摘要
目的了解甘肃省饮水型地方性氟中毒病情流行态势,科学评价改水降氟工程对该病的防治成效。方法将甘肃省饮水型地方性氟中毒病区按不同生态类型划分为陇中黄土高原丘陵区、陇东黄土高原沟壑区、陇南秦岭中山峡谷区、河西沙漠戈壁区和甘南高寒草原草甸区5个区域。2021年,对5个区域中所有饮水型地方性氟中毒病区村的基本情况、改水降氟工程运转情况、饮用水水氟含量(氟离子选择电极法)及8~12岁儿童氟斑牙患病情况(Dean法)进行调查,依据《生活饮用水卫生标准》(GB 5749-2006)、《氟斑牙诊断》(WS/T 208-2011)等国家标准进行判定。结果共监测饮水型地方性氟中毒病区村2000个,其中已有1999个病区村实施改水降氟工程,工程覆盖率为99.95%(1999/2000)。所有改水降氟工程均正常运转,无间歇运转和报废工程。共对34616名8~12岁儿童开展氟斑牙病情调查,氟斑牙检出率为4.18%(1448/34616),氟斑牙指数为0.09。不同年龄儿童氟斑牙检出率比较差异有统计学意义(χ^(2)=69.77,P<0.001);不同生态类型区儿童氟斑牙检出率比较差异有统计学意义(χ^(2)=775.11,P<0.001)。8~12岁儿童氟斑牙指数与儿童所处区域历史水氟含量显著相关(r=0.29,P=0.042);河西沙漠戈壁区改水时间与当地8~12岁儿童氟斑牙检出率显著相关(r=-0.48,P=0.023)。结论2021年甘肃省所有饮水型地方性氟中毒病区村的疾病防治情况均已达到国家控制标准,但由于不同生态类型区生态特征各异及水源分布变化,仍需进一步加强对所有病区村饮水型地方性氟中毒病情的监测,巩固现有防治成果。
Objective To investigate the epidemiological situation of drinking water-type endemic fluorosis in Gansu Province,and scientifically evaluate the effectiveness of water improvement and fluoride reduction projects in preventing and controlling the disease.Methods The drinking water-type endemic fluorosis areas in Gansu Province were divided into five regions according to different ecological types:the Longzhong Loess Plateau Hilly Area in central Gansu,the Longdong Loess Plateau Gully Area in eastern Gansu,the Longnan Qinling Zhongshan Canyon Area in southern Gansu,the Gobi area of the Hexi Desert,and the Alpine Grassland Meadow Area in southern Gansu.In 2021,a survey was conducted on the basic situation,running situation of the water improvement and fluoride reduction projects,fluoride content in drinking water(fluorine ion-selective electrode),and the prevalence of dental fluorosis(Dean)among children aged 8 to 12 in all drinking water-type endemic fluorosis villages in the five regions.The pertinent assessments were executed in accordance with national guidelines such as the"Standards for Drinking Water Quality"(GB 5749-2006)and"Diagnosis of Dental Fluorosis"(WS/T 208-2011).Results A total of 2000 villages in drinking water-type endemic fluorosis areas were monitored,among which 1999 villages had implemented water improvement and fluoride reduction projects,with a coverage rate of 99.95%(1999/2000).All water improvement and fluoride reduction projects were operating normally,with no intermittent operation or scrapping.A total of 34616 children aged 8 to 12 were investigated for dental fluorosis.The detection rate of dental fluorosis was 4.18%(1448/34616),and the dental fluorosis index was 0.09.There was a statistically significant difference in the detection rate of dental fluorosis among children of different ages(χ^(2)=69.77,P<0.001).The difference in the detection rate of dental fluorosis among children of different ecological types of areas was statistically significant(χ^(2)=775.11,P<0.001).The dental fluorosis index of children aged 8-12 was significantly correlated with the historical water fluoride level(r=0.29,P=0.042).The water improvement time in the Gobi area of the Hexi Desert was significantly correlated with the detection rate of dental fluorosis in local children(r=-0.48,P=0.023).Conclusions In 2021,the prevention and control of drinking water-type endemic fluorosis in all villages in Gansu Province has reached the national control standards.However,due to the different ecological characteristics and changes in water source distribution in different ecological types of areas,it is still necessary to further strengthen the monitoring of the condition of drinking water-type endemic fluorosis in all the affected villages and consolidate the existing prevention and control achievements.
作者
李青林
何爱伟
王燕玲
陈国华
陈晓燕
费秀兰
Li Qinglin;He Aiwei;Wang Yanling;Chen Guohua;Chen Xiaoyan;Fei Xiulan(Department for Endemic Diseases Control,Gansu Centre for Disease Prevention and Control,Lanzhou 730000,China)
出处
《中华地方病学杂志》
CAS
北大核心
2023年第11期893-898,共6页
Chinese Journal of Endemiology
基金
甘肃省中医药管理局科研项目(GZKP-2020-27)
甘肃省卫生行业科研管理项目(GWGL-201029)。
关键词
氟化物中毒
改水降氟工程
生态类型区
氟中毒
牙
Fluoride poisoning
Water improvement and fluoride reduction project
Ecological type zone
Fluorosis,dental
