Abstract
赵丽军,裴俊瑞,张微,王伟,于光前,孙殿军,高彦辉.中国2013年度饮水型地方性氟中毒监测[J].Chinese journal of Epidemiology,2016,37(6):816-820
中国2013年度饮水型地方性氟中毒监测
Surveillance on drinking-water-born endemic fluorosis in China, 2013
Received:October 19, 2015  
DOI:10.3760/cma.j.issn.0254-6450.2016.06.015
KeyWord: 地方性氟中毒  饮用水  氟斑牙  监测  改水工程
English Key Word: Endemic fluorosis  Drinking water  Dental fluorosis  Monitoring  Water-improved project
FundProject:重大公共卫生服务地方病防治项目(2013)
Author NameAffiliationE-mail
Zhao Lijun Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Pei Junrui Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Zhang Wei Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Wang Wei Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Yu Guangqian Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Sun Dianjun Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China  
Gao Yanhui Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission(23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China gaoyh411@163.com 
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Abstract:
      目的 掌握目前中国饮水型地方性氟中毒病区病情现状及防治措施落实情况。方法 按照《饮水型地方性氟中毒监测方案》规定的方法和要求,在全国28个省(自治区、直辖市)和新疆生产建设兵团,抽取136个监测县,每个监测县随机抽取3个病区村作为固定监测点。根据《氟斑牙诊断》(WS/T 208-2011)对监测点所有8~12周岁儿童进行氟斑牙检查。调查改水村改水工程运行情况及水氟含量,以及未改水村饮水氟含量。水氟检测采用生活饮用水标准检验方法(GB/T 5750.5-2006)。结果 所有监测点8~12周岁儿童氟斑牙患病率平均为28.58%(7950/27817),氟斑牙指数为0.58。其中改水工程正常运转且水氟含量合格的监测村患病率为22.28%(3917/17583),氟斑牙指数为0.44;改水工程未正常运转或改水后水氟含量仍然超标的监测村患病率为38.74% (1926/4971),氟斑牙指数为0.84;未改水监测村患病率为40.03%(2107/5263),氟斑牙指数为0.81。三类病区儿童氟斑牙患病率的差异存在统计学意义。降氟改水工程的正常运转率为93.77%(286/305),改水工程水氟含量合格率为76.77%(228/297)。结论 全国饮水型地方性氟中毒病区儿童氟斑牙的病情整体上为边缘流行,有效改水可以显著降低病区儿童氟斑牙病情;病区降氟改水工程正常运转率接近95%,但水氟含量合格率低于80%。
English Abstract:
      Objective To investigate the prevalence of fluorosis and related control measures on drinking water type of endemic fluorosis in China. Methods According to the national program-"Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis", 136 counties were selected in 29 provinces, autonomous regions and municipalities. Three epidemic villages were randomly selected as fixed monitoring sites in each county. Dental fluorosis of all the children aged 8-12 living in the villages under the monitoring program, was identified under the ariteria from "Diagnosis of dental fluorosis" (WS/T 208-2011). Operating conditions and contents of fluoride in all the ‘water-improved projects’ were investigated. Contents of fluoride in drinking water were tested in villages without the ‘water-improved projects’. "Standard Test Method for Drinking Water" (GB/T 5750.5-2006) was used to detect the water fluoride. Results The overall prevalence of dental fluorosis among children aged 8-12 in all the villages under monitor program, was 28.58% (7 950/27 817), with the dental fluorosis index (DFI) as 0.58. Among them, the prevalence was 22.28% (3 917/17 583) and DFI was 0.44 in the ‘water-improved projects’ villages that under normal operation and with qualified fluoride contents. The prevalence appeared as 38.74% (1 926/4 971) with DFI as 0.84 in those villages with ‘water-improved projects’ but mal-operated or with excessive fluoride. The prevalence was 40.03% (2 107/5 263), and DFI was 0.81 in those villages without ‘water-improved projects’. The prevalence rates of dental fluorosis in children from the three types of endemic areas were significantly different. For ‘water-improved projects’, the normal opration rate was 93.77% (286/305) and the qualification rate of fluoride content was 76.77% (228/297). Conclusions Dental fluorosis in children living in the drinking-water-born endemic fluorosis areas was on the edge of epidemics in China. Effective improvement on the quality of drinking water can significantly reduce the severity of dental fluorosis in children. The rate of proper operation on ‘water-improved projects’ was near to 95% in the endemic area. However, rate that met the criteria on qualified fluoride contents of these projects was still below 80%.
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