目的 了解和评价山西省定襄县氟中毒流行现状和改水降氟防治效果。 方法 按照山西省2008年度《中央补助地方公共卫生专项资金饮水型地方性氟中毒防治项目技术方案》,水氟测定采用地方性氟中毒病区饮水氟化物的测定方法(WS/T 106);尿氟测定采用离子选择电极法(WS/T 89);氟斑牙诊断采用Dean's法,并记录牙齿缺损情况;临床氟骨症诊断采用地方性氟骨症诊断及分度标准(WS 192-2007)。 结果 3个监测点水氟含量均超标;8~12岁儿童氟斑牙检出率为60.7%,缺损型氟斑牙检出率为12.1%,氟斑牙指数为1.23;儿童尿氟均值为5.66 mg/L,标准差为1.94 mg/L,范围值3.11~12.4 mg/L;成年人尿氟均值为7.31 mg/L,标准差为2.41 mg/L,范围值4.07~19.5 mg/L;成年人氟骨症临床检出率为8.9%。 结论 监测显示氟中毒病情总体呈下降趋势,但3个监测点水氟、儿童氟斑牙患病率、尿氟含量仍高于正常值。降氟改水工程在80年代末建成,由于年久失修,井管破损严重,氟水向井内渗透,造成水氟含量回升,应加大改水降氟力度,提高防治效果。
Objective To understand the prevalence of fluorosis through water drinking and evaluate the effects of the prevention project by reducing fluorine in water in Dingxiang county. Methods The fluorine in water was detected by detection methods of fluorine in water in endemic fluorosis area(WS/T 106), the fluorine in urine was detected by ion selective electrode method(WS/T 89), the dental fluorosis was diagnosed by Dean's method(tooth defect was recorded)and the clinical fluorosis of bone was diagnosed according to diagnosing and grading standard of endemic fluorosis of bone(WS 192-2007)specified in the technical protocol of prevention and treatment of endemic fluorosis through water drinking. Results The content of fluorine in water in 3 surveillance areas exceeded limit; The detection rate of dental fluorosis was 60.7%, the detection rate of defective dental fluorosis was 12.1% and the dental fluorosis index was 1.23 in children aged 8-12 years, The median of urine fluorine value in children was 5.66 mg/L(ranged from 3.11 mg/L to 12.4 mg/L)and the standard deviation was 1.94 mg/L. The median of urine fluorine value in adults was 7.31 mg/L(ranged from 4.07 mg/L to 19.5 mg/L)and the standard deviation was 2.41 mg/L The detection rate of clinical fluorosis of bone in adults was 8.9%. Conclusion The surveillance indicated that the overall prevalence of fluorosis had declined in 3 surveillance areas, but the content of fluorine in water, the detection rate of dental fluorosis and urine fluorine value in children were still high. It is necessary to improve the quality of the water quality improvement project to reduce fluorine content to reduce the prevalence of endemic fluorosis.