Analysis the Results of Control and Elimination of Coal-Burning-Borne Endemic Fluorosis in Chongqing City

Objective: Discuss the analysis of the results of control and elimination of coal-burning fluorosis in Chongqing, and evaluate the effect of prevention and control. Methods: Dean’s method was used to investigate the fluorosis for the local children whose ages ranged from 8 to 12 years old, the use of improved stoves in residential households, the drying of corn and pepper for human consumption, and the results were evaluated and discussed according to the national standard for the control and elimination of coal-burning fluorosis. Results: The prevalence rate of dental fluorosis borne-disease in children whose ages ranged from 8 to 12 years old was about 11.28% in 661 historically diseased villages in 100 townships and in 13 districts and counties of Chongqing city. The correct utilization rates of improved stoves, qualified improved stoves, and qualified stoves were 100%, 98.82%, and 99.45%, respectively. The correct drying rates of corn and pepper for human consumption were 99.88% and 99.75% respectively. There are 24 uncontrolled villages, 225 controlled villages, and 412 villages in eliminated disease zones in administrative villages. There are 4 villages and counties in uncontrolled, 4 in controlled, and 5 eliminated areas in districts and counties. Conclusion: Fluorosis borne-disease caused by coal-burning in Chongqing has reached the control and elimination targets of the twelfth Five-year plan.

Investigation and Analysis on Current Situation of Coal-Burning Fluorosis Prevalence

Objective: The purpose of the paper is to provide the result from investigation on the current situation of coal-burning fluorosis prevalence in Chongqing City and make an assessment on the prevention and curing measures. Method: The Dean’s Method is applied to investigate on the fluorotic teeth of locally-born children aged between 8 to 12;investigate how modified cooking stoves are utilized by households and how food maize and hot pepper are being dried;and test the urinary fluorine content and pepper fluorine content. Result: The investigations show that, in the 661 villages with illness history from the 100 townships of 13 districts in Chongqing City, 11.28% (7464/ 66,162) of the children aged between 8 and 12 suffer from dental fluorosis;the stoves modified rate, qualified rate of modified stoves, and correct utilization rate of qualified modified stoves are respectively 100%, 98.82%, and 99.45%;and food maize and hot pepper’s drying rates are respectively 99.88% and 99.75%. Conclusion: The result shows that the coal-burning type fluorosis prevalence in the endemic area of Chongqing City has decreased dramatically, the preventive measure is effectively implemented, and a long-term preventive mechanism has preliminarily been established.

GEOGRAPHICAL ENVIRONMENTAL CHARACTERISTICS OF ENDEMIC FLUOROSIS IN CHINA

Endemic fluorosis is given rise to by human intake of excess fluorine from environment by way of food chain. In China it is one of the extensively prevalent endemic diseases and its distribution shows clearly regional characteristics. In macroscopic sight, three large fluorosis zones may be divided: (1) The arid and semi-arid plains in the north of China. These regions have a dry climate, making fluorine accumulation in the Quaternary deposits. Thus, the drinking water with high content of fluorine is the main cause of the disease formation. (2) The Yunnan-Guizhou Plateau. In the region, rocks and soils rich in fluorine bring about fluorine excess in crop food. This plays an important role in the disease formation. (3) Southeast hills. The hot spring with high content of fluorine leads to fluorosis.The fluorine absorbed by people from the environment is firstly from the drinking water and secondly from the crop food originating from soil. The fluorine in the air can be accumulated in crop leaves to

Chemical endemic diseases and their impact on population in china

This paper deals with some endemic diseases related to selenium, iodine and fluoride in eco-environment. Keshan disease and Kaschin-Beck disease are associated with low selenium, they mainly occur in a belt zone across China ranging from North-East to South-West. Selenium contents in food grains and human hair from the disease affected areas are usually below 0.020ppm and 0.20ppm respectively. The endemic goitre caused by iodine deficiency distributes extensively in China, mainly in mountainous and hilly districts, swamp and peat areas, some sand soil and limestone areas. Also there is another kind of endemic goitre which caused by iodine excess in interior and coast areas. Endemic cretinism usually occurs in the endemic goitre seriously affected areas. Endemic fluorosis is also widely distributed in China, but mainly occurs in dry or semi-dry areas of north China. The fluoride sources for causing endemic fluorisis are drinking water and food grains polluted by coal smoke in the backing process of maize and chilli.

