2013年山东省饮水型地方性氟中毒流行病学调查

An epidemiological study of drinking water type of endemic fluorosis in Shandong Province in 2013

目的了解山东省饮水型地方性氟中毒的流行现状，为制订防制策略提供科学依据。方法按随机数字表法，在山东省选择10个县（市、区），调查改水降氟工程进度和运行效果；每个县（市、区）选择3个村作为调查村，氟离子选择电极法测定饮用水水氟含量，Dean法检查8．12岁儿童氟斑牙患病情况。结果在10个县（市、区）中，共有改水降氟工程515个，覆盖3207个病区村，改水率为81．71％（3207／3925）。调查的85个改水工程均运行正常；水氟含量合格（≤1．20mg／L）的工程51个．合格率为60．00％（51／85），水氟最大值为4．38mg／L。29个调查村均已改水，水氟均值≤1．20mg／L的村21个，占调查村的72．41％（21／29）；水氟均值〉1．20mg／L的村8个，占27．59％（8／29），水氟最大值为4．02mg／L。在水氟合格村共检查8～12岁儿童1023名，氟斑牙检出率为38．12％（390／1023），氟斑牙指数为0．67，氟斑牙流行强度为极轻度流行。在水氟超标村共检查8～12岁儿童449名，氟斑牙检出率为54．79％（246／449），氟斑牙指数为1．18．氟斑牙流行强度为轻度流行。结论山东省改水降氟工程的水氟超标严重，儿童的氟斑牙病情仍较严重，改水措施有待进一步加强。

Objective To study the prevalence of drinking water type of endemic fluorosis in Shandong Province, and to provide a scientific basis in making strategies for prevention and control of the disease. Methods Ten counties （cities, districts） were selected by random number table method to carry out the epidemiological study, and to study the progress and effect of water-improving and defluoridation projects. Three villages in each county （city, district） were chosen to determine fluoride content of drinking water and to check the prevalence of dental fluorosis of children 8 to 12 years old. Water fluoride content was determined with fluoride ion-selective electrode, and dental fluorosis was diagnosed by the Deans method. Results In the 10 counties （cities, districts）, a total of 515 water-improving and defluoridation projects were built covering 3 207 fluorosis villages, and the water- improving rate was 81.71% （3 207/3 925）. A total of 85 water-improving and defluoridation projects were investigated in the 10 counties （cities, districts）, and all of the projects were operating normally. The number of projects that water fluoride concentration ≤ 1.20 mg/L was 51; the qualified rate of water fluoride concentration was 60.00% （51/85）, and the maximum value of water fluoride was 4.38 mg/L. A total of 29 villages that had water- improving and defluoridation projects were investigated in the 10 counties （cities, districts）, and the number of villages that mean of water fluoride ≤1.20 mg/L was 21, accounting for 72.41% （21/29）; 〉 1.20 mg/L was 8, accounting for 27.59% （8/29）, and the maximum value of water fluoride was 4.02 mg/L. In the 21 qualified villages of water fluoride concentration, a total of 1 023 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 38.12% （390/1 023）; dental fluorosis index was 0.67, and the prevalence of dental fluorosis was extremely low. In the 8 exceeding-standard villages of water fluoride content, a total of 449 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 54.79% （246/449）; dental fluorosis index was 1.18, and theprevalence of dental fluorosis was mild. Conclusion In Shandong Province, the water fluoride content of water- improving and defluoridation projects exceeds the national standard seriously, and the condition of children＇s dental fluorosis is still serious, and the measures of water-defluoridation should be further strengthened.