摘要：
Objective To analyze the operation of water improvement projects in drinking water-borne fluorosis areas of Qinghai Province and the trend of dental fluorosis in children aged 8 to 12 years, and to evaluate the effects of prevention and control measures comprehensively, so as to provide basis for improving prevention and control strategies. Methods In 2009 - 2017, according to the "Qinghai Drinking Water Endemic Fluorosis Surveillance Program", four project counties of Huangyuan, Minhe, Hualong and Guide were selected in Qinghai Province. Three villages in each project county were selected according to their mild, moderate and severe conditions, and monitored the operation of water improvement projects, water fluoride content and dental fluorosis among children aged 8 to 12-year-old in each diseased village. Results In 2009-2017, the normal operation rate of water improvement projects increased from 2/8 to 7/8; the batch operation rate of the projects decreased from 5/8 to 1/8; the number of abandoned projects decreased from 1 to 0; the number of people covered by qualified water fluoride increased from 9962 to 80760 people; there was no significant difference in water fluoride content between different years (F = 0.758, P > 0.05). The total detection rate of children's dental fluorosis was 33.01％(1812/5489) from 2009 to 2017, the index of dental fluorosis was 0.65, and the epidemic intensity was slightly prevalent;the detection rate of children's dental fluorosis was 30.02％(951/3168) in villages with normal operation of water improvement projects and qualified water fluoride content, the index of dental fluorosis was 0.58, and the epidemic intensity was marginal;the detection rate of children's dental fluorosis was 32.72％(583/1782) in villages with abnormal operation of water improvement projects or excessive fluoride, the index of dental fluorosis was 0.66, and the epidemic intensity was slight; the detection rate of children's dental fluorosis in villages without changing the water was 51.58％ (278/539), and the index of dental fluorosis was 1.04, belonging to the moderate epidemic intensity; the detection rate of children's dental fluorosis in villages without changing the water was significantly higher than that in villages with normal operation of water improvement projects and qualified water fluoride content (χ2 = 102.30, P 0.05).2009-2017年,儿童氟斑牙总检出率为33.01％(1812/5489),氟斑牙指数为0.65,流行强度为轻微流行;改水工程运转正常且水氟含量合格村的儿童氟斑牙检出率为30.02％(951/3168),氟斑牙指数为0.58,流行强度为边缘流行;改水工程非正常运转或水氟含量超标村的儿童氟斑牙检出率为32.72％(583/1782),氟斑牙指数为0.66,流行强度为轻微流行;未改水村儿童氟斑牙检出率为51.58％(278/539),氟斑牙指数为1.04,属中度流行强度;未改水村儿童氟斑牙检出率显著高于改水工程运转正常且水氟含量合格村(χ2=102.30,P<0.01).结论 饮水型氟中毒病区内的改水工程运行良好,运转率逐年上升.改水工程正常运转且水氟含量合格村的8～12岁儿童氟斑牙检出率明显低于未改水病区村.应加强氟中毒病情监测和改水工程的后期维护,尽快解决未改水村居民的饮水问题.
