Objective To find out the effect of improving cooking stove to reduce fluoride in burning coal fluorosis areas in Ankang city Shaanxi province,and to provide a basis for continuing the consolidation of control measures and the elimination of the hazards of burning coal fluorosis.Methods According to the results of a census of 2001 in Ankang city on burning coal fluorosis,cluster sampling method was used in 2009,and 10％ of the diseased villages were included in the study according to the state of the disease(mild,moderate and severe) in seven counties.In each selected village 10 households were selected,and the quality of improved stoves was checked door to door,maintenance and satisfaction of the stoves were asked on the spot,and health education questionnaire was carried out among housewives.Thirty village primary schools were investigated,dental fluorosis of children aged 8 to 12 was checked by Dean method,urinary fluoride was tested by ion selective electrode,health education and knowledge questionnaire survey was curried out.Results A total of 1000 households were investigated in the seven diseased counties,and the completion rate of improved stoves was 90.00％ (900/1000);the rate of improved stoves in good condition was 87.14％ (630/723); overall use of improved stoves was 80.33％(723/900); proper use of improved stoves was 79.39％ (574/723),satisfaction rate of improved stoves was 86.89％(782/900),and self-maintenance of improved stoves was 8.00％(72/900).Total detection rate of dental fluorosis of children aged 8 to 12 was 23.74％(509/2144),dental fluorosis index was 0.50.Awareness of prevention knowledge among housewives and students was 65.20％ (2608/4000) and 83.36％(4518/5420),respectively.A total of 358 urine samples of children aged 8 to 12 were tested,urine fluoride ranged 0.16 - 6.35 mg/L,and geometric mean 0.79 mg/L.Conclusions The implementation of defluoridation project by improving cooking stove has achieved the goal of prevention and treatment of fluoride poisoning in burning coal fluorosis areas of Ankang city.Local residents are satisfied with the improved stoves,and most of the improved stoves are used constantly.The detection rate of dental fluorosis is less than 30％ of the control line.Some furnace are damaged,correct usage rate is not high.There is a need to further strengthen the management of the project and strengthen health education interventions to improve stove maintenance outlets,and make sustained control of the disease.%目的 了解陕西省安康市燃煤污染型氟中毒病区改灶降氟效果,为持续巩固防制措施和消除燃煤型氟中毒危害提供依据.方法 依据2001年安康市燃煤污染型氟中毒病区病情普查结果,2009年采取整群抽样方法,在7个病区县按照病情轻、中、重各抽取10％的病区村,在每个村中抽取10户农户,逐户对改良炉灶质量、使用情况进行现场查看,询问农户改良炉灶维修情况和满意度,并对家庭主妇进行健康教育知识问卷调查.同时抽取30所病区村小学,Dean法检查8～ 12岁儿童氟斑牙,氟离子选择电极法检测儿童尿氟,并进行健康教育知晓情况问卷调查.结果 7个病区县共调查1000户,改良炉灶完成率为90.00％(900/1000)；改良炉灶总体使用率为80.33％ (723/900)；改良炉灶完好率为87.14％(630/723)；改良炉灶正确使用率为79.39％(574/723);改良炉灶的满意率为86.89％(782/900)；改良炉灶的自行维修率为8.00％(72/900).8～12岁儿童氟斑牙总检出率为23.74％( 509/2144),氟斑牙指数为0.50,流行程度为边缘.家庭主妇、学生防治知识知晓率分别为65.20％ (2608/4000)、83.36％(4518/5420).检测8～ 12岁儿童尿样358份,尿氟范围为0.16～6.35mg/L,几何均数为0.79 mg/L.结论 安康市燃煤污染型氟中毒病区实施降氟改灶项目达到防治氟中毒效果,群众对改良炉灶较为满意,大多数改良炉灶继续使用,儿童氟斑牙检出率达到控制线(30％)以下.病区炉具有损坏,主动维修率低,病区群众知晓率较低,炉灶正确使用率不高,需进一步加强项目后期管理和强化健康教育干预工作,完善炉灶维修网点,使燃煤污染型氟中毒病区改灶降氟效果得到持续控制.
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