山东省淄博市饮水型地方性氟中毒流行现状调查与分析

目的采用横断面调查的方法,对山东省淄博市饮水型地方性氟中毒流行现状进行调查与分析。方法于2021年6月至12月对淄博市辖区内7个区县(张店区、临淄区、周村区、博山区、桓台县、高青县、沂源县)原有的氟中毒病区村及疑似病区村进行逐一调查登记,对8~12岁1200名在校儿童进行氟斑牙患病率的调查分析,并对淄博市采取的114个改水降氟工程运行情况及运行后的水质状况进行监测与分析。结果地方性氟中毒在淄博市分布广泛,7个区县共3102个行政村中地方性氟中毒病区村459个,高氟危及人群达28万人。高青县是淄博市地方性氟中毒最为严重的地区,病区村占总数的75.2%;高青县中病区村数量占中病区村总数的92.2%,12个重病区均位于高青县。高青县也是8~12岁儿童氟斑牙的患病率最高的地区,20个村的88名儿童的氟斑牙检出率为100%,因受地理环境、气候及经济状况的影响,高青县345个病区村中仅有224个实施了改水降氟工程,占64.9%,是淄博市病区改水率最低的地区。结论淄博市地方性氟中毒总体处于低度流行趋势,但高青县地方性氟中毒防治形势仍然十分严峻,应加大防治经费的投入及改水降氟措施的落实力度,为早日控制地方性氟中毒的流行,保障人民群众免受地方性氟病的威胁做出努力。

氟离子选择电极法测定砖茶含氟量

采用氟离子选择电极法测定砖茶含氟量,对比云南省保山市内五个不同地区6批次样品检测结果,探讨其影响含氟量高低的主要因素。结果表明:砖茶样品中均检测出一定含量的氟,但均符合国家标准规定,平均含量高低排列顺序为:昌宁D>隆阳E>龙陵C>施甸F>腾冲A>腾冲B。

Potential release of hydrogen fluoride from domestic coal in endemic fluorosis area in Guizhou,China

Almost half of the total rural area of Guizhou Province and many regions within the 11 adjacent provinces in southwestern China have a long history(at least 70 years) of endemic fluorosis,including dental fluorosis and osteofluorosis along with its associated deformities and disabilities.Over decades of research,this specific type of endemic fluorosis has been defined as coal-burning fluorosis,which is distinct from drinking-water fluorosis.It is generally acknowledged that indoor burning and combustion of high-fluorine coal leads to food contamination,and fluorine then enters the human body.However,the exact chemical form of fluorine during its release and transfer to the body is still unknown.In the present study,21 domestic coal samples from outcrop and semi-outcrop coal collected in five villages with fluorosis were analyzed by time-of-flight secondary ion mass spectrometry(TOF-SIMS).The total mass fraction of sulfur in the samples ranged from 0.24%-5.58% and total fluorine content ranged 90.2-149.2 mg/kg.H3O+,H2SO4+ and HSO4-were detected in the samples by TOF-SIMS,which indicated that sulfuric acid hydrate(H2SO4.H2O) was present in the samples.F-was detected in all of these,which suggested the samples contain ionic fluorine compounds.Under certain circumstances,such as heating or burning,the prevalence and coexistence of the acid(H2SO4.H2O) and base(F-) would lead to a neutralization reaction producing volatile hydrogen fluoride(HF,bp = 19.5℃).This would be the chemical form of fluorine released from the coal.Further studies using HF and SO2 test tubes on headspace gas over coal samples heated to 200℃ in the laboratory and on headspace gas over stoves or chimney tops at rural residences confirmed the release of HF.

2008-2021年北京市地方性氟中毒监测结果分析

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。

地方性氟中毒家兔的心、肝、肾组织病理学特征

目的观察地方性氟中毒(地氟病)家兔心、肝、肾组织的病理学变化。方法24只家兔随机均分为3组,对照组饮用自来水20周,10周组饮用200 mg/L含氟水10周、20周组饮用200 mg/L含氟水20周造模,实验持续20周;观察实验期间各组家兔的生长情况,实验结束时处死家兔,采用氟离子选择电极法测定家兔股骨骨氟含量,取各组家兔心肝肾、观察外观变化,苏木素-伊红(HE)染色、病理形态学观察。结果实验期间,10周组、20周组家兔体长、体质量平均增长率略低于对照组,差异无统计学意义(P>0.05);对照组、10周组、20周组家兔骨氟分别为(548.33±41.65)mg/kg、(1709.40±236.91)mg/kg、(2754.65±427.61)mg/kg,后两组较对照组家兔的骨氟含量明显增加,差异有统计学意义(P<0.05);与对照组相比,两模型组家兔心脏稍充血,肝脏增大,肾脏外观较苍白;HE染色发现,与对照组相比,两模型组家兔心肌横纹模糊、心肌纤维肿胀、界限不清,肝细胞排列紊乱、部分出现水肿、胞浆疏松、出现空泡变性,部分肾小管上皮细胞空泡样变、偶见局灶性坏死、炎性细胞浸润。结论地方性氟中毒家兔的心肝肾均发生病理学改变。

