2010年江苏省饮水型地方性氟中毒监测结果分析

Monitoring the Endemic Fluorosis in Jiangsu Province in 2010

目的了解江苏省地方性氟中毒的病情现状,为制订防治策略提供科学依据。方法 2010年选择徐州沛县、连云港东海县、宿迁泗洪县作为监测县。对监测县的改水工程运行情况进行调查。随机抽取9个村,调查降氟改水工程运行情况、饮水氟含量、进行儿童氟斑牙检查以及成人氟骨症X线检查。结果3个监测县共有已改水村数420个,改水率达到82.68%。改水工程数269个,其中正常使用的工程数为189个,正常使用率为70.26%。9个病区村共监测8～12岁学生564人,检出氟斑牙患者160例,检出率为28.37%;缺损率为5.50%,氟斑牙指数为0.55。已改水且水氟含量合格村、已改水但水氟含量超标村和未改水村的儿童氟斑牙患病率有显著性差异(P<0.05),已改水且水氟含量合格村的儿童氟斑牙患病率最低。9个病区村X线拍片共486人,检出氟骨症病例152人,检出率为31.28%。已改水且水氟含量合格村、已改水但水氟含量超标村和未改水村的成人X线诊断氟骨症检出率无显著性差异(P>0.05)。随着年龄的增加,成人X线诊断氟骨症的检出率有增加的趋势(P<0.05)。结论江苏省氟中毒病区村降氟改水工程的正常使用率不高。降氟改水能够有效地减少儿童氟斑牙的发生。由于时间较短,尚未观察到成人氟骨症的发病率降低。

Objectives To investigate the current status of endemic fluorosis in Jiangsu Province, and to provide scientific evidence for making strategies for prevention and control of the disease. Methods Pei county, Donghai county and Sihong county were monitored in 2010. All water supply facilities in the three counties were investigated. The facilities in the nine villages were selected by random and the content of fluoride in drinking water was determined. Dental fluorosis of children aged 8 -12 was examined. Skeletal fluorosis of adults was diagnosed by radiography. Results The water supply facilities in 269 of 420 villages have been improved and the rate of qualified water was 82.68%. The content of fluoride was qualified in 189 water-improving projects, which had been normal in use and running regularly, and the rate was 70.26%. A total of 564 children aged 8 - 12 in the nine villages were examined, the detection rate of dental fluorosis was 28.37% （160/564） , the detectable rate of defective dental fluorosis was 5.50% and the dental fluorosis index was 0.55. There was a statistical difference in the detection rates of dental fluorosis among villages with water-improving projects and qualified water, the villages with water-improving projects and unqualified water and the villages without water-improving projects （P 〈 0.05）. A total of 486 adults were examined by radiography. The detection rate of skeletal fluorosis by radiography in adults was 3128% （152/486）. No statistical difference was observed on the detection rates of skeletal fluorosis by radiography among the villages with water-improving projects and qualified water, the villages with water-improving projects and unqualified water and the villages without water-improving projects （P 〉 0.05 ）. There was a positive correlation between the detection rate of skeletal fluorosis by radiography and age （P 〈 0. 05）. Conclusions The rate of using water-improving projects normally was not high. The detection rate of dental fluorosis in children was reduced after water-improving projects being conducted. The detection rate of skeletal fluorosis by radiography in adults was not obviously decreased due to the time was too short to have a change. The situation of endemic fluorosis control in Jiangsu Province is still severe. Prevention efforts need to be further strengthened.