山东省梁山县地方性氟中毒5年监测结果分析

Survey analysis with fluorosis of drinking water in Liangshan county Shandong provine

目的了解梁山县改水降氟措施的落实情况和监测点徐东村地方性氟中毒病情变化,观察采取防治措施产生的预防效果。方法儿童氟斑牙检查采用Dean法,水、尿测定氟采用氟离子选择电极法,成人氟中毒的体征、症状及氟骨诊断标准依照卫生部地病司《地方性氟中毒防治手册》执行。结果梁山县共落实改水降氟措施131个病区村(109处工程),占全部氟病村的60.9%,受益人口10余万人。已落实防治措施病村中正常运转的改水工程63处,含74个病村,占已改水病区村的56.5%。监测点东徐村8～12岁儿童氟斑牙患病率由1997年的68.9%降至2001年的32.2%,尿氟水平由1997年的1.31mg/L减低至2001年的1.06mg/L,成人氟骨症的患病率随改水时间的延长明显降低,且病变程度显著减轻。结论改水降氟是控制饮水型地方性氟中毒切实可行的重要措施,改水设施的运行正常与否,是保证预防效果的关键。

Objective To understand the process of altering water sources to lower fluoride level, to observe the effects of prevention and treatment, and to provide evidences for the formulation of scientific strategies in prevention and treament. Methods Epidemiological investigation methods were adopted. Dental fluorosis of children were examined by Dean index. The fluoride content in drinking water and in the urine were determined by the fluoride selective ion electrode. Adult fluorosis was abided by the Endemic Fluorosis Prevention Manual. Results At present, water improving was completed in 60.09% in Liangshan. After defluoridation, only 56.5% were normal in all the projects of defluoridation. Dental fluorosis prevalence rate of 8~12 years old students in Dongxu was dropped from 68.95% of 1997 to 32.2% of 2001. Fluoride in urine was decreased from 1.31 mg/L of 1997 to 1.06 mg/L of 2001. Prevalence rate of ostefluorosis was significantly decreased since they drunk low fluoride content water. The symptom in the patients with osteofluorosis had been obviously improved with defluoridation's time extending. Conclusions It is an effective way to lower fluorine in drinking water by altering water source. The quality of this project is key to assure the effect.