Objective The purpose of the study was to explore the effects of different ways of water improvement and water usage on fluorosis prevention and population health,and to provide a basis for scientific prevention and control of drinking-water-borne-fluorosis in the future.Methods Villages with and without the water-improvement project were selected as monitoring points and classified as the water-unimprovement villages,the water-improvement villages with unqualified fluoride level,the incomplete water-improvement villages (fluoride level was reduced through a certain equipment),and the complete water-improvement villages(surface water improvement).Dental fluorosis of children aged 8 to 12 in the villages was monitored by Dean method in 2007,2010 and 2012,respectively.Results Detectable rates of 8-10 years old Children in water-unimprovemt village were 59.3％(131/221) in 2010 and 58.7％(145/247) in 2012(x2 =0.02,P ＞ 0.05); These Two indicators in water-improvement with unqualified fluoride villages were 25.6％(22/86) in 2010 and 51.5％(35/68) in 2012 (x2 =10.85,P ＜ 0.05); Two indicators in incomplete water-improvement villages were 98.9％ (91/92) in 2007,98.7％ (76/77) in 2010,and 92.9％(65/70) in 2012(x2 =10.85,P ＜ 0.05); Two indicators in complete water-improvement villages were 94.0％(188/200) in 2010 and 83.0％(185/223) in 2012(x2 =12.30,P ＜ 0.05).Conclusions Complete water-improvement (surface water improvement) has the greatest impact on population health improvement lived in the drinking-water-boren fluorosis areas.Though the dental fluorosis detectable rate has decreased,the health effect is not obvious in the incomplete water-improvement villages (fluoride level was reduced through a certain equipment).Complete water-improvement is the best choice to improve the control and prevention effect on drinking-water-borne-fluorosis.%目的 了解不同改水方式和用水方法对饮水型氟中毒防控效果的影响和人群健康效应,为科学防控饮水型氟中毒工作提供依据.方法 2007、2010、2012年,在天津市,按不同改水方式将病区村分为未改水村、改水工程水氟不合格村、未完全改水(设备降氟)工程村和完全改水(改地面水)工程村.以病区村8～ 12岁儿童为监测人群,按照Dean法进行氟斑牙监测.结果 2010、2012年未改水村8～12岁儿童氟斑牙检出率分别为59.3％(131/221)、58.7％(145/247),组间比较差异无统计学意义(x2=0.02,P＞0.05);2010、2012年改水工程水氟不合格村8～ 12岁儿童氟斑牙检出率分别为25.6％(22/86)、51.5％(35/68),组间比较差异有统计学意义(x2=10.85,P＜ 0.05);2007、2010、2012年未完全改水工程村8～ 12岁儿童氟斑牙检出率分别为98.9％(91/92)、98.7％ (76/77)、92.9％ (65/70),组间比较差异有统计学意义(x2=6.19,P＜ 0.05);2010、2012年完全改水村8～ 12岁儿童氟斑牙检出率分别为94.0％(188/200)、83.0％(185/223),组间比较差异有统计学意义(x2=12.30,P＜0.05).结论 天津市完全改水工程(改地面水)对饮水型氟中毒病区人群防病效应影响最大;不完全改水工程(设备降氟工程)经过近10年的使用,监测人群氟斑牙检出率虽有下降,但健康效果不明显,采用完全改水方式是提高饮水型氟中毒防控效果的最佳选择.
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