2014年陕西省燃煤污染型地方性氟中毒防治效果评估  

An evaluation of the prevention and control measures on coal-burning-borne endemic fluorosis in Shaanxi Province in 2014

作　　者：周蓉[1] 杨晓栋[1] 李晓茜[1] 任宇飞[1] 范中学[1] 杜怡[1] 崔成宝[1] 

机构地区：[1]陕西省地方病防治研究所地方性氟砷防治研究室,西安710003

出　　处：《中华地方病学杂志》2015年第9期693-696,共4页Chinese Journal of Endemiology

摘　　要：目的了解陕西省燃煤污染型地方性氟中毒病区防氟灶具使用情况、相关行为形成情况、氟中毒病情现状，评价防治效果，为上级部门及时调整防治策略提供科学依据。方法按照《陕西省燃煤污染型地方性氟中毒防治效果评估实施方案》的要求，在陕西省安康市紫阳、岚皋两县开展流行病学现况调查。采用分层抽样的方法，在每个县的历史轻、中、重病区村按每层5％的比例抽取调查村，最少为1个，最多为30个。同时，在每个县的非病区抽取1～3个调查村。对调查村全部居民进行入户问卷调查，询问做饭、取暖燃料变动情况．改炉改灶情况，改良炉灶的正确使用情况，与供人食用的玉米和辣椒有关的生活行为转变情况，以及防治工作后期管理的开展情况。每个调查村隔户选择10户居民，采集用作主食的自产玉米（或大米）和干辣椒，按照《食品中氟的测定》（GB／T5009．18-2003）测定氟含量。调查所有8～12岁学生氟斑牙患病情况。同时每个年龄段采集10份尿样测定尿氟，氟斑牙诊断采用《氟斑牙诊断标准》（WS／T208．2011），尿氟含量采用《尿中氟的离子选择电极法）（WS／T89．1996）。调查病区村学生、家庭主妇防氟知识知晓情况和16岁以上重度氟骨症患者，氟骨症诊断依据《地方性氟骨症诊断标准》（WS192-2008）。结果在病区村共调查7998户，病区村改良炉、灶正确使用率分别为91．43％（3019／3302）、95．72％（3578／3738）。改良炉灶自主更换率为0．61％（49／7998）。玉米的正确干燥率、正确保管率和加工前淘洗率均为100．0％（300／300），辣椒的正确干燥率、正确保管率和加工前淘洗率均为98．3％（7863／7998）。病区玉米、辣椒氟含量中位数分别为0．800、2．863mg／kg。非病区玉米、辣椒氟含量中位数分别为0．443、4．065mg／kg。病区村家庭Objective To investigate the usage of defluoridation stove and the formation of related behavior in the disease affected areas and the current situation of coal-burning-borne endemic fluorosis, to evaluate the control effect, so as to provide a theoretical basis for superior department to adjust the control strategy in time. Methods According to ＂The Implementation Plan for Prevention and Treatment of Coal-burning-borne Endemic Fluorosis in Shaanxi Province＂, Ziyang and Langao in Ankang City were chosen for epidemiological survey. Using stratified sampling method, according to the degree of disease situation, each county was divided into 3 layers and then 5% from each layer was extracted to carry out an investigation, respectively. The number of investigated village was at least 1, up to 30. The number in a non-endemic area was 1 - 3. Questionnaire survey of all residents was carried out to ask of the changes of cooking and heating fuel; the correct usage of the improved stove; the changes of life behavior related to the corn and pepper for human consumption and the development of prevention and treatment of post management. In endemic areas and in non-endemic areas, according to the ＂Determination of Fluoride in Foods＂ （GB/T 5009.18-2003）, fluoride levels of corn （or rice） and chili which collected from 10 families were determined. Meanwhile, the criteria for ＂Diagnosis of Dental Fluorosis＂ （WS/T 208-2011） was used to diagnose dental fluorosis and the criteria of ,＇Urine-determination of Fluoride-ion Specific Electrode Method＂ （WS/T 89- 1996） was used to evaluate urine fluoride; dental fluorosis of every child aged 8 - 12 was examined and 10 copies of urine samples were randomly collected in each age group. Housewives and students over the age of 16 in endemic areas were quizzed of the knowledge of health and diagnosed serious skeletal fluorosis according to ＂The Diagnostic Criteria of Endemic Fluorosis＂ （WS 192-2008）. Results The rates of correct usage of improved furnace

关 键 词：氟化物中毒 改良炉灶 氟中毒 牙 效果评估 

分 类 号：R599[医药卫生—内科学]