山东省农村环境卫生与疾病分布区域性分析

Regional differences in environmental hygiene and disease prevalence in rural areas of Shandong province

目的分析山东省不同农村地区的环境卫生与疾病的现状及区域变化特点,为制定相应的干预和控制措施提供依据。方法2015—2017年,结合山东省地理位置,按东部、中部、西部进行分层,共选取25个县(市),采用抽签的方法在每县随机抽取20个自然村,每自然村随机抽取5户家庭,共500个村2500户,采用统一调查表,通过查阅资料、现场调查、访谈、土壤样品采集、实验室检测等方式收集相关信息。结果调查县无害化卫生厕所普及率为53.34%,东、中、西部的差异有统计学意义(P<0.05),无害化卫生厕所普及率与区域的人均年纯收入呈正相关(r=0.997,P<0.05)。500个村粗死亡率为563/10万,心脏病、恶性肿瘤、脑血管病是死亡的主要原因。垃圾、污水处理厂人口覆盖率平均为58.50%和40.80%,东、中、西部差异有统计学意义(P<0.05)。农村土壤中蛔虫卵检出率为17.20%,东、中、西部差异无统计学意义(P=0.31),活蛔虫卵检出率为5.20%,东、中、西部差异有统计学意义(P<0.05);东、中、西部的蛔虫卵检出率与人均年纯收入呈显著负相关(r=–0.998,P=0.04)。土壤重金属合格率为87.40%,东、中、西部差异有统计学意义(P<0.05),土壤中镉合格率为89.00%,东、中、西部差异有统计学意义(P<0.05)。结论山东省不同地域的农村环境因素和疾病间明显相关,西部地区土壤中活蛔虫卵检出率偏高;东部地区土壤污染的主要因素是镉;应针对不同地域特点采取相应的干预和控制措施。

Objective To analyze the status quo and regional variations of environmental hygiene and disease prevalence in rural areas of Shandong province and to provide evidences for developing targeted interventions and control measures.Methods We conducted surveys at 500 villages in 25 counties or prefectures selected using stratified random sampling across Shandong province during 2015–2017.The surveys included relevant information collection,field study,soil sample collection for every villages selected,interviews with family members of 2500 households in the villages surveyed using a unified questionnaire,and laboratory test to detect heavy metal and ascaris eggs in the soil samples.Results The coverage rate of harmless sanitary toilet was 53.34%for all the counties surveyed and the rate differed significantly among the counties with different geographical locations(P<0.05).The regional coverage rate of harmless sanitary toilet was positively correlated with regional annual net income per capita(r=0.997,P=0.045).During the 3-year period among the residents in the 500 villages,the crude mortality rate was 563/100000 and the major causes of the mortality were heart diseases,malignant tumors and cerebrovascular diseases.For all the residents in the 500 villages,the mean coverage rate of garbage and sewage treatment plant was 58.50%and 40.80%and the rate was significantly different for the residents living in eastern,central and western areas of the province(P<0.05).The detection rate of ascaris eggs was 17.20%for all soil samples and there was no significant difference in the detection rate among the samples collected in different regions(P=0.31);but the regional detection rate of ascaris eggs was inversely correlated significantly with the regional annual net income per capita(r=–0.998,P=0.04).The detection rate of live ascaris eggs was 5.20%for all the soil samples and there was a significant regional difference in the rate(P<0.05).The qualified rate of heavy metal concentration for all soil samples was 87.40%,with a significant regional difference(P<0.05);the qualified rate of cadmium concentration was 89.00%,also with a significant regional difference(P<0.05).Conclusion Environmental hygiene conditions are significantly associated with disease prevalence in rural areas of Shandong province.The detection rate of live ascaris eggs in soil samples is relatively higher for western rural region and soil cadmium pollution is more serious in the eastern rural region of the province.The results suggest that region specific interventions and control measures should be implemented.