2015-2020年陕西省燃煤污染型地方性砷中毒监测结果分析  

Analysis of monitoring results of coal-burning-borne endemic arsenism in Shaanxi Province from 2015 to 2020

作　　者：周蓉 李晓茜[2] 范中学[2] 崔成宝[2] 白爱梅[2] 邓英[3] 卢美璇 郭雄[1] 王溪[1] 宁玉洁 Zhou Rong;Li Xiaoqian;Fan Zhongxue;Cui Chengbao;Bai Aimei;Deng Ying;Lu Meixuan;Guo Xiong;Wang Xi;Ning Yujie(Key Laboratory of Trace Elements and Endemic Diseases,National Health Commission,Institute of Endemic Diseases,School of Public Health,Xi'an Jiaotong University,Xi'an 710061,China;Department of Endemic Fluorosis and Arsenism,Shaanxi Institute for Endemic Disease Prevention and Control,Xi'an 710003,China;Shaanxi Ankang Center for Disease Control and Prevention,Ankang 725000,China;Shaanxi Hanzhong Center for Disease Control and Prevention,Hanzhong 723000,China)

机构地区：[1]西安交通大学公共卫生学院地方病研究所,国家卫健委微量元素与地方病重点实验室,西安710061 [2]陕西省地方病防治研究所地方性氟砷中毒防研室,西安710003 [3]陕西省安康市疾病预防控制中心,安康725000 [4]陕西省汉中市疾病预防控制中心,汉中723000

出　　处：《中华地方病学杂志》2023年第1期30-35,共6页Chinese Journal of Endemiology

摘　　要：目的掌握陕西省燃煤污染型地方性砷中毒病情变化、改良炉灶使用和健康相关行为形成情况,评价防治措施效果。方法2015-2020年按照《陕西省燃煤污染型砷中毒监测实施方案》在陕西省安康、汉中市的2个县、4个自然村定期开展现场调查,了解监测村基本防治情况。采用单纯随机抽样方法,每年每个村抽取10户家庭,调查炉灶使用及健康相关行为形成情况,抽取其中5户家庭,采集煤样并按照《煤中砷的测定方法》(GB/T 3058-2008)进行煤砷含量测定。对监测村内高砷煤暴露人群按照《地方性砷中毒诊断》(WS/T 211-2015)标准开展病情调查,每年采集30名成年砷中毒患者(男女各半)即时尿样,采用《尿中砷的二乙基二硫代氨基甲酸银-三乙醇胺分光光度测定方法》(WS/T 28-1996)测定尿砷含量。结果共监测240户家庭,其中2018-2020年病区监测家庭改良炉灶质量合格率和正确使用率均持续维持在100.00%;清洁能源使用率由2015年的75.00%(30/40)上升至2018-2020年的100.00%(40/40,χ^(2)趋势=25.5,P<0.001),73.75%(177/240)的家庭使用多种清洁能源。2018-2020年玉米、辣椒的正确干燥、储存和加工前淘洗率均持续达到100.00%(40/40)。共采集病区煤样120份,煤砷含量为(118.09±57.91)mg/kg,范围为16.70~280.94 mg/kg。砷中毒患者检出率由2015年的6.34%(231/3646)降至2020年的2.90%(109/3754,χ^(2)趋势=121.8,P<0.001),未检出皮肤癌及鲍文氏病患者。共采集尿样720份,尿砷含量几何均值为0.0381 mg/L,范围为0.0005~0.3129 mg/L。结论陕西省燃煤污染型地方性砷中毒病区病情达到国家消除标准,改良炉灶质量、正确使用率和清洁能源使用率均提升,健康相关行为基本形成,防治工作取得较好成效。Objective To learn about the changes of the condition of coal-burning-borne endemic arsenism,the use of improved stoves and the formation of health-related behaviors in Shaanxi Province,and evaluate the effect of prevention and control measures.Methods From 2015 to 2020,according to the"Implementation Plan for Monitoring Coal-burning-borne Endemic Arsenism in Shaanxi Province",regular field surveys were carried out in 4 natural villages,2 counties in Ankang City and Hanzhong City,Shaanxi Province,to learn about the basic prevention and control situation in the monitoring village.Using the simple random sampling method,10 families in each village were selected to investigate the use of stoves and the formation of health-related behaviors,and 5 of these families were selected to collect coal samples for arsenic content determination in accordance with the"Determination of Arsenic in Coal"(GB/T 3058-2008).According to the"Diagnosis of Endemic Arsenicosis"(WS/T 211-2015),the condition of the people exposed to high arsenic coal in the monitoring village was investigated.Urine samples of 30 adult patients(half males and half females)with arsenic poisoning were collected,the content of arsenic in urine was determined by the"Urine-Determination of Arsenic-Silver Diethyldithiocarbamate-Triethanolamine-Spectrophotometric Method"(WS/T 28-1996).Results A total of 240 households were monitored in the past 6 years,and the quality conformance and correct utilization rates of improved stoves in the households monitored in the disease areas remained at 100.00%in 2018-2020.The utilization rate of clean energy increased from 75.00%(30/40)in 2015 to 100.00%(40/40)in 2018-2020(χ^(2)trend=25.5,P<0.001).The 73.75%(177/240)of households using a variety of clean energy.From 2018 to 2020,the correct drying,storage and pre-processing washing rates of corn and pepper continued to reach 100.00%(40/40).The arsenic content of coal(n=120)in the disease areas was(118.09±57.91)mg/kg,ranging from 16.70 to 280.94 mg/kg.The detection rate of arsen

关 键 词：砷中毒 煤 改炉改灶 尿砷 监测 

分 类 号：R599.1[医药卫生—内科学]