2009~2013年陕西省燃煤污染型氟中毒监测结果分析

Analysis of monitoring results of coal-burning borne endemic fluorosis in Shaanxi province in 2009～2013

目的：了解陕西省燃煤污染型氟中毒病区防氟改炉改灶、病情变化和防治措施落实情况,为上级部门及时调整防治策略提供科学依据。方法：在燃煤污染型氟中毒病区随机抽取平利、岚皋和镇巴县,每县随机抽取3个病区村作为固定监测点,每个监测点抽取10户家庭,调查炉灶使用及相关行为转变情况;依据dean＇s法检查每个监测村所有8~12周岁学生的氟斑牙患病情况,同时按每年龄组采集10份尿样测定氟含量;每5年开展一次氟骨症X线检查。结果：固定监测村共监测450户,铁炉合格率占92.04%,改良灶合格率占95.02%。改良铁炉正确使用占85.67%,改良灶正确使用占81.00%。共监测8~12岁儿童1734人次,氟斑牙总检出率为42.10%。检测儿童尿氟1734人次,尿氟几何均值为0.62 mg/L。检查成人氟骨症871人次,检出率17.22%。结论：改炉改灶是燃煤型氟中毒病区预防氟中毒流行的有效措施,能有效降低病区病情流行状况。

Objective：To understand the usage of defluoridation stove and the current situation of coal- burning borne fluorosis in the infected area, to evaluate the control effect, so as to provide a theoretical basis for superiors＇ policy- making. Methods： Three counties （Pingli, Langao and Zhenba） were chosen randomly in coal- burning fluorosis area, selected 3 villages in each county randomly as the fixed monitoring points,and 10 families were randomly selected in each of the monitoring points, and a survey on the stove using and related behavior changes was carried out. By using Dean method, the dental fluorosis of every child aged 8-12 in the monitoring villages was examined, meanwhile 10 copies of urine samples were randomly collected in each age group were determined. Examine skeletal fluorosis by X- rays every five years once. Results： 450 families were monitored in the fixed monitoring points. The quality qualified rate of iron furnace accounted for 92.04 %, the improved oven accounted for 95.02 %. The correct use of iron furnace accounted for 85.67% and the correct use of improved oven accounted for 81.00%. A total of 1734 children aged 8 -- 12 were monitored, the detection rate of dental fluorosis was 42.10 %. A total of 1734 copies of children urine samples were tested , the geometric mean value of fluoride content was 0.62 mg/L. A total of 871 adults were examined, and the detection rate of skeletal fluorosis was 17.22%. Conclusions： Improving oven is an effective measures to prevent of fluorosis in coal- burning borne endemic fluorosis areas, it can effectively reduce the prevalence of endemic disease.