2011-2015年四川省燃煤污染型地方性氟中毒监测结果分析
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摘要
目的分析四川省燃煤污染型地方性氟中毒流行趋势,为调整防治措施提供依据。方法按照《四川省燃煤污染型氟中毒监测方案》的要求,选择古蔺县、叙永县、兴文县、珙县和旺苍县5个县为监测县,每个县按方位选择了5乡,每乡随机选择1个村,监测炉灶使用情况,玉米、辣椒的干燥、保管和淘洗情况,成人氟骨症和儿童氟斑牙及尿氟情况。结果敞炉敞灶使用率呈下降趋势,5年使用率平均分别为8.20%(155/1 890)和10.42%(197/1 890)。改良炉使用率基本保持不变。改良灶、电热器、电炊具等其他灶具使用率呈上升趋势。改良炉、改良灶质量合格率、改良炉的正确使用率、改良灶的正确使用率均呈上升趋势,改良炉和改良灶的5年正确使用率平均分别为96.84%(1 503/1 650)和93.15%(1 047/1 420)。成人氟骨症检出率49.66%,儿童氟斑牙检出率呈下降趋势,2015年检出率为16.29%(308/1 891)。结论四川省燃煤污染型地方性氟中毒病区儿童氟斑牙病情正逐年减轻,成人氟骨症检出率较高,还应继续采取积极的防治措施。
Objective To analyze the prevalence trend of coal-burning-born endemic fluorosis in Sichuan Province and provide a basis for adjustment of control measures. Methods In accordance with the requirements in Programme for Surveillance of Coal-burning-borne Endemic Fluorosis in Sichuan Province,five counties including Gulin,Xuyong,Xingwen,Gongxian and Wangcang were selected as surveillance counties. In each county,five towns were selected according to the locations,and in each town one village was randomly selected.Use of stoves,drying,storage and washing of corn and pepper as well as skeletal fluorosis in adults and dental fluorosis and urine fluoride of children aged 8 to 12 were monitored. Results The use rate of open furnaces and open stoves showed declining trends. The 5-year average use rates were 8. 20%(155/1 890) and 10. 42%(197/1 890),respectively. The use rate of modified furnaces remained essentially unchanged. Use rates of modified stoves,electric heaters and electric cookers showed increasing trends. Conformity rates and correct use rates of modified furnaces and modified stoves showed increasing trends. The average 5-year correct use rates of modified furnaces and modified stoves were 96. 84%(1 503/1 650) and 93. 15%(1 047/1 420),respectively. The detection rate of skeletal fluorosis in adults was 49. 66%. The detection rate of dental fluorosis in children showed a decreasing trend and was 16. 29%(308/1 891) in 2015. Conclusion The condition of pediatric dental fluorosis in epidemic regions of coal-burning-borne fluorosis in Sichuan Province is remitting yearly,but the detection rate of skeletal fluorosis in adults is still high. We should continue to take active measures to prevent and control endemic fluorosis.
Objective To analyze the prevalence trend of coal-burning-born endemic fluorosis in Sichuan Province and provide a basis for adjustment of control measures. Methods In accordance with the requirements in Programme for Surveillance of Coal-burning-borne Endemic Fluorosis in Sichuan Province,five counties including Gulin,Xuyong,Xingwen,Gongxian and Wangcang were selected as surveillance counties. In each county,five towns were selected according to the locations,and in each town one village was randomly selected.Use of stoves,drying,storage and washing of corn and pepper as well as skeletal fluorosis in adults and dental fluorosis and urine fluoride of children aged 8 to 12 were monitored. Results The use rate of open furnaces and open stoves showed declining trends. The 5-year average use rates were 8. 20%(155/1 890) and 10. 42%(197/1 890),respectively. The use rate of modified furnaces remained essentially unchanged. Use rates of modified stoves,electric heaters and electric cookers showed increasing trends. Conformity rates and correct use rates of modified furnaces and modified stoves showed increasing trends. The average 5-year correct use rates of modified furnaces and modified stoves were 96. 84%(1 503/1 650) and 93. 15%(1 047/1 420),respectively. The detection rate of skeletal fluorosis in adults was 49. 66%. The detection rate of dental fluorosis in children showed a decreasing trend and was 16. 29%(308/1 891) in 2015. Conclusion The condition of pediatric dental fluorosis in epidemic regions of coal-burning-borne fluorosis in Sichuan Province is remitting yearly,but the detection rate of skeletal fluorosis in adults is still high. We should continue to take active measures to prevent and control endemic fluorosis.
引文
[1]GB17018-2011地方性氟中毒病区划分[S].2011.
[2]陈敬,杨小静,邓启才,等.2006-2010年四川省燃煤型地氟病监测报告[J].预防医学情报杂志,2013,29(7):543-547.
[3]fawell J,Bailey K,Chilton J,et al.Fluoride in drinking-water[M].2rd edition,London:National Academies Press,2006:13-20.
[4]陈秉衡,屈卫东.世界卫生组织对氟化物的卫生评价[J].中国地方病学杂志,2000,19(6):477-478.
[5]Akers D.J.The redistribution of trace elements during the benefication of coal[A].In:Swaine D.J,Goodarzi F.Environmental aspects of trace elements in coal[M].Dordrecht:Kluwer Academic Publishers,1995:93-110.
[6]吴代赦.中国煤中氟的环境地球化学研究[D].中国科学院地球化学研究所,2004.
[7]刘文东,李金娟,郭兴强,等.贵州省贫困农村氟污染现状及贡献源分析[J].地球与环境,2013,41(2):138-141.
[8]Wasowicz W,Golebiowska M,Chlebna-Sokol D.Increased urinary excretion of selenium in children[J].Trace elements in medicine,1988,5(1):43-46.
[9]边建朝,戚树梅,王学松,等.氟中毒患者口服亚硝酸钠对体氟及抗氧化酶类的影响[J].氟研究通讯,1994,16(1):56-60.
[10]曹静祥.硒硼拮抗氟中毒研究进展[J].卫生研究,2002,31(6):472-473.
[2]陈敬,杨小静,邓启才,等.2006-2010年四川省燃煤型地氟病监测报告[J].预防医学情报杂志,2013,29(7):543-547.
[3]fawell J,Bailey K,Chilton J,et al.Fluoride in drinking-water[M].2rd edition,London:National Academies Press,2006:13-20.
[4]陈秉衡,屈卫东.世界卫生组织对氟化物的卫生评价[J].中国地方病学杂志,2000,19(6):477-478.
[5]Akers D.J.The redistribution of trace elements during the benefication of coal[A].In:Swaine D.J,Goodarzi F.Environmental aspects of trace elements in coal[M].Dordrecht:Kluwer Academic Publishers,1995:93-110.
[6]吴代赦.中国煤中氟的环境地球化学研究[D].中国科学院地球化学研究所,2004.
[7]刘文东,李金娟,郭兴强,等.贵州省贫困农村氟污染现状及贡献源分析[J].地球与环境,2013,41(2):138-141.
[8]Wasowicz W,Golebiowska M,Chlebna-Sokol D.Increased urinary excretion of selenium in children[J].Trace elements in medicine,1988,5(1):43-46.
[9]边建朝,戚树梅,王学松,等.氟中毒患者口服亚硝酸钠对体氟及抗氧化酶类的影响[J].氟研究通讯,1994,16(1):56-60.
[10]曹静祥.硒硼拮抗氟中毒研究进展[J].卫生研究,2002,31(6):472-473.