2016年山东省饮水型地方性氟中毒病情调查  

Drinking water-borne endemic fluorosis in Shandong Province in 2016

作　　者：汪春雷[1] 李伟国 雷帅 高红旭[1] 赵荣荣[4] 熊传龙[5] 李峥[5] 黄金明 张本政 尹玉岩[1] Wang Chunlei;Li Weiguo;Lei Shuai;Gao Hongxu;Zhao Rongrong;Xiong Chuanlong;Li Zheng;Huang Jinming;Zhang Benzheng;Yin Yuyan(Department of Endemic Fluorosis and Kaschin-Beck Disease, Shandong Institute for Endemic Disease Prevention and Control, Jinan 250014, China;Qingzhou Institute for Endemic Disease Prevention and Control, Qingzhou 262500, China;Pediatric Orthopedics Department, Shandong Provincial Hospital, Jinan 250021, China;Intervention Center of Shandong Chest Hospital, Jinan 250013, China;Technical Guidance Center for Rural Water Improvement, Chinese 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]山东省青州市地方病防治研究所,262500 [3]山东省立医院小儿骨科,济南250021 [4]山东省胸科医院介入中心,济南250013 [5]中国疾病预防控制中心农村改水技术指导中心,北京102206

出　　处：《中华地方病学杂志》2019年第10期823-826,共4页Chinese Journal of Endemiology

基　　金：卫生行业科研专项(201302004);中央补助地方公共卫生专项资金地方病防治项目(2016年);山东省医药卫生科技发展计划项目(2013WS0177、2018WS325).

摘　　要：目的掌握山东省饮水型地方性氟中毒病情现状,为制定防治策略提供科学依据。方法2016年,按照《全国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,在山东省选取10个县(市、区),每个县(市、区)抽取3~5个村,调查改水降氟工程运转情况及水氟含量;每个村采集1份末梢水水样检测水氟含量。同时,对监测村全部8~12岁儿童进行氟斑牙检查和对≥25岁成人进行氟骨症X线检查。水氟检测采用离子选择电极法;水氟判定依据《生活饮用水卫生标准》(GB 5749-2006);氟斑牙诊断、分度及流行强度判定依据《氟斑牙诊断》(WS/T 208-2011);氟骨症诊断及分度依据《地方性氟骨症诊断标准》(WS 192-2008)。结果10个县(市、区)的32个村全部进行改水,改水降氟工程均正常运转。其中水氟合格(≤1.20 mg/L)村有24个,水氟超标村有8个。儿童氟斑牙检出率为25.75%(419/1 627),10个县(市、区)间比较差异有统计学意义(χ2 = 288.55,P < 0.01);氟斑牙指数为0.48,缺损率为2.77%(45/1 627)。成人氟骨症检出率为4.72%(72/1 525),10个县(市、区)间比较差异有统计学意义(χ2 = 18.83,P < 0.01)。结论山东省改水降氟工程的水氟超标问题仍比较严重,氟中毒病情尚未得到全面控制,防治工作还有待进一步加强。Objective To grasp the current situation of drinking water-borne endemic fluorosis in Shandong Province, and provide a scientific basis for formulating preventive strategies. Methods In 2016, according to the "National Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis" and "Shandong Provincial Surveillance Scheme of Drinking Water-Borne Endemic Fluorosis", 10 counties (cities, districts) were selected in Shandong Province, 3-5 villages were selected in each county (city, district), to investigate the operation of water improvement and fluorine reduction project and the water fluorine, and 1 tap water sample in each village was collected to detect water fluorine. At the same time, dental fluorosis examination was performed on all children aged 8-12 years old and fluorosis X-ray examination was performed on adults aged ≥25 years old. Water fluorine was detected by ion selective electrode method;the water fluorine was determined according to "Standards for Drinking Water Quality"(GB 5749-2006);criteria for diagnosis, grading and epidemic intensity of dental fluorosis were based on "Diagnosis of Dental Fluorosis"(WS/T 208-2011);the diagnostic and grading criteria for skeletal fluorosis were based on the "Diagnostic Criteria for Endemic Skeletal Fluorosis"(WS 192-2008). Results All the 32 villages in 10 counties (cities, districts) changed water, water improvement and fluorine reduction project ran normally, 24 villages had qualified water fluorine (≤1.20 mg/L), and 8 villages had water fluorine exceeding the standard. The detection rate of dental fluorosis in children was 25.75%(419/1 627), and the difference between 10 counties (cities, districts) was statistically significant (χ2 = 288.55, P < 0.01);the dental fluorosis index was 0.48, and the defect rate was 2.77%(45/1 627). The detection rate of skeletal fluorosis in adults was 4.72%(72/1 525), and the difference between 10 counties (cities, districts) was statistically significant (χ2 = 18.83, P < 0.01). Conclusions The problem of water fluorin

关 键 词：地方病 氟中毒 牙 氟骨症 流行病学监测 数据收集 

分 类 号：R5[医药卫生—内科学]