青海省贵德县饮水型氟中毒防治现状调查

Analysis on the prevention and treatment of drinking water fluorosis Guide county, in Qinghai province

目的 掌握青海省贵德县地方性氟中毒防治现状及改水降氟工程修建、使用情况,为深入开展氟中毒的防治提供科学依据.方法 在2005年,对贵德县未改水病区村进行普查,并对病区村及周边非病区村进行高氟水源筛查,每个村按东、西、南、北、中五个方位采集居民户家中饮用水水样 对已改水病村,进行工程运转状况调查、采集全部水源水、末梢水进行改水工程质量监测,水氟测定采用〈地方性氟中毒病区饮水氟化物的测定方法〉.在2008年,按改水前水含氟量,将贵德县氟中毒病区村按轻、中、重分类,分别抽取其中1、1、3个村作为调查村,采用Dean法对调查村所有8～12岁儿童进行氟斑牙检查,每个年龄段抽检尿样6份,尿氟测定采用离子选择电极法 对调查村16岁及以上成人进行临床氟骨症检查,在中、重病区村,每村按年龄抽取20人（男女各半）进行X线氟骨症检查.结果 共对85个村进行了高氟水源筛查,其中有3个村饮水含氟量超过国家饮用水标准（〈1.0 mg/L） 在16个改水降氟工程中,有8个间歇供水,3个报废,工程正常使用率仅为31.25%.8～12岁儿童氟斑牙检出率为41.13%（116/282） 尿氟中位数为1.06 mg/L,范围为0.20～9.44 mg/L 16岁以上成人临床氟骨症检出率为47.95%（969/2021）,X线氟骨症检出率为20.73%（17/82）.结论 青海省贵德县地方性氟中毒病区大部分改水工程供水不正常,病情有回升趋势,地方性氟中毒防治的重点应放在保证改水降氟工程的正常使用上.

Objective To observe the state of endemic flurosis, construction and running status of water improvement projects in order to provide a scientific basis for prevention and treatment fluorosis. Methods Water samples of the diseased and nondiseased villeges were collected from east, west, south, north and centre of each villege in 2005, and fluoride concentration was determined for each surveyed village with unimproved-water. At the same time, all the tap water and source water samples were collected to determine fluoride concentration in each water-improved village surveyed. In 2008, all the endemic fluorosis villages in Guied county were divided into slight, medium and heavy types according to the water fluoride content before water improved, and 1,1,3 survey villages were chosen from each type. In all of the village children aged 8 to 12 years were tested for dental fluorosis by Dean method. Six copies of the urinary fluoride were sampled in different age groups. The fluorine content in water and urine was determined by F-ion selective electrode. The situation of clinical skeletal fluorosis of adults over 16 years of age was investigated, 20 adults （evenly divided between men and women） in the villages of medium and heavy types were examined by X-ray for skeletal fluorosis. Results In 3 village fluoride content of drinking water exceeded the national drinking water standards （ 〈1.0 mg/L） of 85 surveyed villages with improved-water. Among the 16 projects, 8 were intermittently running and 3 were retired, leaving only 31.25% of the projects active. Theprevalence of enamel fluorosis was 41.13%（ 116/282）, that of skeletal flurosis was 47.95%（969/2021） and that of X-ray checked was 20.73% （17/82）. The median of urine fluoride was 1.06 mg/L and the scope was 0.20 - 9.44 mg/L.Conclusions Most of the improved-water projects do not normally supply water in the disease ward of Guide county. Therefore, there is an increasing trend of the disease, so further control measures are needed.