中国改水降氟措施效果评价和标准研究

Evaluation on the Effects of Water Defluoridation Measures in China

为了解中国改水降氟措施的管理、使用情况及其防治地方性氟中毒的效果，本课题在全国饮水型地方性氟中毒流行严重的１０省市，整群抽样调查了１９６０个改水降氟工程，约占全部工程的１０％。本次回顾性调查采用了统一方法，统一标准与统一表格进行，调查结果输入计算机数据库进行统计分析与效果评价。本项课题研究的全部结果，陆续发表于《卫生研究》１９９８年１～３期。本期为全国改水降氟措施效果评价。结果表明，改水降氟措施对防治地方性氟中毒发挥了良好效果，水氟浓度基本能控制在１ｍｇ／Ｌ范围，氟斑牙患病率控制在３０％～４０％，且以轻度氟斑牙为主。一些改水降氟工程随着时间的延长、管理措施与监测工作放松降氟效果下降，加之水氟自然回升等原因，使饮水氟浓度与氟斑牙患病率有上升趋势。在改水措施中，主要为改换水源，以打井为主。理化降氟只宜在少数无低氟水源地区实行，因其费用昂贵，管理技术要求高，水量小，在农村不易坚持。今后改水降氟措施的主要方向应推广改用低氟水源，加强管理；地方病防治与卫生防疫部门要坚持水氟浓度与儿童氟斑牙的监测工作，建立计算机监测档案，以保证改水降氟措施更好地发挥作用。

n order to find out the situation of managenment and application of water defluoridation measures, as well as the effects on the prevention of endemic fluorosis in 10 provinces and cities with heavy endemic fluorosis from the drinking water sources, 1960 water engineering projects accounting for about 10% of all projects were investigated. The authors applied uniform method, criteria and forms to carry out the retrospective investigation. The data were entered into the computer database and analyzed statistically. The results demonstrate that all the defluoridation projects have significant effectiveness on the prevention of endemic fluorosis. The concentrations of water fluoride were below 1mg/L. The prevalences of dental fluorosis were 30%～40% and the main type was light dental fluorosis. But with the time prolonging, less attention has been paid in managing and monitoring of some projects. The natural water fluoride levels increased, and the concentrations of fluoride in drinking water and the prevalence of dental fluorosis were increased in certain areas. Among the water improvement measures, changing water sources and drilling well are the main effective methods. Physicochemical defluoridation can only be applied in some regions without low fluoride water source, because the cost is high and the technological requirements in management is limited.Using lower fluoride water source is the recommended method for water defluoridation and the management should be strengthened. Anti epidemic stations should continue to monitor the concentration of fluoride in drinking water,to examine the dental fluorosis prevalence of children, and to develop computerzed monitoring file so as to ensure the measures of defluoridation to be implemented.