2009—2014年山东省饮水型地方性氟中毒监测结果分析

发布时间：2018-01-30 19:52

本文关键词： 饮用水地方性饮水型氟中毒卫生监测农村　出处：《环境与健康杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的掌握山东省饮水型地方性氟中毒病区防治措施落实效果及病情动态。方法于2009—2014年在山东省饮水型地方性氟中毒病区,按照国家《饮水型地方性氟中毒监测方案》和《山东省饮水型地方性氟中毒监测方案》规定的方法和要求,抽取10个监测县,每个监测县随机抽取10个改水降氟工程,调查其运行效果,并测定水氟浓度;每个监测县选择3个病区村作为固定监测村,调查改水村改水工程运行情况及水含氟量,检测未改水村饮水氟浓度,检查8~12岁儿童氟斑牙患病情况,对25岁以上成人进行氟骨症X线检查和尿氟检测。结果在监测县中,共监测改水降氟工程511个,正常运转率为97.06%(354/511),水氟合格率为55.19%(282/511)。在165个已改水村中,共监测147个改水工程,正常运转率为97.28%(143/147),水氟合格率为62.59%(92/147)。在12个未改水监测村,水氟1.20 mg/L的村占58.33%(7/12)。2009—2014年全部监测村8~12岁儿童氟斑牙检出率平均为50.10%(4 563/9 107),氟斑牙指数为1.0,氟斑牙检出率呈逐年下降趋势(χ~2=172.69,P0.01)。改水工程正常运行且水氟合格监测村儿童氟斑牙的检出率为44.81%(2 543/5 675),氟斑牙指数为0.87,氟斑牙检出率呈逐年下降趋势(χ~2=248.30,P0.01)。改水工程非正常运行或水氟超标监测村儿童氟斑牙的检出率为61.10%(1 750/2 864),氟斑牙指数为1.26。未改水监测村儿童氟斑牙的检出率为47.54%(270/568),氟斑牙指数为1.07。改水工程正常运行且水氟合格监测村的儿童氟斑牙检出率低于改水工程非正常运行或水氟超标的监测村(χ~2=202.11,P0.01)。2009和2014年度25岁及以上成人氟骨症X线检出率分别为8.04%(119/1 481)和7.25%(106/1 463)。2014年水氟合格村和水氟超标村成人尿氟几何均值均低于正常值上限(1.60 mg/L)。结论山东省改水防治饮水型地方性氟中毒取得了一定的效果,但改水降氟工程的水氟超标问题较为严重,氟中毒病情尚未得到全面控制,防治工作有待进一步强化和深入。
[Abstract]:Objective to understand the effect of preventive measures and the state of illness of drinking water endemic fluorosis in Shandong Province from 2009 to 2014. According to the methods and requirements stipulated by the National Monitoring Program for drinking Water endemic fluorosis and the Shandong Province drinking Water endemic fluorosis Surveillance Program, 10 monitoring counties were selected. Ten fluorine reduction projects were randomly selected from each monitoring county to investigate the operation effect and determine the water fluorine concentration. Three villages were selected as fixed monitoring villages in each monitoring county to investigate the operation and water fluorine content of the water-changing village, to detect the fluorine concentration in drinking water of the unmodified village and to check the prevalence of dental fluorosis in children aged 8 to 12 years. Fluorosis X-ray examination and urine fluorine test were performed in adults over 25 years old. Results 511 fluorine reduction projects were monitored in monitoring county, the normal operation rate was 97.06% 354 / 511). The qualified rate of fluorine in water was 55.19 / 282 / 5110.A total of 147 water improvement projects were monitored in 165 villages, and the normal operation rate was 97.28.3 / 14.7). The qualified rate of fluorine in water was 62.59 / 92 / 1470.It was found in 12 unmodified water monitoring villages. Water fluorine 1.20 mg/L accounted for 58.33% of fluorosis. The average detection rate of fluorosis in 812 year old children from 2009 to 2014 was 50.10% (P < 0.05). 4 563/9 107). The dental fluorosis index was 1.0 and the detection rate of dental fluorosis was decreasing year by year (蠂 2 / 172.69). The detection rate of dental fluorosis was 44.81% and the dental fluorosis index was 0.87. The detection rate of dental fluorosis decreased year by year (蠂 2 + 248.30). The detection rate of dental fluorosis in children in the village was 61.10 ~ (10) and 1 750/2 ~ 864). The dental fluorosis index was 1.26. The detection rate of fluorosis teeth in village children was 47.54 / 568). The dental fluorosis index was 1.07.The detection rate of dental fluorosis in children in the villages with normal operation of water improvement project and water fluorine qualified monitoring village was lower than that in the monitoring village with abnormal operation of water improvement project or water fluoride exceeding standard (蠂 ~ 2 / 2 / 202.11). The X-ray detection rate of fluorosis in adults aged 25 and over in 2009 and 2014 was 8.04 and 7.25106 / 1463, respectively. In 2014, the geometric mean values of urinary fluorine in adults in water fluorine qualified villages and water fluorine exceeding standard villages were below the normal upper limit of 1.60 mg / L). Conclusion the prevention and treatment of drinking water endemic fluorosis in Shandong Province has achieved certain effect. However, the problem of water fluorine exceeding the standard is more serious, the condition of fluorosis has not been completely controlled, and the prevention and treatment work needs to be further strengthened and deepened.
【作者单位】：山东省地方病防治研究所氟中毒与大骨节病防治研究科;
【基金】：中央补助地方重大公共卫生服务地方病防治项目(2009-2014) 山东省医药卫生科技发展计划项目(2014WS0390)
【分类号】：R181.8;R599.1
【正文快照】： 饮水型地方性氟中毒(以下简称地氟病)是由于人们长期饮用高氟水所致的儿童牙齿和成人骨骼病变的疾病,是严重危害人体健康的地方病之一[1-3]。山东省地处黄河下游冲积平原地带,是我国饮水型地方性氟中毒危害最为严重的省份之一[4]。自20世纪80年代实施以改水降氟为主的防治措施

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