2008年陕西省饮水型地方性氟中毒调查分析

目的 掌握2008年陕西省饮水型地方性氟中毒流行现状,为防治工作提供依据.方法 根据陕西省饮水型地方性氟中毒历史资料,将榆林、渭南、咸阳市15个病区县(区)按照饮水含氟量或病情分为轻、中、重病区,在上述病区分别抽取12、39、45个调查村.对每个调查村全部8～12岁儿童进行氟斑牙检查,对16岁及以上人群进行I临床氟骨症检查.在轻、中、重病区中分别抽取30%的调查村,每个村抽取男女各10人进行X线氟骨症检查;在未改水调查村,按东、西、南、北、中采5份水样,水源不足5个的全部采集,对已改水调查村,采3份末梢水样及1份水源水样,水氟测定采用氟离子电极法.在各病区中抽取50%的调查村,每个村采集8～12岁儿童尿样30份,每个年龄组6份,总数不足30人或各年龄组不足6人时全部采集其尿样,采用氟离子电极法测定尿氟.结果 共调查8～12岁儿童3652人,检出氟斑牙患者1930例,检出率为52.85%,氟斑牙指数为1.22.其中定边、靖边、蒲城县的检出率较高,分别为90.43%(170/188)、82.89%(126/152)、80.65%(325/403).共调查16岁及以上成人加543人,检出临床氟骨症患者5935例,总检出率为14.64%.轻、中、重度检出率分别为9.17%(3717/40 543)、4.36%(1769/40 543)、1.11%(449/40 543).X线拍片706例,检出阳性人数280例,总阳性率为39.66%.轻、中、重度阳性率分别为17.28%(122/706)、17.00%(120//06)和5.38%(38/706).采集饮用水水样427份,水氟为(2.22 ±1.41)mg/L,超标率为85.01%(363/427).采集儿童尿样1393份,尿氟中位数为2.37 mr/L.结论 陕西省饮水型氟中毒流行仍然较为严重,改水防治措施应进一步加强和完善.、

Investigation and analysis on endemic fluorosis associated with drinking water in Shaanxi in 2008

Objective To investigate the current situation of endemic fluorosis associated with drinking water in Shaanxi province in 2008, providing prevention and control work with scientific evidence. Methods According to data of drinking water endemic fluorosis in Shaanxi, 15 counties in Yulin, Weinan and Xianyang city were divided into mild, moderate and severe diseased areas according to fuoride level in the drinking water or the fluorosis severity, and 12,39,45 endemic fluorosis villages were selected respectively from each area. Dental fluorosis for all the children aged 8 - 12 years old and clinical skeletal fluorosis for the people over the age of 16 were examined. In mild, moderate and severe areas, 30% of the survey villages received X-ray to examine skeletal fuorosis. Five water samples were collected from villages with unimproved water respectively from the east, the west, the south, the north, the middle; if there was less than 5 that could be sampled, then all were collected, moreover 3 peripheral and 1 central water samples were collected from villages with improved water. Also in mild, moderate and severe illness areas, 50% of the surveyed villages were selected; in each village, 30 urine samples of the children aged 8 - 12 were collected, 6 portions in each age group. If Less than 30 children in all the age groups or less than 6 in each age group, all their urine samples were collected to determine fluoride. Results Totally 3652 children aged 8 - 12 years old were examined and 1930 cases of dental fluorosis were diagnosed, the rate was 52.85% and the index was 1.22. The rates in Dinghian, Jingbian and Pucheng village were higher, being 90.43% (170/188) ,82.89%(126/152),80.65% (325/403) respectively. A total of 40 543 adults over the age of 16 were examined and 5935 cases of skeletal fluorosis were diagnosed, in a rate of 14.64%. The rates of the mild, moderate, severe skeletal fluorosis were respectively 9.17%(3717/40 543),4.36%(1769/40 543),1.11%(449/40 543).All 706 adults were taken X-ray films.and 280 cases of positive change were diagnosed,the positive rate was 39.66%. The rates of the mild,moderate,severe change were respectively 17.28%(122/706),17.00%(120/706),5.38%(38/706).All 427 water samples were collected,the fluoride content waS(2.22±1.41)ms/L,and the abnormal rate was 85.01%(363/427).All 1393 portions of urine sample were collected in children and the median of fuoride was 2.37 mg/L Conclusions The endemic fluorosis associated with drinking water is still comparatively serious in Shaanxi.The preventive measures for improving water must be improved.