显示出开县的一般人群健康状况较差.②开县、重庆市和全国1999～2003年传染病发病率比较重庆市的传染病发病率维持在250/10万左右,高于全国水平(190/10万左右).开县的传染病发病率逐年升高,近两年的发病率达国内的1.5倍以上.③水库形成后可能发生的对人群健康产生的潜在影响介水传染病尤其是病毒性肝炎的发病;自然疫源疾病及虫媒传染病性疾病的发生;肝癌等恶性肿瘤性疾病.结论应加强对现有公共卫生体系相对薄弱环节和潜在各种疾病流行和突发公共卫生事件发生的认识.随着三峡工程的进度加快,必须加强防治对策,预防和减轻水库形成后可能对人群产生的健康危害.

Possible potential impact of Three-gorges Project on population health in Kaixian County of Chongqing

BACKGROUND: In the past, the incidence rates of infectious diseases,natural epidemic diseases and endemic diseases in three gorges areas were always high. Because the flooded areas of Kaixian was enormous, the population of Kaixian was intensive density, the pollution may harm to the population health after the dam has been established.OBJECTIVE: To predict the influence of the Three-gorges dam on population health in Kaixian County of Chongqing and put forward to scientific evidence of preventive measures through analyzing the main health indicators and influence factors in Kaixian.DESIGN: Cross-sectional study.SETTING: Public Health College of Chongqing Medical University and Disease Controlled Center in Kaixian County of Chongqing.PARTICIPANTS: The survey was conducted in Kai County of Chongqing,from February to May 2004. All disease surveillance data of people in this county was investigated and other people lived in three-gorges area or around area were selected as the controls.METHODS: Collect and sort relevant indicators of social development,population health and public health system of Kaixian and related area to go deep into the representative townships to do some filed investigation,collect water samples of local drainage areas to carry out laboratory quantitative analysis; carry out comparative analysis based on the relevant materials; carry out comprehensive predicting and evaluation to the potential impact on population health of the three gorges engineering by combining the quantitative and qualitative analysis methods.general people in Kai county, Chongqing city and all over the nations durKai county, Chongqing city and all over the nations during 1999 and 2003;ty, Chongqing city and all over the nations during 1999 and 2001: Mortality rates of infants and under-five children were also higher than that average levels of whole country and Chongqing respectively; Multi-indicators showed that the general population health status of Kaixian was great bad,which stood a distinct gap among average levels of the whole country and Chongqing maintained about 250/100 000 or so, which was higher than the national level (190/10 000), however, the incidence rate of infectious diseases of Kaixian was rising year after year, even that of the recent two years has been reached up to more than 1.5 times higher than that of the whole of the water-based infectious diseases, especially the virus hepatitis, was severe. Another potential impact on population health of three-gorge dam is the emergence of natural epidemic diseases and insect-based infectious diseases. Malignant tumor such as hepatocarcinoma.CONCLUSION: We should strengthen current public health system, and cognition to the possible threat on disease epidemic and public health.With the construction of three-gorge dam, it is necessary to speed up establishment of effective measures to reduce predictable influence on population health.