2014年贵州省11个燃煤污染型氟中毒历史轻病区县防治效果评估

An evaluation of the effectiveness of prevention and control measures on coal-burning-borne endemic fluorosis in the 11 historic mild illness counties in Guizhou Province

目的评估贵州省11个燃煤污染型氟中毒历史轻病区县综合防治效果．提出新的防控措施与对策。方法2014年，对贵州省11个县所有病区常住居民户进行相关健康生活行为情况调查；同时按《氟斑牙诊断》（WS／T208—2011）对全体在校8—12岁学生进行氟斑牙检查。采用《地方性氟中毒病区控制标准》（GB17017—2010）和《燃煤污染型地方性氟中毒病区消除》进行结果判定。结果共计对11个县的1449个行政村进行了评估，以县为单位，各县8—12岁学生氟斑牙检出率均〈15％，改良炉灶合格率、合格炉灶正确使用率、辣椒正确干燥率均〉95％；调查的所有居民户主食均不再食用玉米。以行政村为单位．除平坝县尚有32个村8～12岁儿童氟斑牙检出率在15％-30％外．其他所有村检出率均≤15％；除平坝县尚有15个村改良炉灶合格率在90％～95％外。其他所有村的改良炉灶合格率、合格炉灶正确使用率、辣椒正确干燥率均达到95％以上。结论贵州省11个燃煤污染型氟中毒历史轻病区县综合防治效果较好，除平坝县为控制外，其他10个县均已达到消除标准。今后的防治管理中应对已经达到控制或消除的病区及时组织全面考核评估，同时对尚存在氟污染风险的病区进行风险评估及原因分析。寻找和落实对策措施。

Objective To evaluate the effects of prevention and control measures on eoal-burning-bo,rne endemic fluorosis in the 11 historic mild illness counties of Guizhou Province and to provide a basis for further prevention and control of the disease. Methods In 2014, the resident households life behavior related to health was investigated in 11 counties. At the same time, according to the ＂Diagnosis of Dental Fluorosis （WS/T 208- 2011）＂, dental fluorosis of all children aged 8 - 12 was examined in the 11 counties＂ historic diseased areas. Results were determined using the standards for ＂Control Criteria for Endemic Fluorosis Areas＂ and ＂Elimination of Coal- burning-borne Endemic Fluorosis＂. Results A total of 1 449 villages of 11 counties were investigated. The detection rate of dental fluorosis of children aged 8 - 12 was ~〈 15% in each county. The qualified rate of improved stoves, the correct usage rate of qualified stoves, and the correct drying rate of chili were all 〉 95%. All households no longer took corn as staple food. Ira administrative villages, the prevalence of dental fluorosis of children aged 8 - 12 was 15% or less in all the villages with the exception of 32 villages of Pingba County; the qualified rate of improved stoves, qualified stoves correct usage, dry chili correct rate of all vaUages were higher than 95%, except the 15 villages of Pingba County. Conclusions The effects of comprehensive control measures on coal-burning- borne endemic fluorosis in the 11 historic mild illness counties in Guizhou are good. Besides Pingba County, other counties have reached elimination, standards. In the future, a comprehensive assessment should be done in areas which has already reached control or elimination standards. At the same time, in areas at risk of fluorine pollution, risk assessment should be carried out to find countermeasures.