2008年云南省昭通市高氟区人群生活习惯和氟斑牙患病情况调查

Survey of habits and customs and prevalence of dental fluorosis in high-fluoride areas of Zhaotong city Yunnan province in 2008

目的 了解云南省昭通市燃煤型高氟区人群的生活习惯和氟斑牙患病情况,为监测和防治地方性氟中毒（简称地氟病）提供依据.方法 2008年对600名昭通市燃煤型高氟区的12岁（400人）和35～44岁（200人）人群进行氟斑牙检查,诊断标准采用Dean法,并抽取120名学生和60名成人进行问卷调查,内容涉及生活习惯、改灶情况、地氟病防治知识知晓情况、社会心理状况评价、口腔卫生行为及治疗需求等.结果 受检人群总体氟斑牙检出率为91.0%（546/600）,氟斑牙指数为2.58 12岁学生氟斑牙检出率为86.5%（346/400）,氟斑牙指数为2.12,其中农村学生氟斑牙检出率为90.5%（181/200）,与城区学生[82.5%（165/200）]比较差异有统计学意义（χ2=5.48,P〈0.05） 35～44岁人群氟斑牙检出率为100%（200/200）,与学生组比较差异有统计学意义（χ2=29.67,P〈0.01）.城区居民生活用燃煤使用率、食物烘烤率和改炉改灶率分别为66.7%（60/90）、14.4%（13/90）和57.8%（52/90）,均明显低于农村居民[95.6%（86/90）、31.1%（28/90）和76.7%（69/90）,χ2值分别为24.51、7.11、7.29,P均〈0.01] 受检人群总体地氟病防治知识知晓率仅为23.3%（42/180）,其中成人知晓率[56.7%（34/60）]高于学生[6.7%（8/120）,χ2=55.9,P〈0.01],而学生组中城区学生知晓率为0（0/60）,农村学生为13.3%（8/60）,二者比较差异有统计学意义（χ2=5.66,P〈0.05）.73.9%（133/180）的人认为氟斑牙对其生活造成严重影响,有91.1%（164/180）的人有治疗需求.受检人群中有84.4%（152/180）的人有刷牙习惯,其中有50.7%（77/152）的人仍然使用含氟牙膏.结论 云南省昭通市属于氟斑牙重度流行区,加强当地人群特别是学生的健康教育宣教和普及,改变不良的生活习惯和方式,是有效控制该地区燃煤型氟中毒发生和发展的关键环节.

Objective To study local people＇s habits and customs concerning the prevention of dental fluorosis in an indoor coal-combustion-type fluorosis area of Zhaotong city Yunnan province, and to provide reference value for monitoring and control of the disease. Methods In 2008, 600 people of a 12-year-old group （400 people） and a 35 - 44-year-old group（200 people） were examined for dental fluorosis and oral health status in an indoor coal-combustion-type fluorosis area of Zhaotong. A questionnaire survey of 120 students and 60 adults was carried out on their habits and customs, stove changing status, knowledge of prevention of dental fluorosis, social psychology status, oral health behavior and their need for medical treatment. Results The total prevalence of dental fluorosis was 91.0% （546/600）, dental fluorosis index was 2.58. The total prevalence of dental fluorosis of 12-year-old group was 86.5%（346/400）, and dental fluorosis index was 2.12. The total prevalence of dental fluorosis of rural student was 90.5% （181/200）, which was obviously higher in the rural group than the urban group [82.5% （165/200）, χ2 = 5.48, P 〈 0.05]. The total prevalence of dental fluorosis of 35-44-year-old group was 100% （200/200）, which was obviously higher than that of the 12-year-old group（χ2 = 29.67, P 〈 0.01）. The rates of using coal, baking of food, changing stoves were 66.7% （60/90）, 14.4% （13/90）,57.8% （52/90）, respectively, and these values of the urban were much lower than those of the rural[95.6%（86/90） ,31.1%（28/90） ,76.7%（69/90）,χ2 = 24.51,7.11,7.29, all P 〈 0.01]. Only 23.3% （42/180） of people surveied had the knowledge of prevention of dental fluorosis, and the rate in the adult group[56.7% （34/60）]was higher than that of the student group [6.7% （8/120）, χ2 = 55.9, P 〈 0.01]. The same rate in the urban student group was 0（0/60）, and the rural student group was 13.3%（8/60）, there was a significant difference between them（χ2 = 5.66, P 〈 0.05）. Seventy-three point nine per cent（ 133/180） of these people thought dental fluorosis had significant effect on their life, 91.1%（164/180） of these ＇people wished to be treated. Eighty-four point four per cent（ 152/180） of the people had a habit of toothbrushing,and 50.7% （77/152） of these people were still using toothpaste containing fluorine. Conclusions Zhaotong is a serious indoor coal-combustion-type fluorosis area. Enhancing health education to local people especially to students, and changing people＇s unhealthy habits and customs are keies to control the prevalence of indoor coal-combustion-type dental fluorosis.