2008-2021年北京市地方性氟中毒监测结果分析

Endemic fluorosis surveillance results in Beijing,2008-2021

目的了解北京市地方性氟中毒防治进展,评价防治效果,为制定防治策略提供科学依据。方法依照中国疾病预防控制中心相应年度的地方病防治监测方案,每年对北京市所有历史病区村改水工程的运行情况进行监测;2008-2018年各区随机选择2所历史病区村小学对在读8~12岁学生进行氟斑牙检查,2019-2021年对全部历史病区村的全部在读8~12岁学生进行氟斑牙普查。结果2008-2021年全市共检测水样4906份,2011-2021年,降氟改水工程全部正常运行,水氟中位数为0.40 mg/L,不同年度水氟含量比较,差异有统计学意义(H=89.205,P<0.001),2012年水氟中位数相对较高,为0.49 mg/L,2021年水氟中位数相对较低,为0.37 mg/L;共检查8~12岁儿童44540名,氟斑牙总检出率为4.74%(2110/44540);2010-2021年标准化氟斑牙检出率随年度的增加呈下降趋势(χ^(2)=300.04,P<0.001),由2010年的9.35%下降到2021年的2.92%;2013-2021年氟斑牙患者以极轻(78.17%,1067/1365)和轻度(20.73%,283/1365)为主,总氟斑牙流行指数为0.07,各年度流行情况均为无氟斑牙流行。结论北京市所有历史病区村降氟改水工程运行良好,无氟斑牙病情流行,地方性氟中毒的防控工作效果良好,未来将坚持各项措施,查缺补漏巩固防治效果。

Objective To investigate the progress of prevention and control of endemic fluorosis in Beijing and evaluate the effect of prevention and control,so as to provide scientific basis for formulating prevention and control strategies.Methods In accordance with the annual Endemic Disease Prevention and Control Monitoring Program issued by the Chinese Center for Disease Control and Prevention,the operation of water improvement projects in all villages of historical disease areas in Beijing is monitored every year.From 2008 to 2018,two primary schools in each district were randomly selected to conduct dental fluorosis examination for students aged 8-12 years old,and from 2019 to 2021,dental fluorosis survey was conducted for all students aged 8-12 years old in all villages with historical affected areas.Results From 2008 to 2021,a total of 4906 water samples were tested in the city.From 2011 to 2021,all the fluorine reduction and water improvement projects were conducted normally.The median of water fluoride was 0.40 mg/L.There were significant differences in fluorine content between different years(H=89.205,P<0.001).The relatively high water fluoride median was 0.49 mg/L in 2012,and the relatively low water fluoride median was 0.37 mg/L in 2021.A total of 44540 children aged 8-12 years were examined.The total detection rate of dental fluorosis was 4.74%(2110/44540).From 2010 to 2021,the standardized dental fluorosis detection rate decreased with years(χ^(2)=300.04,P<0.001),from 9.35%in 2010 to 2.92%in 2021.From 2013 to 2021,the majority of patients with dental fluorosis were extremely mild(78.17%,1067/1365)and mild(20.73%,283/1365).The total epidemic index of dental fluorosis was 0.07.There was no dental fluorosis in all years.Conclusions The fluoride reduction and water improvement project in all historical affected areas of Beijing is conducted well,and there is no epidemic of dental fluorosis.The effect of endemic fluorosis prevention and control is good.It is suggested that all measures should be adhered to and the effect of prevention and control should be consolidated in the future.