CAJ | 학술논문

目的了解陕西省燃煤污染型地方性氟中毒病区防氟灶具使用情况、相关行为形成情况、氟中毒病情现状,评价防治效果,为上级部门及时调整防治策略提供科学依据.方法按照《陕西省燃煤污染型地方性氟中毒防治效果评估实施方案》的要求,在陕西省安康市紫阳、岚皋两县开展流行病学现况调查.采用分层抽样的方法,在每个县的历史轻、中、重病区村按每层5％的比例抽取调查村,最少为1个,最多为30个.同时,在每个县的非病区抽取1～3个调查村,对调查村全部居民进行入户问卷调查,询问做饭、取暖燃料变动情况,改炉改灶情况,改良炉灶的正确使用情况,与供人食用的玉米和辣椒有关的生活行为转变情况,以及防治工作后期管理的开展情况.每个调查村隔户选择10户居民,采集用作主食的自产玉米(或大米)和干辣椒,按照《食品中氟的测定》(GB./T 5009.18-2003)测定氟含量.调查所有8～ 12岁学生氟斑牙患病情况,同时每个年龄段采集10份尿样测定尿氟,氟斑牙诊断采用《氟斑牙诊断标准》(WS/T 208-2011),尿氟含量采用《尿中氟的离子选择电极法》(WS/T 89-1996).调查病区村学生、家庭主妇防氟知识知晓情况和16岁以上重度氟骨症患者,氟骨症诊断依据《地方性氟骨症诊断标准》(WS 192-2008).结果在病区村共调查7 998户,病区村改良炉、灶正确使用率分别为91.43％(3 019/3 302)、95.72％(3 578/3 738).改良炉灶自主更换率为0.61％(49/7 998).玉米的正确干燥率、正确保管率和加工前淘洗率均为100.0％(300/300),辣椒的正确干燥率、正确保管率和加工前淘洗率均为98.3％(7 863/7 998).病区玉米、辣椒氟含量中位数分别为0.800、2.863 mg/kg.非病区玉米、辣椒氟含量中位数分别为0.443、4.065 mg/kg.病区村家庭主妇防氟知晓率为81.27％、学生防氟知晓率为90.32％.病区村8 ～ 12周岁儿童氟斑牙总体检出率为12.52％ (87/695),氟斑牙指数为0.24,尿氟范围为0.04～ 7.00mg/L,几何均数为0.61 mg/L.病区无新发重度氟骨症患者.结论陕西省地方性氟中毒病区防治效果明显,今后应继续加强健康教育、健康促进和病情监测工作并强化防氟炉具后期管理工作. 目的瞭解陝西省燃煤汙染型地方性氟中毒病區防氟竈具使用情況、相關行為形成情況、氟中毒病情現狀,評價防治效果,為上級部門及時調整防治策略提供科學依據.方法按照《陝西省燃煤汙染型地方性氟中毒防治效果評估實施方案》的要求,在陝西省安康市紫暘、嵐皋兩縣開展流行病學現況調查.採用分層抽樣的方法,在每箇縣的歷史輕、中、重病區村按每層5％的比例抽取調查村,最少為1箇,最多為30箇.同時,在每箇縣的非病區抽取1～3箇調查村,對調查村全部居民進行入戶問捲調查,詢問做飯、取暖燃料變動情況,改爐改竈情況,改良爐竈的正確使用情況,與供人食用的玉米和辣椒有關的生活行為轉變情況,以及防治工作後期管理的開展情況.每箇調查村隔戶選擇10戶居民,採集用作主食的自產玉米(或大米)和榦辣椒,按照《食品中氟的測定》(GB./T 5009.18-2003)測定氟含量.調查所有8～ 12歲學生氟斑牙患病情況,同時每箇年齡段採集10份尿樣測定尿氟,氟斑牙診斷採用《氟斑牙診斷標準》(WS/T 208-2011),尿氟含量採用《尿中氟的離子選擇電極法》(WS/T 89-1996).調查病區村學生、傢庭主婦防氟知識知曉情況和16歲以上重度氟骨癥患者,氟骨癥診斷依據《地方性氟骨癥診斷標準》(WS 192-2008).結果在病區村共調查7 998戶,病區村改良爐、竈正確使用率分彆為91.43％(3 019/3 302)、95.72％(3 578/3 738).改良爐竈自主更換率為0.61％(49/7 998).玉米的正確榦燥率、正確保管率和加工前淘洗率均為100.0％(300/300),辣椒的正確榦燥率、正確保管率和加工前淘洗率均為98.3％(7 863/7 998).病區玉米、辣椒氟含量中位數分彆為0.800、2.863 mg/kg.非病區玉米、辣椒氟含量中位數分彆為0.443、4.065 mg/kg.病區村傢庭主婦防氟知曉率為81.27％、學生防氟知曉率為90.32％.病區村8 ～ 12週歲兒童氟斑牙總體檢齣率為12.52％ (87/695),氟斑牙指數為0.24,尿氟範圍為0.04～ 7.00mg/L,幾何均數為0.61 mg/L.病區無新髮重度氟骨癥患者.結論陝西省地方性氟中毒病區防治效果明顯,今後應繼續加彊健康教育、健康促進和病情鑑測工作併彊化防氟爐具後期管理工作.
