山东省2002～2003年地方性氟中毒监测分析

Analysis on surveillance of endemic fluorosis in Shandong between 2002 and 2003

目的了解2002、2003年梁山县地方性氟中毒防治工作进展情况和重点监测点东徐村地氟病的病情变化。方法按照全国地方性氟中毒监测方案的要求,调查梁山县的改水进度,已改水工程管理、使用、饮水含氟量现况;对重点监测点东徐村10户居民末梢水含氟量进行检测,调查该点8～12岁儿童氟斑牙患病率、氟斑牙指数以及即时尿含氟量等。结果监测县梁山共有地氟病村215个,已完成降氟改水131个(109处降氟设施),改水完成率60.9%;109处改水设施能够正常使用的61处,占56%;61处正在使用的降氟设施水含氟量≤1.0mg/L的2年检测平均为76.5%,水氟最高达2.80mg/L。重点监测点东徐村10户末梢水含氟量每年检测均在0.5mg/L以下且持续稳定;8～12岁儿童氟斑牙患病率2年分别为16.5%,15.0%,氟斑牙指数分别是0.39,0.30,尿氟含量几何均值均在1.0mg/L以下,已完全达非病区标准。结论改水降氟是控制饮水型地方性氟中毒行之有效的主要措施,但是监测县改水降氟措施落实进度缓慢,改水设施的正常利用率不高,对此,应加大投入,强化管理,加快改水降氟工作步伐,在整体上有效控制饮水型地方性氟中毒的发生。

Objective To understand the process of endemic fluorosis prevention, cure, and the changes of symptom in Dongxu village Liangshan county from 2002 to 2003. Methods According to the national surveillance program of endemic fluorosis, the progress of water-improving and management, usage, fluoride content of drinking water for the water-improved project in Liangshan were investigated. The dental fluorosis incidence rate and index, and fluoride content of urine among children aged 8-12 were researched. The fluoride content of end water among 10 households was examined in Dongxu village. Results 131 villages completed the water-improving project among 215 endemic fluorosis villages in Liangshan county with the accomplishment rate 60.9 %. Among 109 water-improving facilities in total, 61 worked normally with the rate 56%. The average rate of water fluoride content （41.0mg/L） was 76.5% for the normal facilities between 2002 amd 2003, and the highest was 2.8 mg/L. The end water fluoride content remained below 0.5 mg/L; and the prevalence rate of dental fluorosis of children aged 8-12 was 16.5% in 2002 15.0% in 2003 with the dental fluorosis index 0.39, 0.30 respectively. The geometric mean of the urine fluoride in the children was 〈1.0 mg/L. Conclusion The water-improving to reduce fluoride was a major way for controlling endemic fluorosis of drinking water type. However, it was slow to carry out the measures for water-improving and the facilities were not used sufficiently. The county should strengthen the management;increase the investment; speed up the steps in water-improving and effectively control the endemic fluorosis.