2009年江苏省饮水型地方性氟中毒监测结果分析  

Analysis of surveillance results of drinking-water-borne endemic fluorosis in Jiangsu Province in 2009

作　　者：柬长亮[1] 王彩生[1] 汪旸[1] 夏玉婷[1] 陈思红 

机构地区：[1]江苏省疾病预防控制中心环境疾病(地方病)防制所,南京210009 [2]江苏省洪泽县疾病预防控制中心

出　　处：《中华地方病学杂志》2013年第6期662-667,共6页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目（2008）

摘　　要：目的掌握江苏省饮水型地方性氟中毒（简称地氟病）的病情动态和防治措施的落实效果，为进一步开展防治工作提供依据。方法2009年，选择江苏省8个地氟病重点县，每个县根据历史资料将病区村分成轻、中、重3个类型，每个类型各抽取1个村作为监测村。在已改水病区村采集1份出厂水和3份末梢水．在未改水病区村东、西、南、北、中5个方位采集5份水样，按照《生活饮用水标准检验方法》（GB／T5750—2006）测定水氟。对监测村全部8～12岁儿童进行氟斑牙检查，氟斑牙诊断采用Dean法。对监测村全部16岁以上常住人口进行临床氟骨症检查，抽取2个监测县，每个县选择1个村，对有临床氟骨症症状的成人进行x线氟骨症检查，氟骨症诊断采用《地方性氟骨症诊断标准》（WS192—2008）。每个监测村采集儿童尿样30份、成人尿样20份，采用《尿中氟化物的测定离子选择电极法》（WS／T89—1996）检测尿氟。结果8个县的24个病区村中，20个村已改水，其中18个村的改水工程正常运转，2个村的工程报废。共检测水样102份，改水村的水氟均值为1．10mg／L，未改水或工程报废村的水氟均值为1．90mg／L.8～12岁儿童氟斑牙检出率为42．51％（854／2009）。16岁以上人群临床氟骨症检出率为23．23％（2024／8713），X线氟骨症检出率为32．00％（24／75）。共检测儿童尿样664份，尿氟浓度几何均数为1．59mg／L；共检测成人尿样470份，尿氟浓度几何均数为2．20mg／L。结论江苏省地氟病病情尚未完全控制，且有回升迹象，须重视降氟改水措施的落实及改水工程的管理维护，进一步加强地氟病防治工作。Objective To investigate the development trend of drinking-water-borne endemic fluorosis in Jiangsu Province, and to provide the basis for further prevention and treatment of the disease. Methods In 2009, eight major counties were chosen, and in each county all diseased villages were classified into light, moderate and severe disease types according to water fluorine content based on historical data, and one village was chosen from each type. In monitoring villages with improved water, one source water and three tap water samples were collected, respectively. Five water samples were collected in water unimproved monitoring villages according to water well locations of the east, the west, the south, the north and the center. The fluorine content in water was determined according to the ＂Standard Testing Methods for Drinking Water＂ （GB/T 5750-2006）. Children aged 8 to 12 were examined for dental fluorosis by Dean method. Residents over the age of 16 were examined for clinical osteofluorosis, and two monitoring counties were chosen, then one village was respectively chosen in each county, and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray. Both clinical and X-ray diagnosis were on the basis of ＂Diagnostic Criteria of Endemic Skeletal Fluorosis＂ （WS 192-2008）. Urine samples of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected and urinary fluoride was determined by F-ion selective electrode method（WS/T 89-1996）. Results Of all the 24 villages of 8 counties, 20 villages were water improved, and water-improved projects ran normally in 18 villages, while scrapped in the rest 2 villages. One hundred and two samples were tested, and the mean of water fluoride in water-improved villages was 1.10 mg/L, while in water unimproved villages and villages with water improved projects scrapped was 1.90 mg/L The prevalence of dental fluorosis was 42.51% （854/2009）. The prevalence of clinical skeletal fluorosis was 23.23% （2024/8713） an

关 键 词：氟化物中毒 饮水 氟中毒 牙 氟骨症 数据收集 

分 类 号：R599.901[医药卫生—内科学]