2007年青海省饮茶型氟中毒流行现状与居民饮食结构调查

Investigation on prevalence and dietary structure of drinking-tea fluorosis in Qinghai province in 2007

目的调查青海省饮茶型氟中毒流行现状，了解居民饮食结构，为预防控制和科研工作提供科学依据。方法2007年，依据全国《饮茶型地方性氟中毒流行现状调查方案》，结合青海省具体情况对28个县进行调查，每个县抽查3个乡、1个镇，每个乡（镇）抽查2个行政村（居委会），每个村（居委会）抽查50名成人、50名学龄儿童；同时每个县抽查1座寺院，每座寺院抽查成人僧侣50名、儿童僧侣50名。人户调查居民经济收入、饮食结构、砖茶消耗量等。对全部调查对象用Dean法诊断氟斑牙，对同仁、达日、互助县和隆务寺16岁以上成人用200mA X线机拍片诊断氟骨症，并用调查结果估算全省饮茶型氟中毒的患病人数。结果①居民家庭年人均收入大部分在500～〈1000元，其次在1000-〈3000元；牧业区居民经济收入略高于农业区、半农半牧区和城镇居民。②居民饮食结构，牧业区及半农半牧区主食以面粉为主，其次是糌粑及大米；农业区及城镇主食以面粉为主，其次是大米及糌粑；各地区副食均为肉制品占多数，其次为奶制品，蛋类比例很小。③经常食用的蔬菜为土豆、白菜及青椒，每日食用的家庭占62．82％（6497／10343）；水果以苹果、梨及橘子为主，每月食用不足10次的家庭占75．95％（7856／10343）。④共调查居民61999人，年砖茶消耗量为153335kg，人均2．47kg；共调查僧侣1001人，年砖茶消耗量为4120kg，人均4．12kg。⑤乡镇成人氟斑牙检出率为24．11％（2494／10343），儿童氟斑牙检出率为24.38％（3012／12355）；成人僧侣氟斑牙检出率为26．13％（203／777），儿童僧侣氟斑牙检出率为39．73％（89／224）。⑥乡镇成人氟骨症检出率为15．60％（17／109）；成人僧侣氟骨症检出率为4．88％（2／41）。⑦氟斑牙患者95％可信限估算总人数为1084306—1134170人，中位数为1109238人；氟骨症患者95％可信限估算总人数为309177～758199人，中位数为533688人。结论青海省砖茶消耗量较大，饮茶型氟中毒人数多，危害程度比较重；居民饮食结构比较单调，主要靠外地运输。

Objective To investigate epidemical situation of drinking-tea fluorosis in Qinghai province, in order to understand diet structure to provide the scientific basis for the prevention and control and the scientific research. Methods In 2007, according to ＂Scheme for Survey on Epidemical Drinking-tea Fluorosis＂, we carried out an customized investigation in 28 counties, 3 townships sampled in each county, 2 villages in each township, 50 adults and 50 school-age children in each village; at same time, 1 monk temple was sampled in each county, 50 clergy adults and 50 children in each temple. Then we investigated the resident income, the diet structure, the brick tea consumption and so on, and apphed Dean method to diagnose dental fluorosis. The patient number estimated based on the survey result. Results ①Yearly per capita income of people was mostly 500 - 〈 1000 yuan, next 1000 - 〈 3000 yuan; economic income in pasturing area was higher than that of agriculture, half agriculture and half pastoral region and township. ②Staple food was bread flour primarily in the animal husbandry area and half agricultural half pastoral area, next were the roasted barley and the rice; the bread flour was the principle food in the agricultural region and the cities, next were the rice and the roasted barley; among non-staple food, meat came first and milk followed, egg the last. ③The frequently edible vegetables was potato, cabbage and green pepper, eaten by a majority of people[62.82%（6497/10 343） ] ; as for fruits, apple, pear and orange was primarily consumed, 75.95%（7856/10 343） of people ate less than 10 times every month. ④Sixty-one thousand nine hundred and ninety-nine residents were registered, 153 335 kg of brick tea was consumed in villages and towns, 2.47 kg per person; in 1001 monks investigated, 4120 kg of brick tea was consumed every year, 4.12 kg per person. ⑤Detection rate of adult dental fluorosis in the villages and towns was 24.11%（2494/10 343）, that of the children was 24.38% （3012/12 355） ; detection rate of dental fluorosis in monks was 26.13%（203/777）, that of the children was 39.73% （89/224）. ⑥Detection rate of adult skeletal fluorosis in villages and towns was 15.60%（17/109）; that of monks was 4.88%（2/41 ）. ⑦The 95% confidence limit estimated a total number of dental fluorosis patients were 1 084 306 - 1 134 170 persons, the median was 1 109 238 persons; the 95% confidence limit estimated a total number of skeletal fluorosis patients were 309 177 - 758 199 persons, the median was 533 688 persons. Conclusions Qinghai province has a great quantity of brick tea consumption, having lots of people with drinking-tea fluorosis which is in severe degree. The resident food structure was monotonous and mostly transported from other region.