山西省地方性砷中毒分布情况调查与分析

Analysis and investigation of the distribution of endemic arsenism in Shanxi Province

目的 掌握山西省高砷水源和地方性砷中毒（简称地砷病）病区的分布范围和危害程度,为今后的防治工作提供科学依据.方法 根据既往调查结果,在已确定的高砷水地区和地砷病病区及周边,选择了全省35个县进行调查,对所有调查点进行水砷筛查,对水砷超标村进行水砷定量普查和病情调查;水砷筛查采用半定量试剂盒法,水砷定量测定采用氢化物发生-原子荧光法（HG-AFS）,地砷病诊断按照《地方性砷中毒诊断标准》（WS/T 211-2001）进行,病区判定和划分按照《地方性砷中毒病区判定和划分标准》（WS 277-2007）进行,数据处理采用SPSS 13.0软件进行.结果 共调查了35个县1 771个村,其中15个县151个村的水砷含量超过了国家标准（0.05 mg/L）,高砷暴露人口为177 018人.对151个超标村进行高砷水源普查和地砷病病情调查,水井超标率为35.10％（2 355/6 709）,最高水砷浓度为1.733 0 mg/L.山西省砷中毒潜在病区分布于11个县33个村,人口数为39 757人;砷中毒病区分布于9个县118个村,人口数为137 261人,其中轻病区82个村,中病区29个村,重病区7个村.砷中毒病区病情调查发现可疑人数1 244人,轻度及以上患者3 473人,轻度及以上检出率为2.54％（3 473/136 924）,砷中毒患者中以轻度为主.结论 山西省地砷病分布于15个县,采取改水除砷等综合防治措施成为今后山西省地砷病防治工作的重点.

Objective To investigate the distribution of endemic arsenism and to provide a scientific basis for control and prevention of the disease.Methods According to previous investigation,in the high-arsenic water areas,the arsenic diseased areas and the surrounding lands,35 counties were investigated.Water arsenic was screened in all the survey sites,villages with water arsenic exceeding the standard were quantitative surveyed of water arsenic and the disease conditions.Screening of arsenic content in drinking water was done by the method of half-quantitative fast reagent kit.Quantitative determination of arsenic in water was done by hydride generationatomic fluorescence spectrometry （HG-AFS）.Patients of endemic arsenism were diagnosed by the ＂Standard of Diagnosis for Endemic Arsenism＂ （WS/T 211-2001）.Identification of area was done by ＂Definition and Division Standard for Endemic Arsenism＂ （WS 277-2007）.The data were analyzed using SPSS 13.0 for windows.Results Water arsenic of 151 villages in 15 counties among 1 771 villages were higher than the national drinking water quality level（0.05 mg/L）.Exposure population of high arsenic was 177 018 people.The census results of high arsenic water sources indicated that the ratio of drinking water arsenic levels higher than the national standard was 35.10% （2 355/6 709） and the highest contents of arsenic was 1.733 0 mg/L.The disease census indicated that there were 33 latency arsenism districts and 118 arsenism districts.There was totally 39 757 patients with latency arsenism.Totally 137 261 people lived in arsenism districts.Light,moderate and severe arsenism districts was 82,29 and 7,respectively.Totally 1 244 suspicious patients with endemic arsenism were discovered,and 3 473 light and more severe patients were discovered and the detected rate of light and more severe patients was 2.54% （3 473/136 924）.Most patient were not serious.Conclusions High arsenic areas and endemic arsenism areas are distributed in 15 counties of Shanxi Province.In the future primary task in prevention and control of endemic arsenism is comprehensive prevention and control measures.