贵州省燃煤污染型氟中毒病区居民总摄氟量调查

An investigation of total fluoride intake of resident in typical coal-burning-borne fluorosis areas in Guizhou Province

目的 了解贵州省燃煤污染型氟中毒流行因素变化、氟摄入主要途径及防治效果,为制订防治措施和策略提供科学依据.方法 在贵州省实施改炉改灶项目后期管理的23个燃煤污染型氟中毒病区县（市、区）,每个县（市、区）按照东、南、西、北、中5个方位,各抽取1个乡（镇）,每个乡（镇）抽取3个病区村,每个村抽取20个居民户进行相关生活行为调查;同时抽取10个居民户,采集其家中食用玉米和干辣椒样品,检测氟含量;在3个抽取病区村的小学,对8～ 12岁学生进行氟斑牙检查;分析病区居民的总摄氟量及其构成情况.玉米和干辣椒氟含量检测参照《食品中氟化物的测定方法》（GB/T 5009.18-2003）进行;氟斑牙检查参照《氟斑牙诊断》（WS/T 208-2011）进行.结果 全省23个燃煤污染型氟中毒病区县（市、区）儿童和成人日人均总摄氟量分别为0.84和1.49 mg.玉米和干辣椒的氟含量均占总摄氟量的30％以下.共检查8～12岁学生17 962名,检出氟斑牙5 803例,氟斑牙检出率为32.31％.其中8～ 12岁5个年龄组的氟斑牙检出率分别为17.79％ （224/1 259）、26.02％（871/3 348）、30.28％（1 255/4 144）、34.07％（1 595/4682）和41.02％（1 858/4529）;极轻度、轻度、中度和重度氟斑牙分别占48.39％（2 808/5 803）、30.43％（1 766/5 803）、15.16％（880/5 803）和6.01％（349/5 803）.结论 贵州省燃煤污染型氟中毒病区的氟中毒防治项目及后期管理效果显著.

Objective To understand the epidemic factors,intake pathway of fluoride and control effects of endemic fluorosis caused by exposure to coal-burning in Guizhou Province,and to provide a scientific basis for making control measures and strategies.Methods A total of 23 counties （cities,districts） in the disease affected areas that fulfilled the stove-improving project in Guizhou Province were selected; one town was selected according to its location at the east,south,west,north and center of each county （city,district）; three villages were selected in each town; and 20 householders were investigated in each village.Corn and dried red pepper were collected from 10 householders for monitoring of fluoride contents.At the elementary schools of those selected villages,all students aged 8-12 years old were examined for dental fluorosis.Total fluoride intake and its proportion were analyzed.Fluoride content detection and dental fluorosis diagnosis were done according to ＂Detection Method of Fluoride in Food＂ （GB/T 5009.18-2003） and ＂Diagnosis of Dental Fluorosis＂ （WS/T 208-2011）.Results Total fluoride intake per day of children and adults was 0.84 and 1.49 mg,respectively in the 23 typical coal-burning-borne fluorosis counties （cities,districts）.Fluoride contents of corn and dried chili were all below 30％ of total fluoride intake.Totally 17 962 children were examined,the rate of dental fluorosis was 32.31％ （5 803/17 962）.The detection rates were 17.79％ （224/1 259）,26.02％ （871/3 348）,30.28％ （1 255/4 144）,34.07％ （1 595/4 682） and 41.02％ （1 858/4 529）,respectively in 5 age groups of 8 to 12 years old.Very mild,mild,moderate and severe dental fluorosis were accounted for 48.39％ （2 808/5 803）,30.43％ （1 766/5 803）,15.16％ （880/5 803） and 6.01％ （349/5 803）,respectively.Conclusion The power project and its late management effect of the fluosis is remarkable in the coal-burning-borne fluorosis areas in Guizhou Province.