2016—2019年江苏省饮水型氟中毒监测结果分析  

Surveillance onendemic fluorosis caused by drinking water in Jiangsu Province from 2016 to 2019

作　　者：汪旸[1] 夏玉婷[1] 刘茂[1] 尚莉[1] 叶云杰[1] 王培桦[1] WANG Yang;XIA Yu-ting;LIU Mao;SHANG Li;YE Yu-jie;WANG Pei-hua(Jiangsu Provincial Center for Disease Control and Prevention,Nanjing,Jiangsu 210009,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009

出　　处：《江苏预防医学》2023年第4期420-423,共4页Jiangsu Journal of Preventive Medicine

摘　　要：目的掌握江苏省饮水型地方性氟中毒病区防治措施落实情况及病情变化趋势。方法根据地方性氟中毒的流行程度,在江苏省选择12个病情最重的县(区)作为固定监测县,每个县(区)按照病情的轻、中、重程度抽取3个病区村作为固定监测村,调查改水工程运行情况,并检测水氟值,检查监测村8~12岁儿童的氟斑牙患病情况。每年轮流在监测村对≥25岁成人开展氟骨症X线拍片和尿氟检测。结果共监测36个病区村,2016—2019年实施大型改水工程占比从30.30%上升到100.00%,水氟合格工程占比从93.94%上升到100.00%;2016—2019年儿童氟斑牙检出率差异有统计学意义(χ^(2)=160.15,P<0.05),2019年最低(16.53%),改水工程正常运转且水氟含量合格村、改水工程水氟含量超标村、未改水村氟斑牙检出率分别为21.78%、73.13%、27.89%,差异有统计学意义(χ^(2)=1100.00,P<0.05),两两比较差异均有统计学意义(χ^(2)值分别为1100.00、4.08、156.64,P值均<0.05)。改水工程正常运转且水氟含量合格村氟骨症检出率为15.43%(255/1653),改水工程水氟含量超标村氟骨症检出率为8.00%(8/100)。改水工程正常运转且水氟含量合格村成人尿氟均值为1.39 mg/L,低于人群尿氟正常值上限(1.60 mg/L);改水工程水氟含量超标村成人尿氟均值为2.53 mg/L,高于正常值上限;两类村成人尿氟含量差异有统计学意义(Z=-9.98,P<0.05)。结论2016—2019年江苏省改水防治饮水型地方性氟中毒取得了明显的效果,改水工程正常运转且水氟含量合格村的儿童氟斑牙患病率显著下降。Objective To investigate the implementation of endemic fluorosis control measures and trends in prevalence of en⁃demic fluorosis in areas where endemic fluorosis caused by drinking water was prevalent in Jiangsu Province.Methods According to the severity of endemic fluorosis,12 counties(districts)with the highest prevalence of endemic fluorosis in Jiangsu Province were se⁃lected as fixed surveillance counties(districts),and three villages with the high,medium and low prevalence of endemic fluorosis were sampled from each surveillance county(district)as surveillance villages.The running of the water improvement project was investiga⁃ted,and fluoride concentrations was determined in drinking water.In addition,the dental fluorosis was detected among children at ages of 8 to 12 years in each surveillance village,and X⁃ray scans for skeletal fluorosis and detection of urinary fluoride concentrations were performed among adults at ages of 25 years and older in surveillance villages each year.Results A total of 36 surveillance villages were enrolled.The proportion of water improvement projects increased from 30.30%in 2016 to 100%in 2019,and the percentage of projects with eligible fluoride concentrations in drinking water increased from 94.94%to 100.00%,while there was a significant differ⁃ence in the detection of dental fluorosis among children from 2016 to 2019(χ^(2)=160.15,P<0.05),with the lowest detected in 2019.There was a significant difference in the detection of dental fluorosis in villages with normal running of water improvement projects and eligible fluoride concentrations in drinking water(21.78%),villages with excessive fluoride concentrations than normal in drinking wa⁃ter(76.13%),villages without water improvement projects and eligible fluoride concentrations in drinking water(27.89%)(χ^(2)=1100.00,P<0.05),with significant differences for pairwise comparisons(χ^(2)=1100.00,4.08 and 156.65,all P values<0.05).The prevalence rates of skeletal fluorosis were 15.43%(255/1653)and 8.00%(8/100)in v

关 键 词：饮用水 氟中毒 牙 氟骨症 监测 

分 类 号：R599.1[医药卫生—内科学]