贵州省地方性砷中毒防治现状及对策

贵州省燃煤污染型砷中毒病区主要分布于4县9乡镇32个行政村，暴露人口约4万人，8700余户．现症病人2848人。其主要流行特点为室内砷暴露水平与煤含砷量、用煤量、燃煤时间、房屋大小及通风情况、食物干燥储存方式等多种因素有关；通过消化道、呼吸道和皮肤等多途径摄砷；多在冬季发病，起病较急，首先出现亚急性砷中毒表现：肝硬化腹水是主要死因之一；氟、砷、二氧化硫等多重污染共存。该病在贵州省发生与流行已久，虽采取一定的防治措施，未能得到完全控制，建议在病区政府领导下．制定限期控制行动计划，采取以健康教育为基础，禁采高砷煤、改炉改灶为主的综合防治措施，尽快控制病区砷污染。

Epidemiological status and countermeasures of endemic arseniasis of Guizhou Province

Endemic regions of Guizhou Province with arseniasis caused by domestic coal burning are distributed in Xingren, Anlong, Xingyi and Zhijin Counties. 9 Towns and 32 Villages are implicated, and the population of direct exposure is about 40 thousand. There are 8 786 households and 2 848 cases with arseniasis. The epidemiology is characterized by that the endemic is influenced by many factors, such as indoor exposure levels to arsenic, concentrations of arsenic in the coal, quantity and time of coal usage, ventilation of the room, the ways of dehydration and storage of the foodstuff. Arsenic is ingested through alimentary and respiratory tract as well as the skin. It occurs mainly in winter with sub-acute symptoms. Cirrhosis of liver and ascites are the two main causes of death. Multiple pollution by chemicals such as arsenic, fluoride and sulfur dioxide exists due to coal burning. Countermeasures have been done since then, but the endemic has not been effectively controlled. It is suggested that, in order to entirely control the endemic as soon as possible, the local government should take integrated controlling actions such as closing down the coal pits of high amount of arsenic with established time limit based on health education and promotion, encouraging the residents to stop mining the high arsenic coal and using the improved stoves.