贵州乡镇中心与边缘区燃煤型氟中毒流行病学调查

Epidemiology of endemic fluorosis in the town central and remote villages of Guizhou province

目的了解贵州省乡镇中心区与边缘区燃煤型氟中毒(地氟病)流行情况,探讨实施健康教育与促进控制地氟病的必要性。方法在贵州省地氟病重度流行县织金县随机选择轻、中、重地氟病乡镇各1个,再分层为中心区和边缘区。中心区调查乡镇政府所在中心村(小学),边缘区随机调查相邻的2个村(小学)。结果所查轻、中、重乡镇之间经济收入及主食大米与玉米比例存在差异,病情越重经济收入越差,玉米食入比例越大。乡镇中心经济收入明显好于边缘区。乡镇边缘区学校儿童氟斑牙检出率及尿氟明显高于中心区。各乡镇生活燃煤氟无显著差别,但中、重乡镇烘炕玉米和辣椒氟高于轻病区。约50%的住户使用铁炉,但其中约50%烟囱未出屋或无烟囱。重病区乡镇炉灶烟囱未出屋或无烟囱户数(比例)显著多于轻病区。结论病区经济、燃煤方式、生活卫生习惯显著影响地氟病流行,烟囱出屋情况、煤火烘烤玉米和辣椒及食入比例明显与病情有关。

Objective To explore the possibility of health education and promotion by studying the epidemiological factors of endemic fluorosis between the town central and remote villages. Methods Mild, medium and severe fluorosis endemic towns were selected at random in Zhijin County. The villages around the town central part and remote region were surveyed on dental fluorosis and urine fluoride level in the children aged 8～12 as well as fluoride contents in domestic coal, corn and chili pepper stored near the stove place. Results The yearly income was different among the farmers of the mild, medium and severe endemic towns. The lower the yearly income and bigger the corn-consuming ratio were, the more severe the prevalence of fluorosis was. The economic condition of the central part was better significantly. The incidence of dental fluorosis in the remote villages was significantly higher than that in the central part. Fluoride level in the urine of the children in the remote region was lower. The contents of fluoride in the coal were similar for all the checked towns, but the contents of fluoride in the corn and chili pepper samples from medium and severe endemic towns were higher than those from the mild ones. About 50% of the households had been using iron stove, but about 50% using it without a chimney (ventilated pipe). The number of the households normally using ventilated pipe in the severe endemic town was significantly smaller compared with that in the mild one. Conclusions The economic condition, the way of domestic coal combustion as well as health and living habit obviously influence the prevalence of endemic fluorosis. The condition of ventilated pipe of the stove, the drying way of the corn and chili pepper as well as the consuming ratio are related to the severity of endemic fluorosis.