镇巴县燃煤污染型氟中毒30年综合防治效果分析  

Effectiveness of Comprehensive Control and Prevention of Coal Fluorosis Pollution for 30 Years in Zhenba County

作　　者：赵开明 戴宏星[2] 范中学[2] 靳俊武 张晓强 李辉鹏 

机构地区：[1]陕西省镇巴县人民医院,陕西镇巴723600 [2]陕西省地方病防治研究所,西安710003 [3]陕西省镇巴县疾病预防控制中心,陕西镇巴723600

出　　处：《预防医学情报杂志》2018年第2期222-227,共6页Journal of Preventive Medicine Information

摘　　要：目的评估镇巴县燃煤污染型氟中毒综合防治效果。方法 2015-11/12,在镇巴县3个燃煤型氟中毒病区镇各随机抽取3个自然村,共9个自然村计270户做为调查点,调查既往、现在炉灶使用、相关行为转变及目标人群燃煤型氟中毒防治核心知识知晓情况;对9个调查点8~12岁所有在校学生进行氟斑牙检查,依据Dean法进行诊断,各调查点按50%儿童随机采集即时尿样,采用WS/T30-1996检测尿氟含量;对各调查点25周岁人以上人群按年龄段随机抽取12人进行氟骨症X线检查,依据WS 192-2008进行诊断。结果镇巴县氟中毒病区累计改灶16 510户(次)、户均改灶2.2个,治疗氟骨症1 402人(次),相关行为形成率、一级目标人群知识知晓率均明显高于防治前;8~12岁学生氟斑牙检出率为14.31%(82/573),较1986年下降56.16个百分点,且差异有统计学意义(χ~2=1 126.00,P<0.01);氟骨症检出率为9.08%(57/628),较1995年下降2.27个百分点,但差异没有统计学意义(χ~2=1.90,P>0.05),氟骨症女性高于男性且随年龄增长而增加,且差异均有统计学意义(χ~2=8.55、33.46,P<0.01);儿童尿氟在0.09~0.67 mg/L,几何均数为0.28±0.14 mg/L,较1995年下降2.10 mg/L,且差异均有统计学意义(u=296.12,P<0.01)。结论镇巴县燃煤型氟中毒防治工作取得了显著成效,病情得到有效控制。加强病情监测和健康教育以及防氟炉具的后期管理是当前防治燃煤型氟中毒的主要任务;发展经济,改变燃料结构是今后防治燃煤型氟中毒的根本所在。Objective To evaluate the effectiveness of comprehensive prevention and control of coal fluorosis pollution in Zhenba County. Methods From November to December 2015,a total of nine ward villages were selected random in three coal type fluorosis ward towns,in order to investigate the use of stoves in the past and present,and the related behavior change and core knowledge about prevention and control of coal type fluorosis.According to the diagnosis of Dean method,all students from 8 to 12 years old in each ward village were examined dental fluorosis, each age group randomly selected 12 children to collect urine sample immediately,used the WS/T30-1996 testing urine fluorine content. Age over 25 who were monitored in the ward villages,12 people were randomly selected in each age group,were examined the skeletal fluorosis X-ray inspection,based on the diagnosis to the WS 192-2008. Results in Zhenba,16 510 households（ times） stoves in the fluorosis ward villages were totally changed,with 2. 2 stoves in each house,and skeletal fluorosis 1 402（ times） were treated. Aware of knowledge about relevant behavior formation rate,target groups were significantly higher than that of control before,and the difference was statistically significant（ χ~2= 1 979. 78,P〈0. 01）; 8 and 12 years old students fluorine spot tooth detection rate was 14. 31%（ 82/573）,compared with 1986,it was reduced 56. 16%,and the difference was statistically significant（ χ~2= 1 126. 00,P〈0. 01）; Skeletal fluorosis detection rate was 9. 08%（ 57/628）,down 2. 27% compared with 1995,but the difference was not statistically significant（ χ~2=1. 90,P〈0. 05）. Women infected with Skeletal fluorosis were more than men,and increased with age,and the differences were statistically significant（ χ~2= 8. 55,33. 46,P〈0. 01）. Children urinary fluoride were 0. 09 to 0. 67 mg/L,geometric mean of 0. 28 ± 0. 14 mg/L,compared with 1995,and the differences were statistically significant（ u = 296. 12,296. 12,P〈0. 01）. Conclusion

关 键 词：氟中毒 石煤 改良炉灶 健康教育 效果评价 

分 类 号：R599[医药卫生—内科学]