2010年山东省地方性氟中毒重点调查结果与分析

摘要

目的 了解山东省4个县(市)正常运转的改水降氟工程水氟含量及地方性氟中毒病情现状,为制订防治策略提供科学依据.方法 按照《山东省地方性氟中毒监测方案》要求,2010年5-11月对高密、嘉祥、郓城、博兴县(市)正常运转的改水工程使用情况、水氟含量进行调查.同时在4个县(市)重点调查了9个村居民饮水含氟量,儿童氟斑牙患病情况和尿氟含量.水、尿氟检测应用离子选择性电极法,儿童氟斑牙检查采用Dean法.结果 4个县(市)共调查288处正常运转改水工程,水氟均值为1.35 mg/L,最大值为6.27 mg/L;水氟合格工程148处(≤1.00 mg/L),合格率为51.39％,不合格率为48.61％.检测9个重点调查村居民饮用水26份,水氟均值为2.02 mg/L,水氟范围为0.62～ 4.36 mg/L;检查8～12岁儿童685人,检出氟斑牙549例,总检出率为80.14％,牙齿缺损率为15.33％( 105/685),氟斑牙指数为1.56;检测儿童尿样379份,尿氟几何均数为3.04 mg/L,尿氟范围为0.66 ～ 13.28 mg/L.结论 本次调查的4个县(市),近50％的改水工程水氟超标(＞1.00 mg/L),9个调查村儿童氟斑牙氟总检出率超过80％,说明山东省氟中毒病区居民病情仍然较重,防治形势依然严峻.%Objective To investigate the water fluoride level of the water improvement project and the prevalent condition of endemic fluorosis in 4 counties in Shandong province,and to provide a scientific basis for the development of control strategies to endemic fluorosis.Methods According to “Shandong Province Survey Scheme of Endemic Fluorosis”,the service conditions of normal operated water improvement project and water fluoride content were investigated in Gaomi,Jiaxiang,Yuncheng and Boxing counties from May to November in 2010.The fluoride content in drinking water,the prevalence of dental fluorosis and urinary fluoride in children were investigated in nine major survey villages of the four counties.Water and urinary fluoride were determined by ion selective electrode and examination of dental fluorosis was done by using Dean method.Results A total of 288normal operated water improvement projects were examined in the 4 counties,the qualified rate of water fluoride (≤ 1.00 mg/L) of the projects was 51.39％(148/288),mean water fluoride was 1.35 mg/L and the maximum value was 6.27 mg/L.A total of 26 copies of drinking water samples were measured,the fluoride content ranged from 0.62mg/L to 4.36 mg/L,and mean water fluoride was 2.02 mg/L.A total of 685 children aged 8 to 12 were examined in the major investigated villages,the detection rate of dental fluorosis was 80.14％ (549/685),detectable rate of the defective dental fluorosis was 15.33％ (105/685),and dental fluorosis index was 1.56.Three hundred and seventynine copies of child urine samples were tested,the geometric mean of urinary fluoride were 0.66 - 13.28 mg/L,and the average was 3.04 mg/L.Conclusions Nearly 50％ of the water fluoride level of the water improvement project exceeds the standard ( ＞ 1.00 mg/L) in the 4 countries.The detection rate of dental fluorosis exceeds 80％ and urinary fluoride is significantly exceeds the standard in the major investigated villages.The endemic fluorosis is still serious and the situation of prevention and control of the disease is still grim.