广东省汕头市地方性氟中毒病区改水降氟效果评价

Effects of drinking water defluoride in endemic fluorosis areas in Shantou city of Guangdong province

目的通过对汕头市地方性氟中毒（简称地氟病）病区水氟及氟中毒状况的调查，为进一步改水工作提供依据。方法于2001、2009年，对4个地氟病病区村（仙港村、范溪村、义英村、溪北村）和一个非地氟病病区村（上南村）检测水氟，每个村抽取约100名（男女各半）8～12岁儿童检查氟斑牙及采集尿样。水氟及尿氟测定采用氟离子选择电极法，按照Dean法进行儿童氟斑牙诊断。结果4个地氟病病区村改水后饮用水氟含量均〈1．0mg／L。2001年儿童氟斑牙检出率[63．29％（1505／2378）]高于2009年[14．12％（462／3271），X2=1466．48，P〈0．01]。在2009年，与上南村[5．88％（77／1309）、（0．54±0．25）mg／L]相比，仙港村儿童氟斑牙检出率[30．95％（321／1037）]和尿氟水平[（0．75±0．58）mg／L]均较高（x。=258．20，t=17．40，P均〈0．05）。结论汕头市改水降氟效果显著，管理部门仍应坚持地氟病病区的定期监测工作。

Objective To provide a scientific basis for drinking-water improvement and defluoridation by survey water fluoride level and situation of flnorosis in the endemic fluorosis areas of Shantou city. Methods Four endemic fluorosis villages and a non-fluorosis village were detected of water fluoride in 2001 and 2009. Randomly selected subjects of about 100 children（men and women in equal, aged 8 to 12） were checked dental fluorosis and urinary fluoride in each village. Fluoride content in water was determined by fluoride selective ion electron. And diagnosis of dental fluorosis of children was made according to Deans method. Results Through monitoring drinking water in 4 villages of the fluorosis areas after water improvement, we found that fluoride content in water source was under the standard limitation of 1.0 mg/L, and prevalence of dental fluorosis decreased from 63.29% （1505/2378） in 2001 to 14.12%（462/3271 ） in 2009, the difference was significant（x2 = 1466.48, P 〈 0.01 ）. But compared with Shangnan village[5.88%（77/1309）, （0.54 ＋ 0.25） mg/L] in 2009, the children in Xiangang village presented a higher prevalence of dental fluorosis[30.95%（321/1037）, X2 = 258.20, P 〈 0.05] and higher urinary fluoride[（0.75 ＋ 0.58）rag/L, t = 17.40, P 〈 0.05]. Conclusions Althoughthewater-improvingprojeet has achieved success in Shantou city, the management department should still keeo on the monitoring.