儿童尿氟的基准剂量及其与氟斑牙相关关系的研究

Study on the BenchMark Dose of urine fluoride in children and it'srelationship to the prevalence of dental flurosis

目的 探讨尿氟的基准剂量及其在地方性氟中毒防治中的应用。方法 选择江苏省某县瓦庙村(地方性氟中毒重病区村)和新淮村(非病区村)的所有在校8～13岁儿童为调查对象,根据儿童尿氟含量及肌酐校正后的尿氟含量把两村儿童分为不同的接触组,即:尿氟含量<1.0 0mg/L(A组)、1.0 0～mg/L(B组)、2 .0 0～mg/L(C组)、3 .0 0～mg/L(D组)、4.0 0～mg/L(E组)、5 .0 0～mg/L(F组)及 6.0 0mg/L(G组)共7组和肌酐校正后的尿氟含量<0 .2 0mg/mmolCr(A1组)、0 .2 0～mg/mmolCr(B1组)、0 .40～mg/mmolCr(C1组)、0 .60～mg/mmolCr(D1组)、及 0 .80mg/mmolCr(E1组)共5组,分别统计各组儿童的氟斑牙和缺损型氟斑牙的患病率及氟斑牙指数。结果 随着儿童尿氟及肌酐校正后尿氟含量的增加儿童氟斑牙患病率和缺损型氟斑牙患病率逐渐增加,呈显著的剂量-反应关系。根据尿氟含量及肌酐校正后尿氟含量与儿童氟斑牙及缺损型氟斑牙患病率的剂量-反应关系计算的尿氟含量和肌酐校正后尿氟含量的BMDL分别为:1.5 5、1.88mg/L和0 .43、0 .49mg/mmolCr。由此计算的儿童尿氟和肌酐校正后尿氟含量的参考剂量(RfD ,Refer enceDose)分别为:1.5 5、1.88mg/L和0 .43、0 .49mg/mmolCr。结论 根据本次调查结果并结合同类研究成果,建议8～13岁非病区儿?

Objective Study on the BenchMark Dose of urine fluoride , and to evaluate the significance of urine fluoride on control and prevention of endemic fluorosis. Methods The children, aged 8 to 13 years old, in two primary school of Wamiao village (severe endemic fluorosis area) and Xinhuai village (non-endemic fluorosis area) were recruited in this study. According to the levels of urine fluoride, the children were divided into 7 subgroups, as <1.00mg/L(group A)?1.00～ mg/L(groupB)?2.00～ mg/L(group C)?3.00～ mg/L(group D)?4.00～ mg/L(group E)?5.00～ mg/L(group F)?and 6.00 mg/L(group G); and according to the adjusted levels of urine fluoride by creatinine, the children were divided into 5 subgroups, as <0.20 mg/mmolCr(group A1)?0.20～ mg/mmolCr(group B1)?0.40～ mg/mmolCr(group C1)?0.60～ mg/mmolCr(group D1)?and 0.80 mg/mmolCr(group E1). Epidemiological methods were used to investigate the prevalence of dental fluorosis and defected dental fluorosis. Results There were significant dose -response relationships between the urine fluoride and the prevalence of dental fluorosis or defected dental fluorosis. The BMDLs were 1.55 mg/L?1.88 mg/L and 0.43 mg/mmolCr?0.49 mg/mmolCr respectively, calculated by these relationships. The RfD (Reference Dose) of urine fluoride were 1.55mg/L?1.88 mg/L and 0.43 mg/mmolCr?0.49 mg/mmolCr respectively, calculated by BMDLs. Conclusions Considering the results of this study and the results of other same kind studies, the normal levels of urine fluoride in the 8 to 13 years old children in non-endemic fluorosis areas or the biological limit value of urine fluoride in the same groups in endemic fluorosis areas were suggested as <1.50 mg/L or <0.45 mg/mmolCr?