2015年内蒙古自治区饮水型地方性砷中毒监测结果分析

Analysis of surveillance results of water-borne endemic arsenism in Inner Mongolia in 2015

目的了解内蒙古自治区饮水型地方性砷中毒病情、改水降砷工程使用情况及饮水砷含量变化情况，为及时调整地方性砷中毒防治措施提供科学依据。方法2015年，按照国家《饮水型地方性砷中毒监测方案》，在内蒙古自治区的8个盟市选择38个病区村作为监测点，调查监测村的改水情况及改水降砷工程的运行情况。采集监测村的水样检测水砷含量，对监测村所有正在暴露或以往暴露过高砷水的常住人口进行体检；采集其中30名成人砷中毒患者尿样，测定尿砷含量。结果监测的38个病区村均已实现改水，改水率为100．00％（38／38）。涉及的18个改水工程全部正常运转；水砷含量合格工程17个，覆盖监测村36个；水砷含量超标工程1个，超标率为5．56％（1／18），覆盖监测村2个。36个水砷含量合格的自然村中，检查了4163名居民，砷中毒患者检出率为10．21％（425／4163），其中轻度、中度、重度、皮肤癌患者检出率分别为7．59％（316／4163）、1．68％（70／4163）、O．86％（36／4163）、0．07％（3／4163），无新发病例及新增皮肤癌病例。在2个水砷含量超标的自然村中，检查了饮用高砷水源的常住人口461人，砷中毒患者检出率为3．69％（17／461），无中、重度，新发及皮肤癌病例。改水工程正常运转且水砷含量合格的36个村中，共检测了1107例砷中毒患者尿样，尿砷含量范围为0．000，0．441mg／L，中位数为0．011mg／L。改水工程水砷含量超标的2个村中，共检测了60例砷中毒患者尿样，尿砷含量范围为0．030-0．268mg／L，中位数为0．155mg／L。结论内蒙古自治区防砷改水工作成效明显．但仍存在改水工程水砷含量超标的问题，需加强对改水工程的管理和维护。

Objective To understand the changes of arsenic poisoning in drinking water arsenic poisoning areas in Inner Mongolia Autonomous Region, to provide a scientific basis for timely adjustment of local arsenic poisoning prevention and control measures. Methods In accordance with the requirements of the national ＂Surveillance Scheme of Drinking-Water-Borne Endemic Arsenism＂, 38 villages were selected from 8 cities as monitoring sites in Inner Mongolia Autonomous Region in 2015. The situation of the villages in improving water quality and operation of the arsenic reducing projects was investigated, water samples were collected to detect water arsenic content of all the monitoring villages exposed or previously exposed to high arsenic water in the resident population, and 30 adult patients with arsenic poisoning were tested urine arsenic level. Results Thirty-eight monitored villages had changed the water sources; the change rate was 100.00% （38/38）. Water arsenic content qualified projects were 17, covering 36 villages. The project with water arsenic content exceeded the national standard was 1, the rate of exceeded standard was 5.56% （1/18）, covering 2 monitored villages. In the 36 water arsenic content qualified natural villages, 4 163 people were examined, and arsenic poisoning patients detection rate was 10.21% （425/4 163）. The incidence of mild, moderate, severe and skin cancer cases was 7.59% （316/4 163）, 1.68%（70/4 163）, 0.86% （36/4 163） and 0.07% （3/4 163）, respectively, no new cases and new skin cancer cases. In the natural villages where the content of arsenic in water exceeded the standard, 461 resident people who were drinking high arsenic water were examined. The detection rate of arsenic poisoning patients was 3.69% （17/461）, no moderate, severe, new and skin cancer eases. A total of 1 107 patients with arsenic poisoning were tested for urinary arsenic levels in the 36 villages with normal water available and water arsenic levels in the range of 0.000 - 0.441 mg/L with a median of 0.011 mg/L. The content of urinary arsenic in 60 patients with arsenic poisoning was detected in the 2 natural villages with the arsenic content exceeded the standard. The range was 0.030 - 0.268 mg/L and the median was 0.155 mg/L. Conclusions The projects of anti-arsenic water have effects in Inner Mongolia Autonomous Region. But there are still water projects with water arsenic content exceeded the standard, which seriously affects the health of residents, and the water management and maintenance of water projects needs to be strengthened.