山东省菏泽市地方性氟中毒流行现状调查

A survey of epidemic situation on endemic fluorosis in Heze city of Shandong province

目的掌握山东省菏泽市地方性氟中毒流行现状,为防治工作提供依据。方法按国家《地方病防治项目技术方案》的要求,2009年选择菏泽市的曹县、牡丹区、单县、巨野县、郓城县等5县(区)为监测地,各县(区)按轻、中、重病区各选择1个村为重点调查点,共15个村。调查内容为饮水氟含量、儿童氟斑牙与成人临床氟骨症患病情况及人群尿氟水平。结果其检测5县(区)15个村水样69份,氟含量超过国家标准(>1.0 mg/L)的水样56份,超标率81.16%,其中>2.0mg/L的水样26份,>4.0 mg/L的3份,水氟最大值为7.76 mg/L。检测15个村人群即时尿氟728人份,其中儿童435例,成人293例,几何均数分别为2.73、2.92mg/L。对679名8～12岁儿童进行氟斑牙临床检查,氟斑牙检出率为50.81%(345/679),缺损型率为4.57%(31/679),氟斑牙指数为1.16。调查7 956名成人地方性氟中毒临床症状与体征,临床氟骨症检出率为7.69%(612/7 956),其中检出中、重度病例175例。结论菏泽地区水氟超标仍很严重,以未改水病村(包括改水后报废病村)为主;尿氟水平仍维持在较高水平,氟斑牙与氟骨症仍存在一定程度流行,高氟危害依然存在。因此,应加大落实科学有效的改水降氟措施力度,控制地方性氟中毒流行。

[Objective]To understand the epidemic situation of endemic fluorosis in Heze city of Shandong province,provide the basis for control and prevention. [Methods]According to the requirement of the National technical scheme for endemic disease control,the Caoxian county,Mudan district,Shanxian county,Juye county and Yuncheng county in Heze city were selected as the monitoring spots.The villages of mild,medium and severe endemic area were collected from each monitoring spot as the key spots,and a total of 15 villages were sampled.The investigation included water fluoride content,the prevalence of dental fluorosis in children,the prevalence of clinical skeletal fluorosis in adults and urine fluoride content in population. [Results]Among 69 water samples collected from 15 villages of 5 county（district）,water fluoride content of 56 samples exceeded the national standard（1.0 mg/L）,and the over standard rate was 81.16%.In over standard samples,there were 26 of water fluoride content2.0 mg/L and 3 of 4.0 mg/L,and the maximum value of the water fluoride was 7.76mg/L.728 people were tested for the urine fluoride content,and the geometric mean of children（435 cases） and adults（293 cases） was 2.73 mg/L and 2.92mg/L respectively.679 children aged 8-12 years old received dental fluorosis examination.The detection rate of dental fluorosis was 50.81%（345/679）,the rate of default type was 4.57%（31/679）,and dental fluorosis index was 1.16.7 956 adults were examined for clinical symptoms and signs of endemic fluorosis,the detection rate of clinical skeletal fluorosis was 7.69%（612/7 956）,and there were 175 medium and severe cases. [Conclusion]The over standard rates of water fluoride content is serious in Heze city,especially in villages without water improvement（including water improvement projects are abandoned）.The urine fluoride content maintains at a high level,the prevalence of dental fluorosis and skeletal fluorosis are high,and there still exist the harm of high level of fluorine.Therefore,it is necessary to strengthen the effective and scientific measures of water improvement to reduce fluoride projects,so as to control the endemic fluorosis.