CAJ | 학술논문

目的了解山东省地方性氟中毒的病情现状,为制订防制策略提供科学依据.方法按照国家《2009年地方病防治项目技术实施方案》和《饮水型地方性氟中毒监测方案(试行)》的要求,选择10个县,了解改水工程进度和运行效果；每个县选择3个村,测定饮用水含氟量,对8～ 12岁儿童进行氟斑牙检杏,对25岁以上成人进行氟骨症检查.水氟测定采用氟离子选择电极法,儿童氟斑牙诊断采用Dean法,氟骨症诊断依据《地方性氟骨症诊断标准》(WS 192-2008).结果在10个县中,共有改水降氟工程687个,改水率为83.34％(3247/3896).调查84个改水工程中,运行基本正常的工程占98.81％(83/84);水氟≤1.20 mg/L的工程有41个,合格率为48.81％(41/84),水氟最大值为5.76 mg/L.调查26个已改水村,水氟均值≤1.20 mg/L的村有15个,占57.69％(15/26);水氟均值＞1.20 mg/L的村有11个,占42.31％(11/26),水氟最大值为5.58 mg/L.调查4个未改水村中,水氟均值≤1.20 mg/L的村1个,＞1.20 mg/L的村3个,水氟最大值为2.92 mg/L.检查已改水村8～ 12岁儿童1331人,氟斑牙检出率为59.73％(795/1331),氟斑牙指数为1.17,缺损率为10.14％(123/1331).检查未改水村8～ 12岁儿童138人,氟斑牙检出率为51.45％(71/138),氟斑牙指数为0.95,缺损率为0.72％(1/138).已改水村和未改水村25岁以上成人的氟骨症X线检出率分别为8.80％(113/1284)和3.05％(6/197).结论山东省改水降氟工程水氟超标严重,地方性氟中毒尚未得到有效控制.
목적 료해산동성지방성불중독적병정현상,위제정방제책략제공과학의거.방법 안조국가《2009년지방병방치항목기술실시방안》화《음수형지방성불중독감측방안(시행)》적요구,선택10개현,료해개수공정진도화운행효과；매개현선택3개촌,측정음용수함불량,대8～ 12세인동진행불반아검행,대25세이상성인진행불골증검사.수불측정채용불리자선택전겁법,인동불반아진단채용Dean법,불골증진단의거《지방성불골증진단표준》(WS 192-2008).결과 재10개현중,공유개수강불공정687개,개수솔위83.34％(3247/3896).조사84개개수공정중,운행기본정상적공정점98.81％(83/84);수불≤1.20 mg/L적공정유41개,합격솔위48.81％(41/84),수불최대치위5.76 mg/L.조사26개이개수촌,수불균치≤1.20 mg/L적촌유15개,점57.69％(15/26);수불균치＞1.20 mg/L적촌유11개,점42.31％(11/26),수불최대치위5.58 mg/L.조사4개미개수촌중,수불균치≤1.20 mg/L적촌1개,＞1.20 mg/L적촌3개,수불최대치위2.92 mg/L.검사이개수촌8～ 12세인동1331인,불반아검출솔위59.73％(795/1331),불반아지수위1.17,결손솔위10.14％(123/1331).검사미개수촌8～ 12세인동138인,불반아검출솔위51.45％(71/138),불반아지수위0.95,결손솔위0.72％(1/138).이개수촌화미개수촌25세이상성인적불골증X선검출솔분별위8.80％(113/1284)화3.05％(6/197).결론 산동성개수강불공정수불초표엄중,지방성불중독상미득도유효공제.
Objective To investigate the current status of endemic fluorosis in Shandong province,and to provide a scientific basis for the development of preventive strategies.Methods In accordance with the requirements of the national "Technical Implementation Plan for Endcmic Disease Control Project in 2009" and "Drinking-Water-Borne Endemic Fluorosis Monitoring Program (trial)",ten counties were selected to carry out the epidemiological investigation,to understand the progress and the effect of the water improvement projects; three villages were selected in each county,to determine fluoride content of drinking water,to check dental fluorosis of children aged 8 to 12 and skeletal fluorosis of adults over the age of 25.Water fluoride content was determined by fluoride ion selective electrode method,children dental fluorosis was diagnosed with Dean method and adults skeletal fluorosis by the National Standard for "Diagnosis of Endemic Skeletal Fluorosis" (WS 192-2008).Results There were a total of 687 improved-water defluoridation projects of the 10 counties,the improved-water rate was 83.34％ (3247/3896).The investigation was taken place in 84 improved-water projects of the 10 counties,the projects running normally accounted for 98.81％ (83/84); 41 projects had water fluoride concentration ≤1.20 mg/L,and the pass rate was 48.81％(41/84),with the maximum water fluoride as 5.76 mg/L.In the 26 villages with improved-water projects of the 10 counties,villages with a mean water fluoride ≤ 1.20 mg/L were 15,which accounted for 57.69％ (15/26),＞ 1.20 mg/L were 11,which accounted for 42.31％ (11/26),with the maximum water fluoride as 5.58 mg/L.In the 4 yet to improve water quality villages of the 10 counties,1 village had mean water fluoride ≤ 1.20 mg/L,3 villages had mean water fluoride ＞ 1.20 mg/L,with the maximum water fluoride as 2.92 mg/L.A total of 1331 children aged 8 to 12 were checked in the 26 improved water villages,the detection rate of dental fluorosis was 59.73％ (795/1331),the index of dental fluorosis was 1.17 and the defect rate was 10.14％ (123/1331).A total of 138 children aged 8 to 12 were checked in the 4 yet to improve water quality villages,the detection rate of dental fluorosis was 51.45％(71/138),the index of dental fluorosis was 0.95 and the defect rate was 0.72％ (1/138).In water quality improved villages and yet to improve water quality villages,X-ray detection rates of skeletal fluorosis were 8.80％ (113/1284) and 3.05％ (6/197),respectively,in adults over the age of 25.Conclusions The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.