2014-2021年陕西省饮水型地方性氟中毒监测结果分析  

Analysis of monitoring results of drinking water-borne endemic fluorosis in Shaanxi Province from 2014 to 2021

作　　者：周蓉[1] 李晓茜[1] 范中学[1] 刘晓莉[1] 白爱梅[2] 张盼红 张浩 赵爱珠 刘晓燕 崔成宝[1] Zhou Rong;Li Xiaoqian;Fan Zhongxue;Liu Xiaoli;Bai Aimei;Zhang Panhong;Zhang Hao;Zhao Aizhu;Liu Xiaoyan;Cui Chengbao(Department of Endemic Fluorosis and Arsenism,Shaanxi Provincial Institute for Endemic Disease Control,Xi'an 710003,China;Department of Laboratory,Shaanxi Provincial Institute for Endemic Disease Control,Xi'an 710003,China;Shaanxi Xianyang Center for Disease Control and Prevention,Xianyang 712000,China;Shaanxi Weinan Center for Disease Control and Prevention,Weinan 714000,China;Shaanxi Yulin Center for Disease Control and Prevention,Yulin 719000,China)

机构地区：[1]陕西省地方病防治研究所地方性氟砷中毒防研室,西安710003 [2]陕西省地方病防治研究所实验室,西安710003 [3]陕西省咸阳市疾病预防控制中心,咸阳712000 [4]陕西省渭南市疾病预防控制中心,渭南714000 [5]陕西省榆林市疾病预防控制中心,榆林719000

出　　处：《中华地方病学杂志》2024年第6期467-471,共5页Chinese Journal of Endemiology

摘　　要：目的了解陕西省饮水型地方性氟中毒病区降氟改水工程运转情况、水氟含量现状以及氟中毒病情变化趋势,评价防治措施效果。方法2014年3月至2021年12月,以陕西省饮水型地方性氟中毒病区大荔、定边、靖边、泾阳和礼泉5个县的15个病区村为监测村,调查改水工程运转情况;并采集水样,依据《生活饮用水标准检验方法无机非金属指标》(GB/T 5750.5-2006)检测水氟含量。采用《氟斑牙诊断》(WS/T 208-2011),对监测村出生并居住的全部8~12岁儿童进行氟斑牙检查。采用《地方性氟骨症诊断标准》(WS/T 192-2008)和《尿中氟化物测定离子选择电极法》(WS/T 89-2015),分别对监测村25岁以上且在当地居住5年以上成人进行氟骨症X线检查和尿氟含量测定。结果2014-2021年共调查改水工程122个,均正常运转;水氟合格率从2014年的81.25%(13/16)上升至2021年的100.00%(11/11)。共检查8~12岁儿童5595例,检出氟斑牙儿童1790例,检出率为31.99%;儿童氟斑牙检出率从2014年的52.05%(304/584)下降至2021年的9.68%(93/961),整体呈现下降趋势(χ^(2)_(趋势)=533.76,P<0.001)。2014年检查成人791例,检出氟骨症患者256例,检出率为32.36%;2019年检查成人770例,检出氟骨症患者88例,检出率为11.43%;2019年成人氟骨症检出率低于2014年,差异有统计学意义(χ^(2)=99.54,P<0.001)。2014年采集成人尿样754份,尿氟几何均值为2.571 mg/L;2019年采集成人尿样770份,尿氟几何均值为1.292 mg/L;2019年成人尿氟几何均值低于2014年,差异有统计学意义(Z=-12.74,P<0.001)。结论2014-2021年,陕西省饮水型地方性氟中毒病区改水工程均正常运转,水氟合格率升高。儿童氟斑牙和成人氟骨症患病情况均减轻。后期应持续加强改水工程监测管理工作,防止水氟回升引起居民病情反弹。Objective To learn about the operation of fluoride reduction and water improvement projects,the current situation of water fluoride level and the changing trend of fluorosis in drinking water-borne endemic fluorosis areas in Shaanxi Province,and to evaluate the effect of prevention and control measures.Methods From March 2014 to December 2021,15 endemic villages in drinking water-borne endemic fluorosis areas of Dali,Dingbian,Jingbian,Jingyang and Liquan counties in Shaanxi Province were selected as monitoring villages to investigate the operation of water improvement projects.Water samples were collected,and the water fluoride level was detected according to the"Standard Examination Methods for Drinking Water-Nonmetal Parameters"(GB/T 5750.5-2006)."Diagnosis of Dental Fluorosis"(WS/T 208-2011)was done to detect dental fluorosis in all children aged 8-12 who were born and lived in the monitoring village.Using"Diagnostic Standard for Endemic Skeletal Fluorosis"(WS/T 192-2008)and"Determination of Fluoride in Urine-Ion Selective Electrode Method"(WS/T 89-2015),X-ray examination and urine fluoride level test were performed on adults over 25 years old who had lived in the monitoring village for more than 5 years,respectively.Results From 2014 to 2021,a total of 122 water improvement projects were investigated,all of which were in normal operation.The qualified rate of water fluoride increased from 81.25%(13/16)in 2014 to 100.00%(11/11)in 2021.A total of 5595 children aged 8-12 were examined,1790 children with dental fluorosis were detected,with a detection rate of 31.99%.The detection rate of dental fluorosis in children decreased from 52.05%(304/584)in 2014 to 9.68%(93/961)in 2021,showing an overall downward trend(χ^(2)_(trend)=533.76,P<0.001).In 2014,791 adults were examined,and 256 patients with skeletal fluorosis were detected,the detection rate was 32.36%.In 2019,770 adults were examined,and 88 patients with skeletal fluorosis were detected,with a detection rate of 11.43%.The detection rate of skeletal fluorosis

关 键 词：饮用水 氟中毒 氟斑牙 氟骨症 尿氟 

分 类 号：R599.1[医药卫生—内科学]