2019-2023年陕西省安康市燃煤污染型地方性氟中毒全覆盖监测结果分析  

Analysis of monitoring results of coal-burning-borne endemic fluorosis in Ankang City of Shaanxi Province from 2019 to 2023

作　　者：邓英 张同蕾 梁磊 苏锋 李晓茜[2] 范中学[2] 周蓉[2] Deng Ying;Zhang Tonglei;Liang Lei;Su Feng;Li Xiaoqian;Fan Zhongxue;Zhou Rong(Department for Disease Control and Prevention,Ankang Center for Disease Control and Prevention,Ankang 725000,China;Department of Endemic Fluorosis and Arsenism,Shaanxi Provincial Institute for Endemic Disease Control,Xi'an 710003,China)

机构地区：[1]陕西省安康市疾病预防控制中心地方病防制科,安康725000 [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

出　　处：《中华地方病学杂志》2024年第10期813-817,共5页Chinese Journal of Endemiology

摘　　要：目的评估陕西省安康市燃煤污染型地方性氟中毒防治效果,为今后制定防治策略提供科学依据。方法2019-2023年,按照《陕西省燃煤污染型地方性氟中毒监测方案(2019版)》要求,在安康市下辖7个病区县的所有病区村开展全覆盖监测,采用单纯随机抽样方法在每个病区村选择30户家庭,调查炉灶使用及相关健康生活行为形成情况;检查全部8~12周岁儿童氟斑牙患病情况。同时,于2019、2023年分别抽取6、8个监测村采集8~12周岁儿童即时尿样检测尿氟含量。按照《重点地方病控制和消除评价办法(2019)版》进行病区控制和消除评价。结果2019-2023年共监测203880户家庭,合格改良炉灶率及其正确使用率均>95.00%;改良煤炉(灶)使用率由2019年的16.34%(6584/40290)下降至2023年的8.89%(3706/41700),呈逐年下降趋势(χ^(2)_(趋势)=3400.37,P<0.001);电热器、电炊具等清洁能源灶具使用率由2019年的82.52%(33247/40290)上升至2023年的94.36%(39350/41700),呈逐年上升趋势(χ^(2)_(趋势)=7506.09,P<0.001)。2019-2023年监测村供人食用玉米和辣椒正确干燥率均达到100.00%。共检查8~12周岁儿童455327例,检出氟斑牙2301例,检出率为0.51%;氟斑牙患儿以极轻度和轻度为主,占94.87%(2183/2301);氟斑牙指数为0.012,无氟斑牙流行趋势。儿童氟斑牙检出率从2019年的0.81%(765/94537)下降至2023年的0.24%(204/86066),呈逐年下降趋势(χ^(2)_(趋势)=375.45,P<0.001)。2019、2023年8~12周岁儿童尿氟几何平均数分别为0.48、0.42 mg/L,组间比较差异有统计学意义(Z=-3.05,P=0.002)。截至2023年,1390个病区村均达到消除标准。结论安康市燃煤污染型地方性氟中毒防治成效显著,7个病区县全部达到消除目标。今后应加强高氟煤矿的管理,继续推广清洁能源使用,加强健康促进和病情监测,巩固提升防治成果。Objective To evaluate the prevention and control effect of coal-burning-borne endemic fluorosis in Ankang City of Shaanxi Province,so as to provide a scientific basis for formulating precise prevention and control strategies in the future.Methods From 2019 to 2023,according to the requirements of the"Monitoring Program of Shaanxi Province for Coal-burning-borne Endemic Fluorosis(2019 Edition)",full coverage monitoring was carried out in all affected villages in seven affected counties under the jurisdiction of Ankang City.Using the simple random sampling method,30 households in each affected village were selected to investigate the use of improved stoves and the formation of health-related behaviors.All children aged from 8 to 12 in the village were examined for the prevalence of dental fluorosis.At the same time,6 monitoring villages were selected in 2019,and 8 monitoring villages were selected in 2023 to collect real-time urine samples from children aged 8-12 for determination of urinary fluoride level.The evaluation for control and elimination of disease areas was carried out in accordance with the"Evaluation Approach for Control and Elimination of Priority Endemic Diseases(2019 Edition)".Results From 2019 to 2023,a total of 203880 households were monitored,the rate of qualified improved stoves and the correct use rate of qualified improved stoves were more than 95.00%.The utilization rate of improved stoves decreased from 16.34%(6584/40290)in 2019 to 8.89%(3706/41700)in 2023,showing a decreasing trend year by year(χ^(2)_(trend)=3400.37,P<0.001).The utilization rate of clean energy increased from 82.52%(33247/40290)in 2019 to 94.36%(39350/41700)in 2023,showing an upward trend year by year(χ^(2)_(trend)=7506.09,P<0.001).The correct drying rate of corn and pepper for human consumption were 100.00%.A total of 455327 children aged 8-12 were examined,and 2301 cases of dental fluorosis were diagnosed,with a detection rate of 0.51%.Children with dental fluorosis were mainly extremely mild and mild,accounting for 94

关 键 词：氟中毒 牙 尿 燃煤污染型 改良炉灶 监测 

分 类 号：R599.9[医药卫生—内科学]