2013、2015年德州市5个高碘县(市、区)儿童家庭饮用水碘及碘营养状况调查

Survey on iodine and nutrition status of drinking water among children households in five high iodine counties(cities,districts),Dezhou city,2013 and 2015

目的 了解德州市水源性高碘5县（市、区）停供碘盐后居民内外环境碘含量变化及儿童碘营养状况。方法 采用整群抽样法,分别于2013、2015年在德州市的德城区、庆云县、平原县、乐陵市、禹城市5个高碘县（市、区）,每县（市、区）抽取300户居民进行居民户食用盐监测;再根据水碘含量把5个县区分为2组（150~300、〉300μg/L）,在每组的县（市、区）选择1个水碘含量符合分组条件的乡镇作为监测点,在每个监测点的乡镇小学抽取100名8~10岁儿童,采集其家中饮用水和即时尿样1份检测水碘和尿碘。结果 2013、2015年5个县（市、区）分别检测居民户碘盐1 500、1 316份,无碘盐食用率分别为96.07%（1 471/1 500）、94.91%（1 249/1 316）;两年共检测儿童家庭饮用水1 017份,2013年检测514份,水碘检测值为0.90~1 073.60μg/L,中位数为166.90μg/L,平均数为208.80μg/L。其中,水碘〈10μg/L的48份,占9.34%;10~149μg/L的171份,占33.27%;≥150μg/L的295份占57.39%。2015年检测503份水样,水碘检测值为1.20~943.10μg/L,中位数为28.80μg/L,平均数为96.00μg/L。其中,水碘〈10μg/L的30份,占5.96%;10~149μg/L的374份,占74.35%;≥150μg/L的99份占19.69%。水碘中位数2015年低于2013年（P〈0.01）;2015年高水碘频数明显下降,两年水碘含量频数分布差异有统计学意义（P〈0.01）。两年共检测儿童尿样1 011份,2013年检测尿碘500份,检测值为19.30~2 464.10μg/L,中位数为517.4μg/L。其中,尿碘值〈100μg/L的33份,占6.60%;100~199μg/L的68份占13.60%,〉400μg/L的298份占59.60%;2015年检测尿碘511份,检测值为1.50~1 583.50μg/L,中位数为220.6μg/L。其中尿碘〈100μg/L的87份占17.03%;100~199μg/L的136份占26.61%;〉400μg/L的124份占24.27%,2015年明显低于2013年（P〈0.01）;2015年碘适宜频数增加、高碘频数下降,两年尿碘含量频数分布差异有统计学意义（P〈0.01）;尿碘含量和家庭水碘含量除2015禹城县无相关外（P〉0.05）均成正相关（P〈0.01）。结论 德州市高碘5个县（市、区）停供碘盐措施得到有效的实施,4个监测点改水效果明显,但德城区高碘危害持续存在。2015年总体结果优于2013年,饮用水水碘适宜数量、尿碘适宜频数均大幅上升。

Objective To understand the status of iodine content in the internal and external environments and iodine nutrition among children in 5 high iodine counties（cities,districts） in Dezhou city after the supply of iodized salt stopped. Methods The cluster sampling method was adopted to select 300 households each in 5 high iodine counties（Decheng, Qingyun,Pingyuan,Laoling, and Yueheng） for the monitoring of salt among households in Dezhou city in 2013 and 2015. The five counties（city,district） were divided in two groups according to the water iodine level（150-300 μg/L and 300 μg/L）. Then 1 town which can meet the requirement from each group was selected as as the monitoring point,in the township primary school of each monitoring point, 100 children aged 8-10 years old were selected to collect drinking water and urine samples from their homes for detection of water iodine and urinary iodine. Results A total of 1 500 samples of iodized salt in 2013 and 1 315 samples in 2015 were taken in the five counties（cities, districts）, the non iodized salt consumotion rate was 96.07%（1 471/1 500） and 94.91%（1 249/1 316） respectively,A total of 1 017 childrens＇ household drinking water samples were tested. 514 samples were tested in 2013,The water iodine level was 0.90-1 073.60 μg/L,the median was 166.90 μg/L, the average was 208.80 μg/L. 48 （9.34%） samples were 〈10 μg/L. 171（33.27%） samples were 10-149μg/L,295（57.39%） samples were 9150 μg/L,503 samples weres taken in 2015, The water iodine level was 1.20-943.10 μg/L, The median was 28.80μg/L, the average was 96.00 μg/L. 30（5.96%） samples were 〈10 μg/L. 374（74.35%） samples were 10-149 μg/L,99（19.69%） samples were ≥150 μg/L. The median of water iodine level was lower in 2015 than that in 2013（ P 〈0.01）. In 2015 ,the frequency of high water iodine decreased significantly,and there was a significant difference in the frequency distribution of water iodine content in the two years （ P 〈0.01）. Totally 1 011 urine samples were tested from the children in these two years. 500 samples were tested in 2013 and the urine iodine level was 19.30-2 464.10 μg/L,the median was 517.40 μg/ L. 33 （6.60%） samples were 〈100 μg/L,68（13.60%） samples were 100-199 μg/L,298（59.60%） samples were 〉400 μg/L. 511 samples were tested in 2015 and the urine iodine level was 1.50-1 583.50 μg/L,the median was 220.60 μg/ L. 87 （17. 03%） samples were 〈100 μg/L,136（26.61%） samples were 100-199 μg/L,124（24.27%） samples were 400 μg/L,The median of urine iodine level was lower in 2015 than that in 2013 （ P 〈0.01）, Respectively, the difference between the results of 2013 and 2015 was statistically significant（ P 〈0.01）, The normal iodine level rate increased and the excessive iodine level rate decreased in 2015,the iodine level rate distribution was statistically significant（ P〈0.01）. The urinary iodine level was positively corelated with the household water iodine level （ P 〈0.01）in most areas except Yucheng city（ P 〈0.05）. Conclusion The measure for stopping the supply of iodized salt in the five high iodine counties（cities,districts） of Dezhou city has been well implemented. The four monitoring points have made significant effect in water improvements,however,the harms of high iodine still exist in Decheng district.