2013 - 2017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 2013 to 2017

作　　者：高红旭[1] 雷帅 范景丽[1] 赵荣荣[3] 熊传龙[4] 李峥[4] 黄金明 张本政 尹玉岩[1] 汪春雷[1] Gao Hongxu;Lei Shuai;Fan Jingli;Zhao Rongrong;Xiong Chuanlong;Li Zheng;Huang Jinming;Zhang Benzheng;Yin Yuyan;Wang Chunlei(Prevention Research Section of Endemic Fluorosis and Kashin-Beck Disease,Shandong Institute for Prevention and Control of Endemic Disease,Ji＇nan 250014,China;Pediatric Orthopedics,Shandong Provincial Hospital,Ji＇nan 250014,China;Intervention Center,Shandong Chest Hospital,Ji＇nan 250014,Chin;Rural Water Improvement Guidance Center,China Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]山东省地方病防治研究所地方性氟中毒与大骨节病防治研究科,济南250014 [2]山东省省立医院小儿骨科,济南250014 [3]山东省胸科医院介入中心,济南250014 [4]中国疾病预防控制中心农村改水指导中心,北京102206

出　　处：《中华地方病学杂志》2018年第9期737-741,共5页Chinese Journal of Endemiology

基　　金：卫生行业科研专项（201302004）;山东省医药卫生科技发展计划（2013WS0177）

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 2013 - 2017年，在山东省饮水型地方性氟中毒病区，按照单纯随机抽样的方法，抽取10个监测县（市、区），每个县（市、区）抽取10个改水降氟工程，调查其运行效果，并检测水氟含量。每个监测县（市、区）选择3个病区村作为固定监测村，若监测村已改水，则调查改水降氟工程运行情况，并采集末梢水水样1份，测定水氟含量；若监测村未改水，则按照东、西、南、北、中5个方位各采集1份水样，测定水氟含量。检查所有监测村8 - 12岁儿童氟斑牙患病情况。2013和2017年分别对检测村25岁以上成人进行氟骨症X线检查和尿氟测定。结果 2013 - 2017年在监测县（市、区）中共监测改水降氟工程371个（次），正常运转率为99.19%（368／371），水氟含量合格率为66.85%（248／371）。所有监测村均已改水，在监测村共监测改水降氟工程128个（次），正常运转率为100.00%（128／128），水氟含量合格率为67.19%（86／128）。2013 - 2017年所有监测村8 - 12岁儿童氟斑牙总检出率为33.92%（2 608／7 689），氟斑牙指数为0.68，儿童氟斑牙检出率呈现逐年下降趋势（χ2 = 152.47，P 〈 0.01）。水氟合格的监测村儿童氟斑牙总检出率为26.10%（1 311／5 023），氟斑牙指数为0.47，儿童氟斑牙检出率呈现逐年下降趋势（χ2 = 207.67，P 〈 0.01）。水氟超标的监测村儿童氟斑牙总检出率为48.65%（1 297／2 666），氟斑牙指数为0.90。水氟合格的监测村儿童氟斑牙检出率低于水氟超标的监测村（χ2 = 193.98，P 〈 0.01）。2013和2017年25岁以上成人氟骨症X线检出率分别为8.04%（119／1 481）和6.04%（81／1 342）。2017年水氟合格村和水氟超标村成人尿氟几何均值分别为1.24、1.49 mg／L，均低于正常值上限（1.60 mg／L）。结论 山东省改水Objective To understand the implementation effects of control measures and the dynamic prevalence of drinking water-borne endemic fluorosis in Shandong Province. Methods From 2013 to 2017 in Shandong Province drinking water-borne endemic fluorosis areas, in accordance with the method of simple random sampling, 10 monitored counties were selected, 10 water fluorine decreasing projects were investigated of its running effect, and water fluoride was detected. In each monitored county, 3 villages in the diseased areas were selected as fixed monitored villages. If the monitored village had changed its water, the operation of the project would be investigated. If the monitored village had not changed the water, one water sample would be collected according to 5 directions of east, west, south, north and middle to determine the water fluorine. All children aged from 8 to 12 inthe village were also examined for dental fluorosis. X-ray fluorosis and urinary fluorosis in adults aged over 25 were detected in 2013 and 2017. Results From 2013 to 2017, in monitored counties, the normal operation rate of improved-water defluoridation projects was 99.19% （3681371）, the qualified rate of water fluoride content was 66.85% （248/371）. In 128 improved water projects, the normal operation rate was 100.00% （128/128）, the qualified rate of water fluoride content was 67.19% （86/128）. The average detection rate of dental fluorosis and community fluorosis index （CFI） in children aged 8 - 12 were 33.92% （2 608/7 689） and 0.68 in all monitored counties from 2013 to 2017. The detection rate presented a declining trend year by year （X2 = 152.47 P 〈 0.01）. The average detection rate and CFI in the villages with normal operation projects and qualified fluoride content were 26.10% （1 311/5 023） and 0.47. The detection rate presented a declining trend year by year （X2 = 207.67 P 〈 0.01）. The detection rate and CFI in the villages with water improvement projects under abnormal operation or excessive fluoride

关 键 词：氟化物 中毒 卫生监测 农村 饮用水 

分 类 号：R599.1[医药卫生—内科学]