2016年河南省焦作市饮水型地方性氟中毒控制评价结果分析

Investigation and analysis of endemic fluorosis associated with drinking water in Jiaozuo City of Henan Province in 2016

目的全面掌握河南省焦作市饮水型地方性氟中毒病区改水和病情流行现状，评价防控效果，为科学制订防治规划提供依据。方法按照《重点地方病控制和消除评价办法》，对焦作市所有病区村开展调查。按照改水或未改水采集生活饮用水，水样采用生活饮用水标准检验方法（GB／T5750．5—2006）检测水氟含量；对病区村全部8-12岁儿童按照《氟斑牙诊断标准》（WS／T208．2011）进行氟斑牙检查；按照饮水型氟中毒控制评价内容和判定标准（国卫疾控发[2014]79号）进行评价。结果全市共调查了7个县（市、区）的59个乡镇、589个病区村。其中已改水病区村586个，改水率为99．49％；正常使用村数571个，正常使用率为97．44％；水氟含量超标的村有15个。全市共检查病区村8—12岁儿童35057人，检出氟斑牙13846人，氟斑牙检出率为39．50％。氟斑牙指数0．65，为极轻度流行。全市586个已改水病区村，其中达到控制标准村数147个，达标率为25．09％。7个饮水型地方性氟中毒流行县（市、区）均未达到控制标准。结论全市有439个已改水病区村没有达到控制标准，要进一步加强监测，落实改水措施，解决水氟超标问题；要加强改水工程的管理和维护，保证病区群众长期饮用合格水源，逐步实现全市饮水型地方性氟中毒控制和消除目标。

Objective To fully grasp the epidemic situation of drinking water type of endemic fluorosis in Jiaozuo City of Henan Province, evaluate the efficacy of the prevention and control measures, and to provide a basis for prevention and control of the disease. Methods According to ＂The Measures for Control and Elimination of Key Endemic Diseases＂, all the diseased villages in Jiaozuo City were investigated. For all diseased villages in accordance with the improved water or no improved water, drinking water samples were collected, the fluorine content in water samples was determined based on the standard testing method for drinking water （GB/T 5750.5- 2006）; all children aged 8 to 12 years old of the surveyed villages were examined and determined dental fluorosis using ＂Diagnostic of Dental Fluorosis＂ （WS/T 208-2011）; all evaluations were based on the criteria for drinking water-based fluorosis control （National Health Control [2014] No.79）. Results Totally 7 counties （cities） 59 townships 589 diseased villages were surveyed in the city, 586 diseased villages had improved the water quality, the rate was 99.49%, the number of villages that used the water facility normally was 571, the normal utilization rate was 97.44%, and there were 15 villages with excessive fluoride in water. A total of 35 057 children aged 8 to 12 years old in the diseased villages of the city were examined and 13 846 cases were detected dental fluorosis, the detection rate of dental fluorosis was 39.50%, the index of dental fluorosis was 0.65, which was a moderate epidemic; 147 villages reached the control of standard among the 586 diseased villages with improved water, and the compliance rate was 25.09%, and the 7 drinking water type local fluoride poisoning epidemic counties （cities） in the area all did not reached the control standards. Conclusion Totally 439 diseased villages in the city have not meet the control standard, we should strengthen the monitoring, implement measures to improve water quality, strengthen the management and maintenance of water projects to ensure that the disease affected population to have qualified drinking water in a long-term, and gradually achieve the target to control and eliminate cityls drinking water type of endemic fluorosis.