2009—2014年山东省饮水型地方性氟中毒监测结果分析  

Surveillance on drinking water-borne endemic fluorosis in Shandong province from 2009 to 2014

作　　者：尹玉岩[1] 高杰[1] 张本政 王玉涛[1] 云中杰[1] 陈培忠[1] 

机构地区：[1]山东省地方病防治研究所氟中毒与大骨节病防治研究科,济南250014

出　　处：《环境与健康杂志》2017年第4期345-349,共5页Journal of Environment and Health

基　　金：中央补助地方重大公共卫生服务地方病防治项目(2009-2014);山东省医药卫生科技发展计划项目(2014WS0390)

摘　　要：目的掌握山东省饮水型地方性氟中毒病区防治措施落实效果及病情动态。方法于2009—2014年在山东省饮水型地方性氟中毒病区,按照国家《饮水型地方性氟中毒监测方案》和《山东省饮水型地方性氟中毒监测方案》规定的方法和要求,抽取10个监测县,每个监测县随机抽取10个改水降氟工程,调查其运行效果,并测定水氟浓度;每个监测县选择3个病区村作为固定监测村,调查改水村改水工程运行情况及水含氟量,检测未改水村饮水氟浓度,检查8~12岁儿童氟斑牙患病情况,对25岁以上成人进行氟骨症X线检查和尿氟检测。结果在监测县中,共监测改水降氟工程511个,正常运转率为97.06%(354/511),水氟合格率为55.19%(282/511)。在165个已改水村中,共监测147个改水工程,正常运转率为97.28%(143/147),水氟合格率为62.59%(92/147)。在12个未改水监测村,水氟>1.20 mg/L的村占58.33%(7/12)。2009—2014年全部监测村8~12岁儿童氟斑牙检出率平均为50.10%(4 563/9 107),氟斑牙指数为1.0,氟斑牙检出率呈逐年下降趋势(χ~2=172.69,P<0.01)。改水工程正常运行且水氟合格监测村儿童氟斑牙的检出率为44.81%(2 543/5 675),氟斑牙指数为0.87,氟斑牙检出率呈逐年下降趋势(χ~2=248.30,P<0.01)。改水工程非正常运行或水氟超标监测村儿童氟斑牙的检出率为61.10%(1 750/2 864),氟斑牙指数为1.26。未改水监测村儿童氟斑牙的检出率为47.54%(270/568),氟斑牙指数为1.07。改水工程正常运行且水氟合格监测村的儿童氟斑牙检出率低于改水工程非正常运行或水氟超标的监测村(χ~2=202.11,P<0.01)。2009和2014年度25岁及以上成人氟骨症X线检出率分别为8.04%(119/1 481)和7.25%(106/1 463)。2014年水氟合格村和水氟超标村成人尿氟几何均值均低于正常值上限(1.60 mg/L)。结论山东省改水防治饮水型地方性氟中毒取得了一定的效果,但改水降氟工程的水氟超标问题较为Objective To understand the implementation effects of control measures and the dynamic prevalence of drinking water-borne endemic fluorosis in Shandong province. Methods According to the National Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis and Shandong provincial Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis,ten counties were chosen as the monitoring counties in Shandong province from 2009 to 2014,respectively. Ten improved-water defluoridation projects were selected in each monitoring county every year. For the projects,the operating effect was investigated and water fluoride content was tested. Three epidemic villages were chosen as the fixed monitoring villages in each county. The operating condition and the fluoride level of water improvement projects were investigated in the villages with water improvement projects. The fluoride level of drinking water was tested in the villages without water improvement projects. Dental fluorosis of children aged 8 to 12 were surveyed. The urinary fluoride test and skeletal fluorosis X-ray examination were conducted in adults aged over 25. Results In monitoring counties,the normal operation rates of improved-water defluoridation projects was 97.06%（354/511）, the qualified rate of water fluoride content was 55.19%（282/511）. In 147 improved water projects, the normal operation rates was 97.28%（143/147）, the qualified rate of water fluoride content was 62.59%（92/147）. In12 villages without water improvement projects, the villages with fluoride level 1.20 mg/L accounted for 58.33%（7/12）. The average detection rate of dental fluorosis and community fluorosis index（CFI） in children aged 8-12 were 50.10%（4 563/9 107）and 1.0 in all monitoring counties from 2009 to 2014. The detection rate presented declining trend year by year（χ^2=172.69,P〈0.01）. The average detection rate and CFI in the villages with normal operation projects and the qualified fluoride content were44.81%（2 543/5 675） and 0.87. The detection r

关 键 词：饮用水 地方性饮水型氟中毒 卫生监测 农村 

分 类 号：R181.3[医药卫生—流行病学]