云南省弥渡县饮水型地方性砷中毒病情调查

Investigation on water-type endemic arsenic poisoning in Midu County, Yunnan Province

目的调查云南省水源性高砷重点地区地方性砷中毒病情,为今后的防治工作提供科学依据。方法采集云南省弥渡县2个高砷重点村和1个对照村所有水源,检测水砷含量;对高砷村和对照村村民临床体检,检测疑似砷中毒患者和对照村村民尿砷含量;根据高砷水源饮用史、临床体检结果和尿砷水平确诊砷中毒病例,并按《地方性砷中毒病区判定和划分标准》判定病区。结果检测2个高砷村水源107个,两村共用的温泉水源和13口自家水井砷含量超标(>0.05 mg/L);温泉水源砷含量均值高达0.519 mg/L,是两村最主要的高砷水源,覆盖人口2 000余人;检测对照村水源20个,砷含量均合格;临床筛检两高砷村村民404人、对照村38人,高砷村检出疑似病例61例;检测高砷村人群尿样115份,高芹村尿砷中位数0.24 mg/L,高孟营村尿砷中位数0.07 mg/L;检测对照村村民尿样38份,尿砷中位数0.02 mg/L;确诊地方性砷中毒病例32例,砷中毒可疑病例5例,总检出率9.16%。结论云南省弥渡县两高砷村均被确认为饮水型地方性砷中毒轻病区,是云南省首次确认的地方性砷中毒病区。

Objective To investigate the prevalence of water-type endemic arsenic poisoning in key area with high arsenic in Yunnan and provide scientific evidence for its prevention. Methods Arsenic content in all water sources from 2 high arsenic water villages and 1 control village of Midu County was detected. A clinical examination was performed in the people from 2 villages with high arsenic water and 1 control village of Midu County. Urinary arsenic content of suspected arsenic poisoning cases and comparable population from the control village was detected. Arsenic poisoning cases were diagnosed according to history of drinking high arsenic water, clinical examination and urinary arsenic level. The endemic arsenism area was classified according to definition and division standard for endemic arsenism. Results There were 107 water sources at 2 villages determined. Arsenic content from a common hot spring water source and water from 13 private wells exceeded the standard（〉0.05 mg/L）. The mean of arsenic content in hot spring water, as the most important water source and covering more than 2 000 people, was up to 0.519 mg/L. The arsenic content in 20 water sources from the control village was under the standard. Sixty-one suspected cases were found in two villages with high arsenic after clinic screening out of 404 persons in villages with high arsenic and 38 persons in the control village. 115 urine samples detected from high arsenic village with the median of arsenic content in urine of 0.24 mg/L at Gaoqin village and 0.07 mg/L at Gaomengyin village, and it was 0.02mg/L in 38 urine samples from the control village. There were 32 cases confirmed with endemic arsenic poisoning and 5 suspected cases with the total detection rate of 9.16%. Conclusions There is 2 villages confirmed to be light water-type en-demic arsenic poisoning areas, and it is the first recognized endemic arsenic poisoning areas in Yunnan.