鲁甸县燃煤污染型地方性氟中毒防治效果评价

发布时间：2018-04-26 18:21

本文选题：燃煤污染型地方性氟中毒 + 鲁甸县　；参考：《大理大学》2016年硕士论文

【摘要】：目的:通过现场调查、实验室检测对鲁甸县燃煤型地方性氟中毒病区的改良炉灶、健康教育等防控措施的防治效果进行评价,为制定下一步防控策略和防控措施提供科学依据。方法:2015年在鲁甸县内选择2005-2011年实施了改良炉灶项目,且截至2011年底总改炉改灶率≥95%的病区乡镇中随机抽取5个乡镇,每个乡镇随机抽取2个自然村,与2005基线调查结果比较,了解调查点的一般情况(包括鲁甸县燃煤型氟中毒病区分布、改良炉灶使用情况、病区膳食结构及经济情况等),以及氟污染和燃煤型氟中毒病情的变化(包括空气氟含量、粮食氟含量、儿童氟斑牙患病情况和尿氟含量、成人氟骨症患病情况),并评估燃煤型氟中毒健康教育效果(包括粮食正确干燥率、正确保存率、食前淘洗率等)和相关行为转变情况。对所得数据采用SPSS 22.0统计软件进行分析,正态分布计量资料采用(?x±S)描述,不服从正态分布资料采用中位数和四分位数间距,率或构成比的比较采用卡方检验、非参数检验等统计学方法。结果:(1)鲁甸县燃煤型氟中毒病区分布在84个村委会,涉及101320户,截至2011年,全县燃煤型氟中毒病区改良炉灶率达97.0%。较2015年,在调查的家庭中,每户平均年收入24796元,人均年收入5241元。农作物以玉米和土豆为主,家庭主食以大米为主。(2)8-12岁儿童氟斑牙总检出率为10.14%,氟斑牙指数为0.16,氟斑牙病例以极轻度为主,未检出中、重度氟斑牙和缺损型氟斑牙病例,氟斑牙流行强度为“阴性”,较2015年49.75%的检出率有显著下降。(3)成人氟骨症患病率为1.92%,患者均为氟骨症轻度。(4)儿童尿氟几何均数为0.39mg/L,范围为0.02-2.54mg/L,尿氟含量明显低于世界卫生组织(WHO)推荐的儿童尿氟水平。(5)辣椒氟含量范围为0.26-13.46mg/kg,中位数为0.96mg/kg;大米氟含量范围为0.13-2.2mg/kg,中位数为0.42mg/kg;玉米氟含量范围为0.21-2.54mg/kg,中位数为0.43mg/kg。擦拭抹灰和淘洗两种处理方式均能显著降低辣椒氟含量,淘洗降氟效果比擦拭更明显。(6)空气氟经实验室检测均未超标(20ug/m3),密闭样本中位数为0.32ug/m3,范围是0.11-0.74ug/m3,敞烧样本中位数是1.22ug/m3,范围是0.46-3.71ug/m3。炉灶密闭使用的室内空气样品比敞炉使用样品氟浓度低。(7)水氟含量范围为0.09-0.25 mg/L,中位数为0.1mg/L,未检出超标水样。(8)五年级小学生燃煤型氟中毒防治知识总知晓率为80.93%,家庭户主燃煤型氟中毒防治知识总知晓率为86.32%,家庭户主燃煤型氟中毒防治知识知晓率高于五年级小学生。粮食正确干燥率为100%,粮食正确保存率为99.74%,炉灶正确使用率为100%,上述数据较2005年基线数据均有较大提高,并且均已达到国家燃煤污染型地方性氟中毒消除标准。(9)改良炉灶后每年每户节煤255千克,按市场价每千克0.4元计算,平均每户每年可节省102元。群众对改良炉灶满意率达到100%。结论:通过实施改炉改灶为主、健康教育为辅的综合性防控措施,鲁甸县燃煤型氟中毒防控效果显著。改炉改灶率、改良炉灶完好率、炉灶正确使用率、粮食正确干燥率和正确保存率等均提升到较高水平,人群健康教育知识知晓率达到80%以上,空气样氟含量均达到国家标准,儿童尿氟和空气氟含量处于正常水平,氟斑牙患病率有明显下降,防控效果显著,鲁甸县各项考评指标已达到国家燃煤型氟中毒病区消除标准,改良炉灶为主、健康教育为辅的防控工作取得了较好的社会效益和经济效益。
[Abstract]:Objective: To evaluate the effect of prevention and control measures on the improved stove and health education in Ludian County, and to provide scientific basis for the next prevention and control strategy and prevention and control measures. Methods: in 2015, the improved stove was implemented in Ludian County for 2005-2011 years, and the improvement of the stove was carried out in 2015. As of the end of 2011, 5 villages and towns were randomly selected in the villages and towns of the wards with the rate of more than 95%, and 2 villages were randomly selected from each township, and compared with the results of the 2005 baseline survey, the general situation of the investigation points (including the distribution of the coal-burning fluorosis areas in Ludian County, the improvement of the stove use, the diet structure and the economic situation of the sick areas, etc.), Changes in the condition of fluorine and coal-burning fluorosis (including air fluorine content, grain fluorine content, children's dental fluorosis and urine fluorine content, adult fluorosis condition), and assessing the health education effect of coal-burning fluorosis (including the correct drying rate of grain, correct survival rate, pre food cleaning rate, etc.) and related behavioral changes. The data were analyzed with SPSS 22 statistical software, the normal distribution measurement data were described by (? X + S), and the normal distribution data were disobedient to the median and four quantile spacing, the ratio or the constituent ratio was compared with the chi square test and non parametric test. Results: (1) the coal-burning fluorosis areas in Ludian county were distributed in 84 villagers' villages. The meeting, involving 101320 households, as of 2011, the improved stove rate of the coal-fired fluorosis area of the county was 97.0%. compared to 2015. In the families surveyed, the average annual income of each household was 24796 yuan and the per capita