河南省燃煤污染型地方性氟中毒流行现况调查

摘要

目的 掌握河南省燃煤污染型地方性氟中毒(简称地氟病)流行现状,为地氟病的防治工作提供依据.方法 2006、2007年对河南省13个县(市、区)的1832个历史燃煤污染型地氟病病区村燃煤情况、生活习惯、主食、住房结构、水氟等因素进行普查,对仍使用高氟煤的216个村进行重点抽样调查,每村对8～12岁全部儿童进行氟斑牙检查,并采集30份即时尿样检测尿氟.结果 所有历史病区村饮水含氟量<1.0 mg/L;有独立厨房的居民户占93.7%(241 281/257 393),炉灶有排烟设施的占41.9%(107 917/257 393),使用当地高氟煤做饭的户数占28.6%(73 686/257 393);使用当地高氟煤取暖的户数占24.1%(61 924/257 393);主食来源为自产,占病区村的95.7%(1753/1832),均采用自然晾晒的方式干燥粮食;16.2%(35/216)的病区村8～12岁儿童氟斑牙检出率>30.0%,全部集中在洛阳市;77.8%(168/216)的病区村儿童尿氟≤1.50 mg/L.结论 河南省燃煤污染型地氟病病区范围已大大缩小,危害程度明显减轻.其中8个县(市、区)历史病区村8～12岁儿童氟斑牙病情已经达到了病区控制标准,有5个县(市、区)未达到控制标准,集中分布在洛阳市.%Objective To understand the prevailing status of coal-burning endemic fluorosis in Henan, and to provide scientific grounds for endemic fluorosis prevention. Methods Undertook general surveillance on factors such as coal using, living habit, main foods, the structure of the houses and the fluoride content in drinking-water among 1832 historical coal-burning endemic fluorosis villages within 13 counties in 2006 and 2007, and conducted focal point sampling survey on 216 villages which still using local high-fluoride. For all children aged 8-12 years of each village, conducted dental fluorosis examination and collected 30 immediate urinary samples for fluoride content determination. Results The fluoride content in drinking-water of all historical fluorosis villages was below 1.0 mg/L. Households having individual kitchens accounted for 93.7%(241 281/257 393), those with stoves having smoke evacuation devices accounted for 41.9% (107 917/257 393), those using local high-fluoride coal for cooking accounted for 28.6%(73 686/257 393), those using local high-fluoride coal for heating accounted for 24.1%(61 924/257 393). Villages with serf-supply of main foods accounted for 95.7%(1753/1832) of all fluorosis villages. Solar drying food was used in all households. Villages with dental fluorosis detection rate for children aged 8 to 12 years above 30.0% accounted for 16.2%(35/216), which axe all in Luoyang City. Among 77.8%(168/216) of fluorosis villages, children' s urinary fluoride concentrations were no higher than 1.50 mg/L. Conclusions Coal-burning endemic fluorosis areas in Henan Province were decreased greatly and the extent of the health hazard was becoming slightly. The detection rate of dental fluorosis for children aged 8 to 12 years of 8 counties had reached the standard for fluorosis control, whereas the other 5 counties had not yet, all located in Luoyang City.