목적 료해합서성연매오염형지방성불중독병구방불조구사용정황、상관행위형성정황、불중독병정현상,평개방치효과,위상급부문급시조정방치책략제공과학의거.방법 안조《합서성연매오염형지방성불중독방치효과평고실시방안》적요구,재합서성안강시자양、람고량현개전류행병학현황조사.채용분층추양적방법,재매개현적역사경、중、중병구촌안매층5％적비례추취조사촌,최소위1개,최다위30개.동시,재매개현적비병구추취1～3개조사촌,대조사촌전부거민진행입호문권조사,순문주반、취난연료변동정황,개로개조정황,개량로조적정학사용정황,여공인식용적옥미화랄초유관적생활행위전변정황,이급방치공작후기관리적개전정황.매개조사촌격호선택10호거민,채집용작주식적자산옥미(혹대미)화간랄초,안조《식품중불적측정》(GB./T 5009.18-2003)측정불함량.조사소유8～ 12세학생불반아환병정황,동시매개년령단채집10빈뇨양측정뇨불,불반아진단채용《불반아진단표준》(WS/T 208-2011),뇨불함량채용《뇨중불적리자선택전겁법》(WS/T 89-1996).조사병구촌학생、가정주부방불지식지효정황화16세이상중도불골증환자,불골증진단의거《지방성불골증진단표준》(WS 192-2008).결과 재병구촌공조사7 998호,병구촌개량로、조정학사용솔분별위91.43％(3 019/3 302)、95.72％(3 578/3 738).개량로조자주경환솔위0.61％(49/7 998).옥미적정학간조솔、정학보관솔화가공전도세솔균위100.0％(300/300),랄초적정학간조솔、정학보관솔화가공전도세솔균위98.3％(7 863/7 998).병구옥미、랄초불함량중위수분별위0.800、2.863 mg/kg.비병구옥미、랄초불함량중위수분별위0.443、4.065 mg/kg.병구촌가정주부방불지효솔위81.27％、학생방불지효솔위90.32％.병구촌8 ～ 12주세인동불반아총체검출솔위12.52％ (87/695),불반아지수위0.24,뇨불범위위0.04～ 7.00mg/L,궤하균수위0.61 mg/L.병구무신발중도불골증환자.결론 합서성지방성불중독병구방치효과명현,금후응계속가강건강교육、건강촉진화병정감측공작병강화방불로구후기관리공작.
Objective To investigate the usage of defluoridation stove and the formation of related behavior in the disease affected areas and the current situation of coal-burning-borne endemic fluorosis,to evaluate the control effect,so as to provide a theoretical basis for superior department to adjust the control strategy in time.Methods According to "The Implementation Plan for Prevention and Treatment of Coal-burning-borne Endemic Fluorosis in Shaanxi Province",Ziyang and Langao in Ankang City were chosen for epidemiological survey.Using stratified sampling method,according to the degree of disease situation,each county was divided into 3 layers and then 5％ from each layer was extracted to carry out an investigation,respectively.The number of investigated village was at least 1,up to 30.The number in a non-endemic area was 1-3.Questionnaire survey of all residents was carried out to ask of the changes of cooking and heating fuel;the correct usage of the improved stove;the changes of life behavior related to the corn and pepper for human consumption and the development of prevention and treatment of post management.In endemic areas and in non-endemic areas,according to the "Determination of Fluoride in Foods" (GB/T 5009.18-2003),fluoride levels of corn (or rice) and chili which collected from 10 families were determined.Meanwhile,the criteria for "Diagnosis of Dental Fluorosis" (WS/T 208-2011) was used to diagnose dental fluorosis and the criteria of "Urine-determination of Fluoride-ion Specific Electrode Method" (WS/T 89-1996) was used to evaluate urine fluoride;dental fluorosis of every child aged 8-12 was examined and 10 copies of urine samples were randomly collected in each age group.Housewives and students over the age of 16 in endemic areas were quizzed of the knowledge of health and diagnosed serious skeletal fluorosis according to "The Diagnostic Criteria of Endemic Fluorosis" (WS 192-2008).Results The rates of correct usage of improved furnace and oven were 91.43％ (3 019/3 302) and 95.72％ (3 578/3 738).The autonomous maintenance rate of stoves was 0.61％ (49/7 998).In endemic areas,the correct drying rate and the correct storage rate of corn and pepper were all 100.0％ (300/300);the washing rate of corn and pepper before eating was 98.3％ (7 863/7 998).The fluoride median contents of corn and pepper was 0.800 and 2.863 mg/kg,respectively.In non-endemic areas,The fluoride median contents of corn and pepper was 0.443 and 4.065 mg/kg,respectively.The awareness rates of health knowledge were 81.27％ in housewives and 90.32％ in students.Dental fluorosis detection rate of 8-12 years old children was 12.52％ (87/695);the fluoride content was between 0.04-7.00 mg/L and the geometric mean value of fluoride content was 0.61 mg/L in endemic areas.There was no new case of serious skeletal fluorosis.Conclusions The prevention effect is obvious.Disease surveillance,health education and management of defluoridation stoves are keys to prevent coal-burning-borne endemic fluorosis.