内蒙古自治区饮水型地方性砷中毒流行现状分析  

Epidemic status of drinking water type endemic arsenic poisoning in Inner Mongolia Autonomous Region

作　　者：王晓君 常子丽 李艳红 刘一君 王璇 李振林 赵成祥 崔娜 Wang Xiaojun;Chang Zili;Li Yanhong;Liu Yijun;Wang Xuan;Li Zhenlin;Zhao Chengxiang;Cui Na(Emergency Office,Comprehensive Center for Disease Control and Prevention in Inner Mongolia Autonomous Region,Hohhot 010060,China;Department of Endemic Fluorine and Arsenic Poisoning,Comprehensive Center for Disease Control and Prevention in Inner Mongolia Autonomous Region,Hohhot 010060,China)

机构地区：[1]内蒙古自治区综合疾病预防控制中心应急办,呼和浩特010060 [2]内蒙古自治区综合疾病预防控制中心氟砷中毒防控科,呼和浩特010060

出　　处：《中华地方病学杂志》2023年第9期730-734,共5页Chinese Journal of Endemiology

基　　金：内蒙古自治区自然基金 (2021MS08038、2023QN08032)。

摘　　要：目的调查内蒙古自治区饮水型地方性砷中毒的流行范围、强度,以及患病情况和影响因素,为精准制定防控措施提供科学依据。方法2018-2020年在内蒙古自治区所辖全部旗县的所有自然村按不同供水方式(工程供水、理化净水、分散供水)对居民饮用水进行抽样调查,采用原子荧光法检测水砷含量。采用《地方性砷中毒诊断》(WS/T 211-2015)对各受检村屯所有正在暴露或以往暴露过高砷水的常住人口进行砷中毒诊断,查找砷中毒患者,分析历史病区和高砷村及新发现高砷村的水砷分布情况,并探讨砷中毒患病情况及影响因素。结果全区共有1186个砷中毒历史病区和高砷村,主要分布在巴彦淖尔市、呼和浩特市、包头市等8个盟市的28个旗县,地区分布呈西多东少趋势。目前历史病区和高砷村的改水率为98.23%(1165/1186),水砷含量合格率为99.83%(1184/1186),水砷含量范围为0.000~0.093 mg/L;新发现水砷超标村4个,水砷含量范围为0.074~0.142 mg/L。在已确定病区和高砷村检出砷中毒患者2249例,检出率为1.67%(2249/134645)。以巴彦淖尔市患者数量最多、病情最重,占患者总数的82.70%(1860/2249)。各年龄组砷中毒患者检出率比较差异有统计学意义(χ^(2)=840.52,P<0.001),其中60岁及以上年龄组患者占比较高,为患者总数的61.41%(1381/2249)。男性砷中毒患者检出率高于女性(χ^(2)=132.38,P<0.001)。不同水砷含量组砷中毒患者检出率和病情程度分布比较差异均有统计学意义(χ^(2)=1557.85、1741.05,均P<0.001)。结论经过多年防治工作目前内蒙古自治区大部分历史病区和高砷村水砷含量合格,部分地区存在水砷超标或新发现水砷超标村,同时内蒙古自治区仍有大量砷中毒患者。今后内蒙古自治区地方性砷中毒防治工作仍然不能放松,需要加强水质监测并对新发现的水砷超标村进行改水,防止新病例出现。Objective To investigate the epidemic scope and intensity of drinking water type endemic arsenic poisoning in Inner Mongolia Autonomous Region,as well as the prevalence and influencing factors,in order to provide scientific basis for precise formulation of prevention and control measures.Methods A sampling survey was conducted on residents'drinking water in all villages and counties in Inner Mongolia Autonomous Region,water samples were selected according to different water supply methods(engineering water supply,physical and chemical water purification,and decentralized water supply),and the arsenic content was detected by atomic fluorescence method.The"Diagnosis of Endemic Arsenicosis"(WS/T 211-2015)was used for diagnosis of arsenic poisoning among all permanent residents who were exposing to or had been exposed to excessively high arsenic water,in order to search all the arsenic poisoning patients.Analyze the distribution of water arsenic in the historical disease areas and high arsenic villages and newly discovered high arsenic villages,and explore the prevalence and influencing factors of arsenic poisoning.Results There were a total of 1186 historical disease areas and high arsenic villages in Inner Mongolia Autonomous Region,mainly distributed in 28 banner counties of 8 league cities such as Bayannur,Hohhot and Baotou,with a regional distribution trend of more in the west and less in the east.At present,the water improvement rate in the historical disease areas and high arsenic villages was 98.23%(1165/1186),and the qualified rate of arsenic content in the water was 99.83%(1184/1186).The arsenic content in the water of historical disease areas and high arsenic villages ranged from 0.000 to 0.093 mg/L.Four newly discovered villages with arsenic exceeding standards had been found,and their arsenic content ranged from 0.074 to 0.142 mg/L.A total of 2249 patients with arsenic poisoning were detected in the confirmed disease area/high arsenic villages,and the detection rate was 1.67%(2249/134645).The number of p

关 键 词：饮用水 砷中毒 流行病学研究 

分 类 号：R599[医药卫生—内科学] R181.3[医药卫生—临床医学]