贵州省燃煤污染型地方性氟中毒综合防治后病情调查分析

An investigation of coal-burning-borne endemic fluorosis followed comprehensive control in Guizhou

目的分析贵州省燃煤污染型氟中毒综合防治后儿童氟斑牙检出率及尿样含氟量的变化趋势，评价综合防治措施的效果。方法于2009、2011、2013年，在黔西县、普安县、仁怀市各抽取3个村作为调查点。对抽中村全体在校8—12岁儿童按《氟斑牙诊断〉〉（WS／T208—2011）进行氟斑牙检查，同时采集50例8。12岁儿童即时尿样，按《尿中氟化物的测定离子选择电极法》（ws／T89．1996）测定尿氟。结果黔西县、普安县、仁怀市8～12岁儿童氟斑牙检出率2009年分别为53．20％（490／921）、89．97％（547／608）、51．73％（629／1216）；2011年分别为46．68％（281／602）、63．60％（332／522）、43．84％（530／1209）；2013年分别为34．04％（256／752）、14．29％（80／560）、26．97％（243／901）。各县检出率均呈逐年降低趋势（趋势x。值分别为60．46、674．96、125．95，P均〈0．01）。3个县2009年8—12岁儿童尿样含氟量[几何均数±标准差（G±s）：（1．21±1．29）、（0．89±0．80）、（1.00±0．59）mg／L]明显高于2013年[（0．94±0．52）、（0．68±0．26）、（0．87±0．33）mg／L，t=3．743、4．778、3．418，P均〈0．01]。结论病区综合防治效果明显，8～12岁儿童氟斑牙检出率及尿样含氟量均明显下降。但病情尚未达到控制或消除标准。应继续加强病区综合防治的后期管理。

Objective To observe the effects of comprehensive prevention and control measures through the trend change analysis of the prevalence of dental fluorosis of children and urinary fluoride in Guizhou. Methods Three villages were selected in each county from Qianxi, Pu＇an and Renhuai, in 2009, 2011 and 2013. Dental fluorosis of all children aged 8 - 12 were examined using the reference ＂Diagnosis of Dental Fluorosis＂ （WS/T 208- 2011）; 50 children were selected randomly from each village to detect urinary fluoride content according to the reference ＂Determination of Fluoride in Urine-ion Selective Electrode Method＂ （WS/T 89-1996）. Results The detectable rates of dental fluorosis of children aged 8 - 12 from Qianxi, Pu＇an and Renhuai were 53.20% （490/921）, 89.97% （547/608） and 51.73% （629/1 216）, respectively, in 2009, 46.68% （281/602）, 63.60% （332/522） and 43.84% （530/1 209）, respectively, in 2011 and 34.04% （256/752）, 14.29% （80/560） and 26.97% （243/901）, respectively, in 2013, and the detection rate in each county was reduced year by year （X2 = 60.46, 674.96, 125.95, all P 〈 0.01）. In 2009, 3 counties＂ urinary fluoride levels of children aged 8 - 12 were （1.21 ± 1.29）, （0.89± 0.80） and （1.00 ± 0.59） mg/L, respectively, which were significantly higher than those of 2013 [（0.94 ± 0.52）, （0.68 ＋ 0.26） and （0.87±0.33） mg/L, t = 3.743, 4.778, 3.743, all P 〈 0.01]. Conclusions The dental fluorosis prevalence and urinary fluorine content of children aged 8 - 12 are failing obviously through comprehensive prevention and control measures. The target to control and eliminating the disease of endemic fluorosis is not reached. It should be continue to strengthen management after comprehensive prevention and control measures.