2007年山东省鲁西南地区地方性氟中毒防治现状调查

摘要

目的 了解山东省鲁西南地区地方性氟中毒防治现状.方法 2007年对鲁西南地区主要地方性氟中毒病区嘉祥、郓城、梁山3个县降氟改水措施落实情况、改水设施使用运行状况、饮水含氟量(采用离子选择性电极法)及居民的有关氟中毒病情指标『尿氟、8～12岁儿童氟斑牙(采用Dean法)、成人临床及X线氟骨症、成人心电图改变]进行了调查与检测.结果 3个县共有病村1371个,改水降氟工程完成率为53.61%(735/1371),嘉祥、郓城、梁山3个县完成率分别为38.0%(220/579)、65.51%(378/577)、63.72%(137/215);改水设施使用正常的病村占已改水病村的76.73%(564/735),报废率为23.27%(171/735);抽查3个县改水工程水263处,含氟量符合国家标准(≤1.0 mg/L)的占64.64%(170/263),超标率为35.36%(93/263),水氟最大值为4.17mg/L.检测3个县13个病村440例8～12岁儿童与484例30岁以上成人即时尿氟,几何均值分别为2.98、3.06 mg/L,个体最大值分别是12.83、14.49 mg/L;8～12岁儿童氟斑牙检出率为84.28%(649/770),缺损率为17.66%(136/770),氟斑牙指数为1.89;30岁以上成人临床与X线氟骨症检出率分别为44.40%(234/527)、24.67%(130/527);成人心电图异常检出率为32.43%(168/518),主要表现为T波异常.结论 山东省鲁西南地区改水降氟措施落实进度比较缓慢,改水工程水含氟量超标严重,病情尚未得到有效控制.%Objective To understand the current status of the prevention and control of endemic fluorosis in the southwestern area of Shandong province. Methods In 2007, the progress of water-improving defluoridation, the operating state and water fluoride content of the water-improving project, which was determined by fluorosis selective ion electrode, and the inhabitant related indexes of endemic fluorosis were extensively surveyed in the three main fluorosis counties-Jiaxiang, Yuncbeng and Liangshan of the southwestern area of Shandong province. Results Among 1371 fluorosis villages in the 3 counties, 53.61%(735/1371) of which had undergone water-improving defluoridation, the rate in Jiaxiang, Yuncheng and Liangshan being 38.0% (220/579),65.51% (378/577) and 63.72% ( 137/215 ) respectively; the normally functioning rate of this project was 76.73% (564/735), projects out of order accounted for 23.27% (171/735). Among 263 well-functioning projects from the three counties, the rate with water fluoride higher than 1.0 mg/L was 35.36%(93/263), the maximum value being 4.17 mg/L. The urine fluoride content of 440 children aged 8 - 12 years and 484 adults over 30 years old were examined in 13 fluorosis villages of the three counties, the geometric mean was 2.98,3.06 mg/L respectively; the individual maximum was 12.83,14.49 mg/L respectively; the detectable rate of dental fluorosis among children aged 8 - 12 was 84.28% (649/770) ,17.66%(136/770) had defect and the index of dental fluorosis was 1.89; the rates of the clinical and X-ray skeletal fluorosis of the adults aged more than 30 were 44.40%(234/527) and 24.67%(130/527) respectively, and the abnormal electrocardiography rate was 32.43% (168/518) in the adult, mostly T-wave abnormality. Conclusions The progress of the water-improving defluoridation in the southwestern area of Shandong province was relatively slow, the water fluoride content of the water-improving projects seriously exceeded standard, and the condition of the fluorosis had not been effectively controlled.