娄底市地氟病相关危害因素与综合防制研究  

Study on the related risk factors of endemic fluorosis and its integrated control in Loudi City

作　　者：王健龙[1] 曾桂华[1] 戴练平[1] 吴锦如[1] 吴笃卿[1] 胡东风[1] 杨劝姣 欧阳吾锋 

机构地区：[1]娄底市疾病预防控制中心,湖南娄底417000 [2]娄底市卫生局,湖南娄底417000

出　　处：《中华疾病控制杂志》2011年第2期149-152,共4页Chinese Journal of Disease Control & Prevention

基　　金：娄底市人民政府科研课题(S2009S2033)

摘　　要：目的确证娄底市地氟病的主要氟源,探讨同一区域内病区轻重程度相差悬殊的问题和改灶降氟项目的可持续性。方法检查学生氟斑牙和尿氟浓度,测定煤、制作藕煤的壤土、饮用水和食物氟含量及改灶前后室内空气氟浓度,评价改灶降氟的效果。结果原煤氟含量平均值为91.90 mg/kg,拌煤壤土平均氟含量816.90 mg/kg,各病区差异无统计学意义(F=0.58,P>0.05),干蔬菜氟含量超过卫生标准;25年来病区村数增加了2.42倍,重病区分布于海拔800 m以上山区;实施改灶降氟后,室内空气氟含量下降,差异有统计学意义(P<0.001),学生和村民地氟病防控知识知晓率明显提高。结论娄底市地氟病的氟源具有多源性,且主要来源于拌煤壤土,地氟病病区轻重程度与拌煤壤土氟含量高低不呈正相关;病区分布具明显高海拔特征,社会经济因素在病区形成与发展中起重要作用;地氟病防控项目管理模式要创新,必须强化综合防制策略。Objective To determine the main fluoride source of endemic fluorosis in Loudi,explore the problem that the degrees of severity of fluorosis areas varied greatly in the same district,and to discuss the sustainability of the campaign of de-fluoridation by improving household stoves.Methods School-children were examined for dental fluorosis and urine fluoride concentration.Fluoride content in coal,loam for making briquettes,drinking water,foodstuffs,indoor air before and after the improvement of stoves were determined.And assessments were conducted on the effects of de-fluoridation by improving stoves.Results Mean fluoride content in coal was 91.90 mg/kg while that in loam was 816.90 mg/kg and no significant difference（F=0.58,P〉0.05） was found among the endemic areas of various severity degrees.Fluoride contents in dried vegetables exceeded the hygienic standards.Endemic villages increased by 2.42-fold in the past 25 years,severe fluorosis areas were located in mountainous regions more than 800 meters above sea level.After the implementation of stove-improvement,indoor air fluoride concentration dropped significantly（P〈0.001）,and the awareness rates of prevention knowledge of the school-children and villagers increased remarkably.Conclusions Fluoride sources for fluorosis in Loudi are multi-sources in nature,and the main source is from the loam for making briquettes.However,the degrees of severity of fluorosis areas are not positively correlated with the fluoride contents in the loam.Severe fluorosis areas are obviously characterized by high sea level in location,and socioeconomic factors play an important role in the form and development of endemic fluorosis areas.Creative measures and integrated control strategy are highly desirable in preventing endemic fluorosis.

关 键 词：地方病 土壤 危险因素 社会经济因素 

分 类 号：R181.1[医药卫生—流行病学] R599.5[医药卫生—公共卫生与预防医学]