山西省饮水型地方性砷中毒防治效果评价

Evaluation on prevention and control effect of control measures on drinking-water-borne endemic arsenic poisoning in Shanxi Province

目的掌握山西省饮水型地方性砷中毒病情变化趋势和防治措施落实情况,评估消除目标进展,为实施精细化管理提供客观依据。方法2018年,按照《"十三五"全国地方病防治规划》中期评估方案及《重点地方病控制和消除评价办法》的要求,在全省16个县(市、区)的157个病区村或高砷村,以行政村为单位,对全部常住人口进行普查,调查现症患者病情情况,查找砷中毒新发病例;调查改水措施落实情况和改水工程运行情况;每个行政村采集1份末梢饮用水水样,检测水砷含量;同时以县(市、区)为单位评估砷中毒消除情况。结果全省共计调查1221名饮水型地方性砷中毒病例,其中轻度982人、中度190人、重度49人,各占80.43%、15.56%、4.01%;1221名病例均为2011年以前监测在册的病例,未发现新发病例。157个调查村改水率为94.90%(149/157),改水村水砷含量均值为0.0223 mg/L,范围为0.0005~0.1939 mg/L;改水后水砷合格率为83.89%(125/149),改水工程正常运转率为82.55%(123/149)。10个县(市、区)达到了消除标准,6个县(市)未达到消除标准。结论山西省饮水型地方性砷中毒防治成效显著,多年未有新发病例;今后应加大改水工作力度,实施一村一策式精细化管理,确保所有病区村或高砷村达到国家消除标准,如期实现地方病防治专项三年攻坚行动目标。

Objective To master the changing trend of drinking-water-borne endemic arsenic poisoning in Shanxi Province and the implementation of prevention and control measures,to evaluate the progress of elimination target,and to provide objective basis for the implementation of refined management.Methods In 2018,according to the mid-term evaluation plan of the"Thirteenth Five-Year Plan for National Endemic Disease Control"and the requirements of the"Measures for Elimination Control and Evaluation of Key Endemic Diseases",in 157 disease affected villages or high arsenic villages of 16 counties(cities,districts)in the province,taking the administrative village as the unit,a census of all permanent residents was conducted to investigate the condition of current patients and find out the new cases of arsenic poisoning;the implementation of water improvement measures and the operation of water improvement project were investigated;one tap water sample was collected from each administrative village to detect the arsenic content in the water;and the elimination of arsenic poisoning was evaluated.Results A total of 1221 cases of drinking-water-borne endemic arsenic poisoning were investigated in the whole province,including 982 mild cases,190 moderate cases and 49 severe cases,accounting for 80.43%,15.56%and 4.01%,respectively;all the 1221 cases were monitored and registered before 2011,no new cases were found.In the 157 investigated villages,the rate of water improvement was 94.90%(149/157),the average content of arsenic in water of village with water improvement was 0.0223 mg/L,ranging from 0.0005 to 0.1939 mg/L;the qualified rate of water arsenic after water improvement was 83.89%(125/149),and the normal operation rate of water improvement project was 82.55%(123/149).Ten counties(cities,districts)had reached the elimination standard,and six counties(cities)had not reached the elimination standard.Conclusions The prevention and control effect of control measures on drinking-water-borne endemic arsenic poisoning in Shanxi Province is remarkable,and there is no new case for many years.In the future,efforts should be made to improve water supply,carry out one village one policy refined management,ensure that all disease affected villages or high arsenic villages meet the national elimination standards,and achieve the goal of the special three-year program for prevention and control of endemic diseases.