陕西省饮水型氟中毒流行现状调查

The investigation of prevalence state of drinking water-born endemic fluorosis in Shaanxi

目的掌握陕西省饮水型氟中毒流行现状,评价防治效果。方法采用分层抽样的方法,调查8～12岁儿童氟斑牙、16岁以上人群氟骨症患病情况,对疑似氟骨症患者拍摄X线片,测定饮水氟、儿童尿氟。结果在20个调查县中,儿童氟斑牙患病率平均为38.64%,重病区高达75.56%;临床氟骨症患病率平均为11.76%,重病区高达31.73%;氟骨症X线阳性率达63.61%;饮水氟超标率达62.96%,超标水样含氟在2.1 mg/L以上的占55.15%;儿童尿氟中位数为2.00 mg/L,重病区高达4.58 mg/L。与1980年调查结果相比,85%的调查县儿童氟斑牙患病率出现了不同程度的下降,其中5个县由原来的病区县下降为非病区县,20个县氟斑牙患病率平均下降幅度达46.14%。结论陕西省饮水型地方性氟中毒流行仍然较为严重,以改水为主的综合性防治措施的实施取得了良好的防治成效。

Objective To explore the prevalence state of endemic fluorosis associated with and evaluate control effects in Shaanxi. Methods By stratified sampling, dental fluorosis in children aging 8～12 years and skeletal fluorosis in adults aging above 16 years were examined. X-Ray films were taken in subjects with suspicious skeletal fluorosis. Fluoride levels in drinking water and children's urine were determined. Results In 20 counties, the dental fluorosis rate was 38.64%, and 75.56% in severe fluorosis areas. The skeletal fluorosis rate were 11.76%, and 31.73% in the severe fluorosis areas. The positive rate of X-Ray detection was 63.61%. The fluoride levels in 62.96% of water samples exceeded criterion established by the Ministry of Health of the People's Republic of China. The fluoride levels in 55.15% of water samples of over-criterion were beyond 2.1 mg/L. The median of fluoride levels in children's urine was 2.00 mg/L, and 4.58 mg/L in the severe fluorosis areas. As compared with 1980, the dental fluorosis rate descended in varying degrees in 85% of 20 counties, among which 5 counties had become non-endemic fluorosis areas. Average decreased ranges of the dental fluorosis rate reached 46.14% in 20 counties. Conclusions The prevalence of endemic fluorosis associated with drinking water is comparatively serious in Shaanxi. Prophylactic measures, such as improving water quality, have achieved great results.