本文選題：燃煤污染型地方性氟中毒 + 魯?shù)榭h　； 參考：《大理大學(xué)》2016年碩士論文

【摘要】：目的:通過現(xiàn)場調(diào)查、實驗室檢測對魯?shù)榭h燃煤型地方性氟中毒病區(qū)的改良爐灶、健康教育等防控措施的防治效果進行評價,為制定下一步防控策略和防控措施提供科學(xué)依據(jù)。方法:2015年在魯?shù)榭h內(nèi)選擇2005-2011年實施了改良爐灶項目,且截至2011年底總改爐改灶率≥95%的病區(qū)鄉(xiāng)鎮(zhèn)中隨機抽取5個鄉(xiāng)鎮(zhèn),每個鄉(xiāng)鎮(zhèn)隨機抽取2個自然村,與2005基線調(diào)查結(jié)果比較,了解調(diào)查點的一般情況(包括魯?shù)榭h燃煤型氟中毒病區(qū)分布、改良爐灶使用情況、病區(qū)膳食結(jié)構(gòu)及經(jīng)濟情況等),以及氟污染和燃煤型氟中毒病情的變化(包括空氣氟含量、糧食氟含量、兒童氟斑牙患病情況和尿氟含量、成人氟骨癥患病情況),并評估燃煤型氟中毒健康教育效果(包括糧食正確干燥率、正確保存率、食前淘洗率等)和相關(guān)行為轉(zhuǎn)變情況。對所得數(shù)據(jù)采用SPSS 22.0統(tǒng)計軟件進行分析,正態(tài)分布計量資料采用(?x±S)描述,不服從正態(tài)分布資料采用中位數(shù)和四分位數(shù)間距,率或構(gòu)成比的比較采用卡方檢驗、非參數(shù)檢驗等統(tǒng)計學(xué)方法。結(jié)果:(1)魯?shù)榭h燃煤型氟中毒病區(qū)分布在84個村委會,涉及101320戶,截至2011年,全縣燃煤型氟中毒病區(qū)改良爐灶率達97.0%。較2015年,在調(diào)查的家庭中,每戶平均年收入24796元,人均年收入5241元。農(nóng)作物以玉米和土豆為主,家庭主食以大米為主。(2)8-12歲兒童氟斑牙總檢出率為10.14%,氟斑牙指數(shù)為0.16,氟斑牙病例以極輕度為主,未檢出中、重度氟斑牙和缺損型氟斑牙病例,氟斑牙流行強度為“陰性”,較2015年49.75%的檢出率有顯著下降。(3)成人氟骨癥患病率為1.92%,患者均為氟骨癥輕度。(4)兒童尿氟幾何均數(shù)為0.39mg/L,范圍為0.02-2.54mg/L,尿氟含量明顯低于世界衛(wèi)生組織(WHO)推薦的兒童尿氟水平。(5)辣椒氟含量范圍為0.26-13.46mg/kg,中位數(shù)為0.96mg/kg;大米氟含量范圍為0.13-2.2mg/kg,中位數(shù)為0.42mg/kg;玉米氟含量范圍為0.21-2.54mg/kg,中位數(shù)為0.43mg/kg。擦拭抹灰和淘洗兩種處理方式均能顯著降低辣椒氟含量,淘洗降氟效果比擦拭更明顯。(6)空氣氟經(jīng)實驗室檢測均未超標(20ug/m3),密閉樣本中位數(shù)為0.32ug/m3,范圍是0.11-0.74ug/m3,敞燒樣本中位數(shù)是1.22ug/m3,范圍是0.46-3.71ug/m3。爐灶密閉使用的室內(nèi)空氣樣品比敞爐使用樣品氟濃度低。(7)水氟含量范圍為0.09-0.25 mg/L,中位數(shù)為0.1mg/L,未檢出超標水樣。(8)五年級小學(xué)生燃煤型氟中毒防治知識總知曉率為80.93%,家庭戶主燃煤型氟中毒防治知識總知曉率為86.32%,家庭戶主燃煤型氟中毒防治知識知曉率高于五年級小學(xué)生。糧食正確干燥率為100%,糧食正確保存率為99.74%,爐灶正確使用率為100%,上述數(shù)據(jù)較2005年基線數(shù)據(jù)均有較大提高,并且均已達到國家燃煤污染型地方性氟中毒消除標準。(9)改良爐灶后每年每戶節(jié)煤255千克,按市場價每千克0.4元計算,平均每戶每年可節(jié)省102元。群眾對改良爐灶滿意率達到100%。結(jié)論:通過實施改爐改灶為主、健康教育為輔的綜合性防控措施,魯?shù)榭h燃煤型氟中毒防控效果顯著。改爐改灶率、改良爐灶完好率、爐灶正確使用率、糧食正確干燥率和正確保存率等均提升到較高水平,人群健康教育知識知曉率達到80%以上,空氣樣氟含量均達到國家標準,兒童尿氟和空氣氟含量處于正常水平,氟斑牙患病率有明顯下降,防控效果顯著,魯?shù)榭h各項考評指標已達到國家燃煤型氟中毒病區(qū)消除標準,改良爐灶為主、健康教育為輔的防控工作取得了較好的社會效益和經(jīng)濟效益。
[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.

【學(xué)位授予單位】：大理大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R599.1

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