地方性氟中毒患者多项检验指标的测定及分析

目的 探索地方性氟中毒有意义的检测诊断指标。方法 选轻、中、重不同病情的地氟病病人 6 0 0名 ,进行血、尿常规和生化等 2 1项检查。血、尿氟采用离子选择电极法 ,生化及酶类采用 RA BA生化自动分析仪检验 ;T3、T4用 PEG放射免疫方法测定。结果 地氟病病人随病情加重贫血人数增多 (P <0 .0 5 ) ;血、尿氟明显高于参考值 ;血清钙降低 ,磷升高 ;重症患者尿钙排出量增加 ;碱性磷酸酶 (AKP)随病情加重而升高 (P <0 .0 5 ) ;血清总蛋白、白蛋白含量正常 ,而球蛋白明显升高 ,T3、T4平均水平低于参考值 ,特别是中、重患者偏低更明显。结论 RBC、Hb及血清钙、磷、碱性磷酸酶、球蛋白、T3、T4和尿钙等指标对地氟病的诊断有一定的参考意义。

中国大陆地方性氟中毒防治动态与现状分析

目的 为制定全国地氟病中、长期防治策略提供科学数据。方法 采用流行病学方法分析了地氟病的防治和现状。资料来源于两个方面 :(1) 1991～ 1999年全国地氟病重点监测数据。(2 ) 1991～ 2 0 0 0年全国地方病统计信息系统数据。结果 110年来全国降氟改水率上升 8个多百分点 ,但改水工程合格率下降 15个百分点。各地区改水速度不平衡 ,华北与华东地区改水最快 ,上升 10个百分点 ,最慢是西北 ,上升 4个百分点 ,改水率未超过 3 0 %。 2全国降氟改灶率上升 1个百分点 ,正常使用率上升 7.8个百分点。西部改灶率增长约 2个百分点 ,达到 13 %。包括湖北、湖南其它南方地区改灶率达到 44 %。 3目前 ,改水率未达 44 %的省份有东北的黑龙江、吉林 ;华北的安徽、山西 ;西北的内蒙、甘肃、陕西等 ,其中安徽改水率仅 1%。 4改灶率未达 2 0 %以上的省份有贵州、四川、陕西、湖南等 ,其中贵州改灶率仅 2 %。结论 我国各地区地氟病防治措施落实进度极不平衡 ,西部地区进度最慢 ,应加大西部地区防治力度。同时 ,要重视防氟工程管理 ,建立全国地氟病可持续性消除机制。

地氟病属于“钙矛盾疾病”

膳食低钙是地氟病病区居民中的普遍现象 ,是地氟病 (氟骨症 )的主要促发和加重因素。低钙的作用不仅在于增加肠道氟的吸收 ,更在于它和过量氟同样都可引起甲状旁腺激素分泌增多 ,都可促进成骨、破骨功能活跃。过量氟可进一步加重机体缺钙。我们最近的研究证明 ,氟中毒大鼠肝、肾、脑组织 [Ca2 + ]i 升高 ,培养的成骨细胞样细胞染氟后细胞内钙亦增加 ;即氟中毒存在着全身缺钙继而细胞内钙增多的钙矛盾现象 ,属于钙矛盾疾病。为控制和消除地氟病危害 。

中国大陆地方性氟中毒病情动态与现状分析

目的 明确全国地方性氟中毒 (地氟病 )病情动态与现状。方法 采用流行病学方法分析地氟病的病情动态和现状。资料来源于两个方面 :11991— 1999年全国地氟病重点监测数据。2 1991— 2 0 0 0年全国地方病统计信息系统数据。结果 1在饮水型病区 ,华北、华东、西北地区的地氟病病情均呈下降趋势 ,东北地区不降反升 ;在燃煤型病区 ,西部病情呈上升趋势 ,氟斑牙患病率上升 15个百分点 ,氟骨症患病率上升 2个百分点。 2目前 ,我国饮水型重病区分布在东北三省 ,华北山西、天津 ,华东江苏 ,西北内蒙、陕西、青海等省份 ;燃煤型重病区分布在西部的贵州、四川、云南、陕西和湖北等省份。3我国地氟病病情虽得到一定控制 ,但并不令人满意 ,饮水型氟斑牙患病率为 2 9.3% ,氟骨症患病率为 1.45 % ;燃煤型氟斑牙患病率为 5 2 .2 % ,氟骨症患病率为 4.32 %。饮水型较燃煤型控制得好些。结论 我国地氟病病情仍然较重 ,防治工作绝不能放松 。