annual income was 5241 yuan. The crops were mainly corn and potatoes, and the main family staple food was rice. (2) the total dental fluorosis detection rate of 8-12 year old children was 10.14%, the dental fluorosis index was 10.14%. For 0.16, the cases of dental fluorosis were very mild. In the undetected cases, severe fluorosis and defective dental fluorosis cases, the prevalence of dental fluorosis was negative, and the detection rate of 49.75% in 2015 had a significant decrease. (3) the prevalence rate of adult fluorosis was 1.92%, and the patients were all light degree of fluorosis. (4) the number of fluorosis in urine of children was 0.39mg/L, and the range was 0.02-2.5 4mg/L, the urine fluorine content was significantly lower than that recommended by WHO (WHO). (5) the range of fluorine content in chili was 0.26-13.46mg/kg, the median was 0.96mg/kg, the range of fluorine content in rice was 0.13-2.2mg/kg, the median was 0.42mg/kg, the range of maize fluorine content was 0.21-2.54mg/kg, the median was 0.43mg/kg. wipe plastering and cleaning two kinds. The method can significantly reduce the content of fluorine in chili pepper. (6) the air fluorine has not exceeded the standard (20ug/m3), the median of the closed sample is 0.32ug/m3, the range is 0.11-0.74ug/m3, the median of the open sample is 1.22ug/m3, the range is the indoor air sample used in the 0.46-3.71ug/m3. stove, which is better than the open stove. The concentration of fluorine in the sample was low. (7) the range of water fluorine content was 0.09-0.25 mg/L, the median was 0.1mg/L, no excess water samples were detected. (8) the total knowledge rate of prevention and control of coal burning fluorosis in grade five pupils was 80.93%, and the total knowledge rate of prevention and control of coal burning fluorosis in family heads was 86.32%, and the knowledge rate of prevention and control of coal burning fluorosis in household heads was higher than that of family heads. The correct rate of grain drying in grade five was 100%, the correct preservation rate of grain was 99.74%, and the correct use rate of the stove was 100%. The above data were greatly improved compared with the baseline data in 2005, and all of them had reached the national standard of eliminating local fluorosis in the national coal combustion type. (9) after the improvement of the stove, the coal was 255 kilograms per household per household each year and 0 per kilogram at the market price. .4 yuan per household can save 102 yuan per household per year. The satisfaction of the masses to the improved stove reached 100%. conclusion: through the implementation of the comprehensive prevention and control measures supplemented by the reform of the stove and the health education, the effect of the coal-burning fluorosis in Ludian county is remarkable. The rate of correct preservation was raised to a higher level, the awareness rate of health education knowledge of the crowd was above 80%, the content of fluorine in air all reached the national standard, the Urine Fluorine and air fluorine content in children were at the normal level. The prevalence rate of dental fluorosis was obviously decreased and the prevention and control effect was significant. The evaluation indexes of Ludian county had reached the state coal-burning fluorosis disease. The elimination of standards, improvement of stoves and supplemented by health education have achieved better social and economic benefits.

【学位授予单位】：大理大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R599.1

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