摘要
目的了解西安市饮水型氟中毒病区防治措施落实情况及儿童氟斑牙病情现状,综合评价防治措施的效果。方法选择西安市全部饮水型氟中毒病区村作为调查点,调查病区村改水情况、改水工程运行状况、改水工程及病区村居民生活饮用水水氟含量,水氟含量检测采用《生活饮用水标准检验方法》(GB/T 5750.5-2006)。调查病区村全部8~12岁在校儿童氟斑牙患病情况,氟斑牙检查及诊断依据《氟斑牙诊断》(WS/T 208-2011)。结果全市273个饮水型氟中毒病区村,改水率为91.58%(250/273),改水工程正常运转率为100.00%(196/196),改水工程水氟含量合格率为88.27%(173/196),273个病区村居民生活饮用水水氟含量合格率为86.81%(237/273)。250个已改水病区村和23个未改水病区村居民生活饮用水水氟含量中位数分别为0.78和0.83 mg/L,二者比较差异无统计学意义(Z=1.475,P>0.05)。8~12岁儿童氟斑牙检出率为19.86%(1960/9871),氟斑牙指数为0.39。水氟合格病区村检出率为16.13%(1377/8539),水氟超标病区村检出率为43.77%(583/1332),二者比较差异有统计学意义(χ2=553.283,P<0.01)。水氟含量在0.00~1.20、1.21~1.50、≥1.51 mg/L病区村儿童氟斑牙检出率分别为16.13%(1377/8539)、41.20%(281/682)、46.46%(302/650),三者比较差异有统计学意义(χ2=559.011,P<0.01),病情严重程度与水氟含量呈正相关(r=0.273,P<0.01)。全市202个病区村达到国家控制标准,71个病区村未达到控制标准。结论西安市饮水型氟中毒病区村改水降氟进展缓慢,改水后水氟含量合格率低,水氟含量超标病区村儿童氟斑牙检出率仍处于较高水平,需加快病区改水降氟和安全饮水巩固提升进度,加强病情监测。
Objective To assess the implementation of control measures and dental fluorosis of children in drinking-water-borne endemic fluorosis areas in Xi'an City,and to evaluate the implementation effects of the prevention and control measures.Methods All drinking-water-borne endemic fluorosis villages in Xi'an were selected as the investigation sites.The progress and running condition of all water-improved projects were investigated,fluoride concentration in all the water-improved projects and tap water were tested."Standard Test Method for Drinking Water"(GB/T 5750.5-2006)was used to test the water fluoride.A cross-sectional analytical study was conducted on school children aged 8-12 years old,the dental fluorosis was determined according to"Diagnosis of Dental Fluorosis"(WS/T 208-2011).Results There were 273 drinking-water-borne endemic fluorosis villages,the rate of water improved villages was 91.58%(250/273),and all of the water-improved projects were operating normally(100.00%,196/196).The rate of water-improved projects with qualified water fluoride was 88.27%(173/196),237 villages had fluoride safe drinking water and the qualified rate was 86.81%(237/273).The median of water fluoride in the 250 villages with water-improved projects was 0.78 mg/L,the median was 0.83 mg/L in the 23 villages without water-improved projects,and the difference was not significant(Z=1.475,P>0.05).The overall prevalence of dental fluorosis among children aged 8-12 years old was 19.86%(1960/9871),and the dental fluorosis index was 0.39.The prevalence of dental fluorosis in the villages with qualified water fluoride was 16.13%(1377/8539),and the rate was 43.77%(583/1332)in the villages with unqualified water fluoride,and the difference was significant(χ2=553.283,P<0.01).The prevalence of dental fluorosis in children with water fluoride content of 0.00-1.20,1.21-1.50,and≥1.51 mg/L was 16.13%(1377/8539),41.20%(281/682),46.46%(302/650),and the difference was significant(χ2=559.011,P<0.01),the severity of the disease was positively correlated with water fluorine concentration(r=0.273,P<0.01).The epidemic situation in 202 villages was effectively controlled and 71 villages did not reach the control standard.Conclusions The progress of water-improved projects and the rate of qualified water fluoride are not optimistic in Xi'an,the dental fluorosis of children is still higher than the government standard in the high fluoride drinking-water areas.The measures for water improving defluorination and disease surveillance should be strengthened.
作者
董璐
陈伟
姚培杰
李平
何姗姗
时学花
Dong Lu;Chen Wei;Yao Peijie;Li Ping;He Shanshan;Shi Xuehua(Department of Endemic Disease,Xi'an Center for Disease Control and Prevention,Xi'an 710054,China)
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2020年第1期42-46,共5页
Chinese Journal of Endemiology
基金
陕西省重点研发计划(2018SF-112)。
关键词
氟中毒
牙
改水工程
饮水
儿童
Fluorosis,dental
Water improvement
Drinking water
Child