2009年山东省地方性氟中毒监测结果分析

Analysis of monitoring results of endemic fluorosis in Shandong province in 2009

目的了解山东省地方性氟中毒的病情现状，为制汀防治策略提供科学依据。方法按照国家《2008年地方病防治项目技术实施方案》的要求，在山东省选择34个县为项目县．各项目县将所有病区村按病情的严重程度分为轻、中、重3层，再在每一层各选择1个病区村，进行病情监测。水氟、尿氟测定采用氟离子选择电极法，8～12岁儿童氟斑牙诊断采用Dean法，16岁以上成人临床和X线摄片检查氟骨症。结果在34个县中，调查70个改水村，水氟≤1．00mg／L的村54个，占77．14％（54／70）；〉1．00mg／L的村16个，占22．86％（16／70）；水氟最大值为4．46mg／L。调查32个未改水村，水氟≤1．00mg／L的村9个，占28．12％（9／32）；〉1．00mg／L的村23个，占71．88％（23／32），水氟最大值为4．09mg／L。8～12岁儿童氟斑牙总检出率为45．81％（1988／4340），氟斑牙指数为0．97，缺损率为6．91％（300／4340）。儿童尿氟在1．40mg／L以上的人数占55．33％（1417／2657），最高值为18．53mg／L。16岁以上成人的氟骨症临床和X线检出率分别为4．25％（2462／57968）、28.40％（23／81）。成人尿氟在1．60mg／L以上的人数占55．86％（1130／2023）．最高值为25．44mg/L。结论山东省地方性氟中毒病情尚未得到有效的控制，防治形势依然比较严峻，须进一步加大防治力度。

Objective To investigale the current status of endemic fluorosis in Shandoug province, and to provide the scientific evidence for making strategies for prevention and control of the disease. Methods According to ＂The National Technical Scheme for Endemic Disease Control in 2008＂, thirty-four counties were divided into mild, moderate and severe endemic fluorosis areas and a village was randomly selected from each categmy of the area to caiTy out the monitoring of endemic fluorosis. The content of fluoride in drinking water and urine was determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 was diagnosed by Dean method and skeletal fluorosis diagnosed by clinic and X-rays. Results The monitoring was done in 70 water-improving villages in 34 counties, among which 54 villages had water fluoride content ≤ 1.00 mg/L and accounted for 77.14% （54/70）, 16 villages had water fluoride content 〉 1.00 mg/L and accounted for 22.86%（16/70）, the highest water fluoride content was 4.46 mg/L. The monitoring was also carried out in 32 non-water-improving villages in 34 counties, among which 9 villages had water fluoride content ≤ 1.00 mg/L and accounted for 28.12% （9/32）, 23 villages had water fluoride content 〉 1.00 mg/L and accounted for 71.88% （23/32）, the highest water fluoride content was 4.09 mg/L. The total rale of dental fluorosis of children aged 8 to 12 was 45.81%（1988/4340）, the index of dental fluorosis was 0.97 and the rate of dental damage was 6.91% （300/4340）. The urinary fluoride values above 1.40 mg/L were found in 55.33% （1417/2657） of children aged 8 to 12, with the highest urinary fluoride concentrations was 18.53 mg/L. The rate of skeletal fluorosis by clinic and X-rays in adults older than 16 years were 4.25% （2462/57 968） and 28.40% （23/81）, respectively. The urinary fluoride values above 1.60 mg/L were found in 55.86% （1130/2023） of adults older than 16 years, with the highest urinary fluoride concentrations was 25.44 mg/L. Conclusions Endemic fluorosis in Shandong province has not yet been effectively controlled, control situation is still grim. Prevention efforts need to be further strengthened.