本文關(guān)鍵詞： 飲用水 地方性飲水型氟中毒 衛(wèi)生監(jiān)測(cè) 農(nóng)村　出處：《環(huán)境與健康雜志》2017年04期 　論文類型：期刊論文

【摘要】：目的掌握山東省飲水型地方性氟中毒病區(qū)防治措施落實(shí)效果及病情動(dòng)態(tài)。方法于2009—2014年在山東省飲水型地方性氟中毒病區(qū),按照國(guó)家《飲水型地方性氟中毒監(jiān)測(cè)方案》和《山東省飲水型地方性氟中毒監(jiān)測(cè)方案》規(guī)定的方法和要求,抽取10個(gè)監(jiān)測(cè)縣,每個(gè)監(jiān)測(cè)縣隨機(jī)抽取10個(gè)改水降氟工程,調(diào)查其運(yùn)行效果,并測(cè)定水氟濃度;每個(gè)監(jiān)測(cè)縣選擇3個(gè)病區(qū)村作為固定監(jiān)測(cè)村,調(diào)查改水村改水工程運(yùn)行情況及水含氟量,檢測(cè)未改水村飲水氟濃度,檢查8~12歲兒童氟斑牙患病情況,對(duì)25歲以上成人進(jìn)行氟骨癥X線檢查和尿氟檢測(cè)。結(jié)果在監(jiān)測(cè)縣中,共監(jiān)測(cè)改水降氟工程511個(gè),正常運(yùn)轉(zhuǎn)率為97.06%(354/511),水氟合格率為55.19%(282/511)。在165個(gè)已改水村中,共監(jiān)測(cè)147個(gè)改水工程,正常運(yùn)轉(zhuǎn)率為97.28%(143/147),水氟合格率為62.59%(92/147)。在12個(gè)未改水監(jiān)測(cè)村,水氟1.20 mg/L的村占58.33%(7/12)。2009—2014年全部監(jiān)測(cè)村8~12歲兒童氟斑牙檢出率平均為50.10%(4 563/9 107),氟斑牙指數(shù)為1.0,氟斑牙檢出率呈逐年下降趨勢(shì)(χ~2=172.69,P0.01)。改水工程正常運(yùn)行且水氟合格監(jiān)測(cè)村兒童氟斑牙的檢出率為44.81%(2 543/5 675),氟斑牙指數(shù)為0.87,氟斑牙檢出率呈逐年下降趨勢(shì)(χ~2=248.30,P0.01)。改水工程非正常運(yùn)行或水氟超標(biāo)監(jiān)測(cè)村兒童氟斑牙的檢出率為61.10%(1 750/2 864),氟斑牙指數(shù)為1.26。未改水監(jiān)測(cè)村兒童氟斑牙的檢出率為47.54%(270/568),氟斑牙指數(shù)為1.07。改水工程正常運(yùn)行且水氟合格監(jiān)測(cè)村的兒童氟斑牙檢出率低于改水工程非正常運(yùn)行或水氟超標(biāo)的監(jiān)測(cè)村(χ~2=202.11,P0.01)。2009和2014年度25歲及以上成人氟骨癥X線檢出率分別為8.04%(119/1 481)和7.25%(106/1 463)。2014年水氟合格村和水氟超標(biāo)村成人尿氟幾何均值均低于正常值上限(1.60 mg/L)。結(jié)論山東省改水防治飲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標(biāo)問(wèn)題較為嚴(yán)重,氟中毒病情尚未得到全面控制,防治工作有待進(jìn)一步強(qiáng)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.
【作者單位】： 山東省地方病防治研究所氟中毒與大骨節(jié)病防治研究科;
【基金】：中央補(bǔ)助地方重大公共衛(wèi)生服務(wù)地方病防治項(xiàng)目(2009-2014) 山東省醫(yī)藥衛(wèi)生科技發(fā)展計(jì)劃項(xiàng)目(2014WS0390)
【分類號(hào)】：R181.8;R599.1
【正文快照】： 飲水型地方性氟中毒(以下簡(jiǎn)稱地氟病)是由于人們長(zhǎng)期飲用高氟水所致的兒童牙齒和成人骨骼病變的疾病,是嚴(yán)重危害人體健康的地方病之一[1-3]。山東省地處黃河下游沖積平原地帶,是我國(guó)飲水型地方性氟中毒危害最為嚴(yán)重的省份之一[4]。自20世紀(jì)80年代實(shí)施以改水降氟為主的防治措施

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