山东省饮水型地方性氟中毒防治专项三年攻坚行动健康教育项目实施效果评价  

Effect of health education project of a three-year special action for prevention and control of drinking water-borne endemic fluorosis in Shandong Province

作　　者：黄金明 崔娟 王宁 汪春雷[2] 宗金文 王琨 魏广鑫 李学文[1] Huang Jinming;Cui Juan;Wang Ning;Wang Chunlei;Zong Jinwen;Wang Kun;Wei Guangxin;Li Xuewen(School of Public Health,Shandong University,Jinan 250002,China;Department of Endemic Fluorosis and Kashin-Beck Disease,Shandong Institute for Endemic Disease Prevention and Treatment,Jinan 250014,China;Shandong Maternal and Child Health Hospital,Jinan 250014,China;Shandong Health Publicity and Education Center,Jinan 250002,China)

机构地区：[1]山东大学公共卫生学院,济南250002 [2]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 [3]山东省妇幼保健院,济南250014 [4]山东省卫生健康宣传教育中心,济南250002

出　　处：《中华地方病学杂志》2022年第2期159-163,共5页Chinese Journal of Endemiology

基　　金：山东省医药卫生科技发展计划项目(2018WS325、202012070472、202112070789)。

摘　　要：目的评价山东省饮水型地方性氟中毒(简称饮水型氟中毒)防治专项三年攻坚行动健康教育效果,为下一步制订健康教育措施提供依据。方法2018年在山东省饮水型氟中毒重点防治地区选取19个病区县(市、区)作为项目县(市、区),2019年选取50个病区县(市、区),2020年扩大到全省所有105个病区县(市、区)。在每个项目县(市、区)选择3个乡(镇),在乡(镇)中心小学校4~6年级及所辖3个行政村开展饮水型氟中毒健康教育活动。健康教育前后,抽取学生、家庭主妇进行饮水型氟中毒防治知识问卷调查。在实施健康教育的项目村中,选择既往儿童氟斑牙检出率>30%,水氟含量>1.5 mg/L且改水时间<5年的6个病区村(8~12岁儿童数>50人),每年开展8~12岁儿童氟斑牙患病情况调查。结果开展健康教育后,5年级小学生[2018-2020年:92.46%(4571/4944)比65.80%(3334/5067)、94.84%(12897/13599)比73.55%(9993/13587)、95.59%(30407/31809)比77.52%(24463/31557)]和家庭主妇[2018-2020年:94.12%(2400/2550)比76.04%(1939/2550)、94.99%(6412/6750)比72.00%(4860/6750)、95.53%(16183/16941)比78.43%(12971/16539)]饮水型氟中毒防治知识知晓率均明显提升(χ2=1070.47、2315.27、4456.40,328.25、1294.80、2174.63,P均<0.05);2020年健康教育后,5年级小学生、家庭主妇调查问卷中饮水型氟中毒流行原因、危害、预防措施的正确答题率比较,差异均有统计学意义(χ2=390.78、164.94,P均<0.05);东部地区(青岛市、烟台市、潍坊市)5年级小学生和家庭主妇健康教育前饮水型氟中毒防治知识知晓率均显著高于西部地区(德州市、聊城市、菏泽市,χ2=547.43、210.12,P均<0.05),健康教育后防治知识知晓率均提高到90%以上;儿童氟斑牙检出率呈逐年降低趋势(χ2趋势=27.95,P<0.05)。结论山东省通过开展饮水型氟中毒防治专项三年攻坚行动健康教育项目,目标人群的饮水型氟中毒防治知识知晓率明显提高。但仍然需�Objective To evaluate the effect of health education of a three-year special action for prevention and control of drinking water-borne endemic fluorosis(referred to as drinking water-borne fluorosis)in Shandong Province,and to provide basis for formulating health education measures in the next step.Methods Nineteen of the disease affected counties(cities and districts)were selected as project counties(cities and districts)in key areas for prevention and control of drinking water-borne fluorosis in Shandong Province in 2018,and 50 disease affected counties(cities and districts)were selected in 2019,and the project counties(cities and districts)were expanded to all of the 105 disease affected counties(cities and districts)in Shandong Province in 2020.Three disease affected townships(towns)were selected in each county(city and district),and health education activities on drinking water-borne fluorosis were carried out in Grade 4 to Grade 6 of the central primary schools and the three villages under its jurisdiction.Students and housewives were selected to conduct questionnaire surveys on prevention and control knowledge of drinking water-borne fluorosis before and after health education.The incidence of dental fluorosis among children aged 8-12 years was investigated annually in 6 villages(with children aged 8-12 years>50),where health education activity was implemented and the incidence of dental fluorosis among children was>30%,water fluoride content was>1.5 mg/L and water improvement time was<5 years.Results After health education,the awareness rates of drinking water-borne fluorosis in fifth grade pupils[92.46%(4571/4944)vs 65.80%(3334/5067)in 2018;94.84%(12897/13599)vs 73.55%(9993/13587)in 2019;95.59%(30407/31809)vs 77.52%(24463/31557)in 2020]and housewives[94.12%(2400/2550)vs 76.04%(1939/2550)in 2018;94.99%(6412/6750)vs 72.00%(4860/6750)in 2019;95.53%(16183/16941)vs 78.43%(12971/16539)in 2020]were significantly improved(χ2=1070.47,2315.27,4456.40,328.25,1294.80,2174.63,P<0.05).After health education in 2020,t

关 键 词：地方病 氟中毒 牙 健康教育 效果评价 

分 类 号：R599.1[医药卫生—内科学]