辽宁省饮水型地方性氟中毒病区防治状况调查

目的 开展辽宁省饮水型地方性氟中毒流行状况和病区控制效果普查,依据《地方性氟中毒病区划分》（GB17018—2011）,评价防控措施落实和氟斑牙病情控制效果。方法 2019年,辽宁省对所有的饮水型氟中毒病区进行生活饮用水水氟含量、8~12周岁儿童氟斑牙患病情况普查。集中改水病区村采集1份末梢水水样进行水氟含量检测,分散式改水和未改水病区村按照东、西、南、北、中五个方位在饮用水源各采集1份水样,饮用水源不足5个的则全部采集,测定氟含量。检查病区村当地出生并居住的全部8~12周岁儿童氟斑牙患病情况,检查率不低于90%。结果 辽宁省2 496个饮水型病区村全部开展调查,其中已改水村数2 279个,占病区村数的91.3％,未改水病区村217个,占病区村数的8.7％。已改水病区村中,正常运转工程2 011个,占改水村的88.2％,间歇运转工程64个,占改水村的2.8％,报废改水工程204个,占改水村的9.0％;改水病区水氟合格率为91.8％。全省检查 8~12周岁儿童36 542人,检出氟斑牙患者1 713人,氟斑牙患病率为4.7%。结论 根据普查结果,以县（市、区）为单位统计,全省40个病区县（市、区）实现了氟中毒控制,15个县（市、区）未控制。较2016年“十二五”终期自评的28个县（市、区）达到控制,改水措施的落实明显得到改善,病区儿童氟斑牙病情得到了有效的控制。但依然存在局部地区仍未改水和改水工程水氟超标问题,应予以重视。

Investigation on control and prevention of drinking water endemic fluorosis in Liaoning

Objective To investigate the endemic fluorosis in drinking water type in Liaoning Province and the control effect of endemic fluorosis area, and we evaluate the implementation of prevention and control measures and the control effect of dental fluorosis according to the division of endemic fluorosis areas (GB17018-2011). Methods The fluoride content in drinking water, dental fluorosis in 8-12 years old children were investigated in all fluorosis areas of drinking water in Liaoning Province in 2019. One peripheral water sample was collected from the village of the improved water disease area for water fluoride content detection. Each one water sample was collected from the drinking water source of the villages in the decentralized water improvement and no water improvement areas according to the five directions of east, west, south, north and central. If there were less than 5 drinking water sources, all of them will be collected. Then the fluorine content of the samples was determined. The prevalence of dental fluorosis in 8-12 years old children born and living in the village were investigated. The inspection rate should not be less than 90%. Results A total of 2 496 villages were monitored, including 2 279 villages with water improvement, accounting for 91.3% of the monitored villages, and 217 villages without water improvement, accounting for 8.7% of the monitored villages. Among the villages in the water improvement area, there were 2 011 normal operation projects, accounting for 88.2% of the water improvement villages, 64 intermittent operation projects, accounting for 2.8% of the water improvement villages, and 204 abandoned water improvement projects, accounting for 9.0% of the water improvement villages. The qualified rate of fluoride in the water improvement area was 91.8%. A total of 36 542 children aged 8 to 12 years old were examined in the province, and 1 713 dental fluorosis patients were detected. The prevalence of dental fluorosis was 4.7%. Conclusions According to the census results, taking counties (cities and districts) as the unit of statistics, 40 sick districts and counties (cities and districts) in the province have achieved fluorosis control, and 15 counties (cities and districts) have not been controlled. Compared with 28 counties (cities and districts) in the self-assessment at the end of the 12th Five Year Plan in 2016, the implementation of water improvement measures has been significantly improved, and the dental fluorosis of children in sick areas has been effectively controlled. However, there are still some problems in some areas that have not been improved and water fluoride in water improvement projects exceeds the standard, which should be paid attention to.