山东省鲁西北地区地方性氟中毒流行病学调查

Endemic fluorosis in northwestern region of Shandong province

目的了解山东省鲁西北地区地方性氟中毒的流行现状,为制定防制策略提供科学依据。方法选择山东省鲁西北地区11个县进行水、人尿氟含量测定、8～12岁儿童氟斑牙诊断及临床和X线摄片检查氟骨症调查。结果在11个县调查17个改水村,水氟均值≤1.00 mg/L的村12个,占70.59%(12/17);>1.00 mg/L的村5个,占29.41%(5/17);水氟最大值为4.46 mg/L;调查16个未改水村,水氟均值≤1.00 mg/L的村5个,占31.25%(5/16);>1.00 mg/L的村11个,占68.75%(11/16),水氟最大值为4.09 mg/L;8～12岁儿童氟斑牙总患病率为51.51%(701/1 361),氟斑牙指数为1.05,缺损率为6.25%(85/1 631);儿童尿氟均值在>1.40 mg/L的占60.86%(510/838),最高值为15.20 mg/L;>16岁成人的氟骨症临床和X线检出率分别为2.49%(454/18 257),15.79%(3/19);成人尿氟均值在>1.60 mg/L的占62.27%(406/652),最高值为25.44mg/L。结论山东省鲁西北地区地方性氟中毒病情尚未得到有效的控制,防制形势依然比较严峻,须进一步加大防制力度。

Objective To investigate the prevalence of endemic fluorosis in the northwestern region of Shandong province and to provide scientific evidence for making strategies for the prevention and control of the disease.Methods Eleven counties were chosen to carry out the investigation of endemic fluorosis.The content of fluoride in drinking water and urine was determined with F-ion selective electrode.Dental fluorosis of children aged 8 to 12 years was diagnosed with Dean＇s method and skeletal fluorosis were diagnosed with clinic examination and X-rays.Results The investigation was conduct in 17 water-improvement villages of 11 counties,among which 12 villages（70.59%） had water fluoride content ≤1.00 mg/L,5 villages（29.41%） had water fluoride content1.00 mg/L and the highest water fluoride content was 4.46 mg/L.The investigation was also condcuted in 16 non-water-improvement villages in 11 counties,among which 5 villages（31,25/%） had water fluoride content ≤1.00 mg/L,11 villages（68.75%） had water fluoride content 1.00 mg/L and the highest water fluoride content was 4.09 mg/L.The total prevalence of dental fluorosis among the children was 51.51%（701/1 361）.The index of dental fluorosis was 1.05 and the rate of dental damage was 6.25%（85/1 631）.The urinary fluoride values above 1.40 mg/L were found in 60.86%（510/838）of the children,with the highest urinary fluoride concentration of 15.20 mg/L.The rate of skeletal fluorosis among the adults older than 16 years were 2.49%（454/18 257）and 15.79%（3/19） with clinic and x-ray examination,respectively.The urinary fluoride values above 1.60 mg/L were found in 62.27%（406/652） of the adults,with the highest urinary fluoride concentration of 25.44 mg/L.Conclusion The endemic fluorosis is not effectively controlled and the preventive situation for endemic fluorosis control is still very severe in the northwestern region of Shandong province.So preventive measures for endemic fluorosis should be strengthened.