2013年青海省海南州饮茶型氟中毒流行现况调查结果分析

Analysis of a survey results on drinking brick-tea type fluorosis in Hainan Prefecture of Qinghai Province in 2013

目的了解青海省海南州饮茶型氟中毒流行现状，为制定防治措施提供依据。方法选择共和、同德、贵南、兴海4个县，每个县抽取3个乡和1个镇，每个乡（镇）抽取2个行政村（居委会）作为调查点。每个调查点检查所有8～12岁儿童氟斑牙，并采集尿样，测定尿氟含量；每个调查点抽取16岁以上成人进行氟斑牙及临床氟骨症患病情况检查，并采集尿样，测定尿氟含量；采集调查点所有居民户生活饮用水水样、砖茶水样，检测氟含量。氟斑牙检查采用Dean法，诊断依据《氟斑牙诊断））（WS／T208．2011）标准；成人临床氟骨症诊断依据《地方性氟骨症诊断标准》（wS192．1999）；尿氟测定采用《尿中氟化物的测定离子选择电极法》（WS／T89—1996）；水氟和茶水氟测定采用氟离子选择电极法。结果①儿童氟斑牙及尿氟：共对1824名8—12岁儿童进行氟斑牙检查，检出氟斑牙患者238例，检出率为13．05％（238／1824），氟斑牙指数为0．27；检测儿童尿样1824份，尿氟几何均数为1．02mg／L，范围为0．09～5．77mg／L。②成人氟斑牙及临床氟骨症、尿氟：共对1384名成人进行氟斑牙和临床氟骨症检查，检出氟斑牙266例，检出率为19．22％（266／1384），氟斑牙指数为0．45；临床检查检出氟骨症I度患者1例，Ⅱ度患者3例，Ⅲ度患者1例，检出率为0．36％（5／1384）；检测成人尿样1384份，尿氟几何均数为1．15mg／L，范围为0．12—7．80mg／L。③水氟及茶水氟：共检测水样l384份，水氟均数为0．31mg／L：范围为0．20-0．70mg／L；共检测茶水样379份，茶水氟均数为2．01mg／L，范围为0．23-12．59mg／L。结论海南州饮茶型氟中毒病情较轻，但还须密切关注这些人群饮茶型氟中毒病情，并加强健康教育。

Objective To investigate the epidemic situation of drinking brick-tea fluorosis in Hainan Prefecture, and to provide a scientific basis for making appropriate prevention and control measures. Methods We carried out an investigation in four countries, Gonghe, Tongde, Guinan and Xinghai, 3 townships and 1 town in each county were selected, and 2 villages were selected from each townships. Dental fluorosis of children aged 8 to 12 was examined, and their urine samples were collected, urine fluorine content was determined at each site; the situation of the dental fluorosis and the skeletal fluorosis of adults over 16 years old were examined, and their urine samples were collected, urine fluorine content was determined at each site; the samples of brick-tea water and the samples of drinking water were collected from the residents of each sits, and fluoride contents was detected. Dental fluorosis was determined by Dean method according to the ＂Diagnostic Criteria of Dental Fluorosis＂ （WS/T 208- 2011）; skeletal fluorosis was determined by ＂Diagnostic Criteria of Endemic Skeletal Fluorosis＂ （WS 192-1999）; the content of urinary fluorine was determined by ＂Determination of Fluoride in Urine-Ion Selective Electrode Method＂ （WS/T 89-1996）; the content of water fluoride and tea water fluorine were determined by fluoride ion selective electrode method. Results （1）Children dental fluorosis and the mean of urinary fluoride： A total of 1 824 children aged 8 to 12 were examined, 238 cases were dental fluorosis, the rate of dental fluorosis was 13.05% （238/1 824）,and the index of dental fluorosis was 0.27; 1 824 urine samples of children were determined and geometric mean of urinary fluorine was 1.02 mg/L, the range was 0.09 - 5.77 mg/L. （2）Adult dental fluorosis, clinical skeletal fluorosis and the mean of urinary fluoride： a sum of 1 384 adults were examined, 266 cases of dental fluorosis were detected, the rate of dental fluorosis was 19.22% （266/1 384）, and the index of dental fluorosis was 0.45, clinical examination of skeletal fluorosis found degree I patient 1 case, degree 1I 3 cases and degree II1 1 case, and the rate of skeletal fluorosis was 0.36% （5/1 384）; 1 384 adult urine samples were tested, and the geometric mean of urinary fluorine was 1.15 mg/L the range was 0.12 - 7.80 mg/L. （3）Fluoride concentration of the water and tea： 1 384 water samples were tested, the mean of fluoride was 0.31 mg/L, the range was 0.20 - 0.70 mg/L; 379 tea samples were tested, the mean of fluoride was 2.01 mg/L, the range was 0.23 - 12.59 mg/L. Conclusion The situation of drinking brick-tea fluorosis is lighter in Hainan, we should pay close attention to the disease, and strengthen the health education.