贵州省燃煤污染型氟中毒重点病区流行因素变化研究

Study on the endemic factors of coal-burning fluorosis in the key regions of Guizhou Province

目的了解贵州省燃煤污染型氟中毒重点病区流行因素变化情况,为采取针对性的防治措施提供科学依据。方法以2000年全省流行病学调查结果为依据,分别在氟斑牙流行强度为较显著的病区(A类)和氟斑牙流行强度为中等的病区(B类),各抽取4个调查县。在A类病区调查县,每县抽取3个氟斑牙流行强度为较显著的病区乡,在B类病区调查县,每县抽取3个氟斑牙流行强度为中等的病区乡。在每个调查乡随机抽取3个病区村,每村随机抽取30户,入户回顾性调查上世纪50～90年代病区家庭地氟病流行因素,现况调查2007年病区家庭相同的地氟病流行因素。调查内容包括燃煤情况、燃煤方式、房屋结构、主食构成、食物干燥储存方法、食物加工前淘洗习惯。结果原煤仍然是病区的主要生活能源;敞灶燃煤率、玉米食用比例、玉米和辣椒的敞煤火干燥储存率、草房拥有率与时间呈反比,铁炉拥有率、铁炉烟囱出屋率、大米食用比例、砖混房拥有率、居厨分开率、玉米和辣椒加工前淘洗率与时间呈正比。结论通过多年的综合治理,导致燃煤型地氟病发生的因素逐渐减弱,预防控制地氟病流行的相关措施和健康行为得到逐步落实和建立,但由于经济社会文化发展的不平衡及地理环境条件的差异,A类病区的变化滞后于B类病区。

Objective To explore the changes of factors in the typical coal-burning endemic flurosis regions and provide scientific basics for formulating pertinent control strategies of endemic fluorosis. Methods Four counties were investigated in each type of the two regions which were divided into type of A region where the intensity of dental fluorosis was marker and type of B region where the intensity of dental fluorosis was middle, based on the epidemiologieal survey data of the whole province in 2000. Three towns were randomly investigated in the every county. Three villages were surveyed in each town and 30 households were randomly selected, retrospectively investigating the epidemic factors of coal-burning endemic fluorosis from 1950 to 1990 for the family as well as existing conditions in 2007. The investigation items included the usage of the coal, the way of coal combustion, the framework of the house, the makeup of foodstuff, manners of food dehydration and storage, the habits of washed food before processing and so on. Results The original coal is still the living fuel （energy source） of the endemic regions. The rate of open burning stoves, the proportion of corn and pepper dried by the open burning stove and the ownership of thatched cottage were inversed with the time. The rate of stove usage, the rate of stove chimney out of room, the proportion of rice consumption, the ownership of brick and concrete house, the separating rate of kitchen and bedroom and the washing rate of corn and pepper before eating were proportional with the time. Conclusion The factors resulting in the endemic coal-burning fluorosis have been weakened through many years＇ integrated countermeasures, and the related control measures to prevention the endemic of fluorosis as well as thehealthy behaviors have been step by step implemented and established. But because of the unbalance of economy and geographical differences, the improving change as the total of the type A area is lagging behind that of the type B area.