2010-2012年冕宁县饮水型氟中毒监测报告

Sentinel Surveillance on Drinking Fluorosis in Mianning County,2010- 2012

目的了解四川省冕宁县饮水型型氟中毒病情现状及变化趋势,为制定地氟病防治防治策略提供科学依据。方法按照国家地病中心《饮水型地方性氟中毒监测方案（试行）》选择冕宁县,了解改水工程进度和运行效果,对监测病县8-12岁儿童氟斑牙、对25岁以上成人进行X线氟骨症检查。水氟测定采用《尿中氟化物的测定离子选择电极法》（WS/T 89-1996）,儿童氟斑牙采用Dean氏诊断法（WS/T 208-2011）,氟骨症诊断采用《地方性氟骨症诊断标准》（WS 192-2008）。结果冕宁县共有改水降氟工程10处,改水率为100%,覆盖10个村,覆盖人口1.44万人;2010调查10处工程中,正常运转10处,水氟合格7处,合格率70%,水氟最大值2.78 mg/L,2011年正常运转8处,间歇运转2处,水氟合格5处,合格率50%,水氟最大值为2.65 mg/L;2012年正常运转7处,间歇运转3处,水氟合格6处,合格率60%,水氟最大值为2.94 mg/L;8-12岁儿童氟斑牙平均检出率为76.49%,氟斑牙指数1.5,各年度氟斑牙检出率差异有统计学意义（χ^2=119.03,P〈0.05）;X线氟骨症检查51人,检出率为60.78%。结论冕宁县饮水型氟中毒病区通过改水降氟病情得到一定控制,但局部病区病情仍严重,加强病情监测、健康教育和改水工程管理是防治饮水型氟中毒关键。

Objective To learn drinking fluorosis disease status and trends in Mianning county in Sichuan province for the development of prevention and control strategies for endemic fluorosis. Methods According to the Drinking Endemic Fluorosis Surveillance Scheme（ trial edition）,Mianing county was selected to understand the water project progress and operation effect. The children aged 8- 12 years old were tested dental fluorosis and adults with age over 25 years conducted X rays fluorosis of bone. The water fluorine was tested with ion selective electrode method（ SW / T 89- 1996） and the children dental fluorosis was tested with Dean diagnostic（ WS / T 208-2011） and fluorosis of bone was diagnosed with endemic fluorosis of bone diagnostic（ WS 192-2008）. Results In Mianning,there were 10 places of water improvement to reduce fluoride,the water improvement rate was 100%,covering 10 villages and14 400 residents. In 2010,of the 10 surveyed projects,7 were qualified with water fluorine,with a qualified rate of 70%. The maximum value was 2. 78 mg / L. In 2011,8 were in normal operation and 2 were in intermittent operation,5 places were qualified,with a qualified rate 50. 0%,and the maximum value of water fluorine was 2. 65 mg / L. In 2012,7 were in normal operation,and 3 were in intermittent operation,6 were qualified with water fluorine,with a qualified rate of 60. 0%,the maximum value was 2. 94%. The dental fluorosis detection rate was 76. 49% and the dental fluorosis index was 1. 5,showing statistically difference among years（ χ^2= 119. 03,P 0. 05）. With X ray test,51 were detected fluorosis of bone,with a rate of 60. 78%. Conclusion The epidemic status of fluorosis in Mianning county has been controlled to certain extent. While in part of the area,the illness status is still serious. The key measures are recommended as strengthened surveillance,health education and water improvement project.