山东省梁山县地方性氟中毒10年监测结果分析

目的掌握山东省梁山县地方性氟中毒防治措施落实进度和监测点病情变化动态及防治效果，为制定防治策略提供科学依据。方法按照全国地方性氟中毒监测方案的要求，调查梁山县改水进度、部分改水设施使用管理情况与饮水含氟量；检查监测点居民末梢水含氟量，8-12岁儿童氟斑牙患病情况及尿氟水平，16岁以上成年人临床与X线氟骨症患病情况。结果梁山县共有高氟村215个，已降氟改水137个，改水率为63.70％；正常运转设施的水氟含量超标率28.74％。监测点东徐村居民末梢水含氟量历年监测均符合国家卫生标准（≤1.0mg／L），10年连续监测持续稳定在0.50mg／L以下。东徐村8-12岁儿童氟斑牙患病率与氟斑牙指数逐年下降，均已达到非病区水平，至2006年检出率已为0；8-12儿童群体尿氟水平连续监测均低于1.40mg／L的正常参考上限。16岁以上成人x线氟骨症阳性检出率已由64.58％降至16.67％（P〈0.01），且无Ⅲ度病例检出。结论改水降氟是控制饮水型地方性氟中毒最有效的方法，但是监测县改水降氟措施落实进展缓慢，设施正常利用率较低，对此应增加投入，加快改水工作步伐，在整体上控制氟中毒的发生与发展。

Inspection Analysis of Endemic Fluorosis in Liangshan County of Shandong Province in Ten Years

[Objective] To understand, the effect of endemic fluorosis prevention and the dynamic epidemic changes in Liangshan sounty and provide scientific evidence for the establishment of preventive countermeasures. [Methods] According to the methods and requirement of the national survey scheme of endemic fluorosis, investigation was carried out on the water-improving process, water-improving facilities management and fluoride content of drinking water in Liangshan county ; examination was made on the fluoride concentration in twig water, dental fluorosis morbidity and urine fluoride among children aged from 8 to 12 and the clinical and X-ray situation of skeletal fiuorosis among people over 16. [Results] 215 endemic fluorosis villages were found in Liangshan County, 137 of which have carried out water-improvement （63.70%）; the standard exceeding rate of fluoride content in the normally running projects was 28.74% ; the twig water fluoride content in the survey spot remained below 0.50mg/L in the continuous ten years in Dongxu Village; among the children aged from 8 to12, the morbidity of dental fluorosis decreased every year, the detection rate was 0 in 2006, the urine fluoride level was below 1.40mg/L in the continuous inspection; the positive rate of the X-ray skeletal fluorosis decreased gradually from 64.58% to 16.67% among the adults over 16（P〈0.01）; no case of level Ⅲ was detected. [Conclusion] Water-improvement to reduce fluoride is the most effective measure for controlling drinking water fluorosis; however, the process of water-improving is quite slow in the inspected county and the facilities are not sufficiently applied; investment should be increased in order to the imorove fluorosis control.