地方性氟中毒病区与非病区儿童氟斑牙表现及意义

目的了解地方性氟中毒病区和非病区儿童氟斑牙表现、特点及区别,为地方性氟中毒临床诊断提供参考。方法以分层抽样的方法,随机抽取轻、中、重地方性氟中毒病区12个屯,非病区8个屯。对4063名8～12岁儿童做氟斑牙检查,按Dean法进行诊断、分度,计算和比较不同地区儿童氟斑牙总的检出率和各度检出率;测定受检者饮水氟和尿氟排泄量。对重点对象进行随访。结果高氟区儿童氟斑牙检出率55.7%,低氟区为16.5%,高氟区检出率明显高于低氟区(P<0.005)。在高氟区儿童各度氟斑牙检出率均较高,而低氟区氟斑牙以极轻度为主。中、重度氟斑牙仅见于长期居住在高氟区者。结论氟斑牙并非仅为高氟摄入所致,它与氟化物广泛联系着,较低水平的氟化物即可造成氟斑牙。中、重度氟斑牙是氟中毒的结果,这两种程度的改变对氟中毒的临床诊断有重要意义。

贵州省燃煤型地方性氟中毒流行病学调查

目的 评价贵州省地方性氟中毒 (地氟病 )流行现状、影响因素及防制效果。方法 采用横断面调查方法 ,2 0 0 1年 5～ 9月对全省燃煤地区乡镇中心小学 8～ 12岁学生氟斑牙患病情况进行了调查 ,同时对原烧柴地区进行了地氟病线索调查。结果 在 85 7个乡镇中调查 772个 (受检率 90 .0 9% ) ,查出病区乡 5 92个 (检出率76 .6 8% ) ,其中轻病区乡 5 19个 (占 87.6 7% ) ,中病区乡 4 9个 (8.2 8% ) ,重病区乡 2 4个 (4.0 5 % )。病区人口约190 0万人 ,全省燃煤地区 8～ 12岁儿童氟斑牙患病率为 5 6 % ,缺损率为 6 .5 % ,推算 8～ 12岁氟斑牙儿童约 110万人。重病区仍然主要分布在省境内西北地区的毕节地区和六盘水市。与 1986年调查结果比较 ,儿童氟斑牙患病率 <30 %的乡镇无明显变化 ,30 %～ 80 %的乡镇检出率增高 ,而 >80 %的乡镇数明显减少。在约 4 0 %的由烧柴转为烧煤的乡镇发现氟中毒病人。结论 贵州省地方性氟中毒流行得到明显控制 ,但形势仍然严峻 ,病区有扩大趋势。

贵州省3个县地方性氟中毒健康教育干预效果评估

目的评估贵州省白云、西秀及龙里3个县(区)地方性氟中毒(地氟病)防治健康教育干预效果。方法采用分层随机抽样方法,考核学生和妇女目标人群地氟病防治知识知晓率、相关行为形成率和室内氟污染控制情况。结果被抽样单位,学生和妇女目标人群地氟病防治卫生知识知晓率和相关行为形成率显著提高、室内存放的玉米、辣椒及室内空气含氟量均显著下降。结论地氟病防治健康教育干预试点工作取得明显效果。健康教育应作为贵州省地氟病控制的重要策略。

黔西地方流行病——氟中毒起因新解

国内外闻名的黔西地方流行病氟中毒常常归因于黔西晚二叠世煤中高含量的氟以及不科学的燃煤方式。通过对黔西 5 0个煤层刻槽样品的研究发现 ,黔西晚二叠世煤中氟的含量范围为 16 .6～ 5 0 0 μg/ g,算术均值为83.1μg/ g,接近于中国大部分煤中氟的含量 (82 μg/ g)和美国煤中氟的平均含量 (98μg/ g)。当地饮用水和新鲜的玉米中氟的含量亦很低 ,不足以导致氟中毒。然而 ,当地居民把粘土作为煤燃烧的添加剂和制作煤球的粘合剂 ,这种粘土中的氟含量很高 ,为 10 0 .8～ 2 4 5 5 .7μg/ g,均值为 10 2 7.6 μg/ g。