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目的调查地方性氟中毒的病区变迁、目标人群氟斑牙患病率的变化、分析致病因素,为开展改灶降氟和长期的综合防治提供科学依据。方法检查学生氟斑牙、尿氟,比较不同年代不同病区学生患病率和尿氟水平;测定煤、制作藕煤的壤土、饮用水、大米、茶叶、改灶前后室内空气氟含量;测定人群防治知识知晓率。结果病区村从349个增加到1192个;学生氟斑牙患病率从47.64%下降至40.42%;重病区只限于海拔800m以上山区。检测煤氟含量为32.4～513.6mg/kg;壤土氟为139.0～1312.0mg/kg;干蔬菜、茶叶、大米含氟量均超过卫生标准。实施健康教育后居民和学生的地氟病防治知识知晓率从49.6%、44.8%提高到88.6%、92.4%。改灶后室内空气氟含量下降到0.019mg/m3以内。结论烧煤是导致地方性氟中毒病区扩大和患病人数不断增多的根本原因。制作藕煤的壤土氟含量高,是致氟中毒的重要氟源;村民冬春季节燃煤取暖,房屋无向外排气装置致室内空气氟含量高;主食大米、干菜、饮用水均含氟导致人体摄入过量而中毒。实施健康教育可显著提高居民和学生的地氟病防治知识。使用降氟炉灶可以有效降低室内空气氟浓度。
Objective To investigate the changes of endemic fluorosis in ward, the prevalence of dental fluorosis in target population, analyze the risk factors and provide a scientific basis for the improvement of fluoride-lowering and long-term comprehensive prevention and control. Methods The students’ dental fluorosis and urinary fluoride were examined to compare the prevalence and urinary fluoride levels of students in different wards of different ages. The coal content, the loam soil, drinking water, rice and tea, Crowd prevention knowledge awareness. Results The number of ward villages increased from 349 to 1192. The prevalence rate of dental fluorosis in students dropped from 47.64% to 40.42%. The areas of severe illness were limited to mountainous areas above 800m above sea level. Detection of coal fluorine content of 32.4 ~ 513.6mg / kg; loam fluoride 139.0 ~ 1312.0mg / kg; dry vegetables, tea, rice fluoride content exceeded the health standards. After the implementation of health education, the awareness rates of prevention and treatment of earth-flu disease among residents and students increased from 49.6% and 44.8% to 88.6% and 92.4% respectively. After the change to the indoor air fluoride content decreased to 0.019mg / m3 or less. Conclusion Coal burning is the root cause of the increasing number of endemic fluorosis areas and the increasing number of patients. The production of lotus root loam fluorine content is high, is an important source of fluorine fluoride poisoning; villagers in winter and spring coal-fired heating, indoor non-outward exhaust caused by high indoor air fluoride content; staple rice, dried vegetables, drinking water are fluoride Lead to excessive intake of the human body and poisoning. Implementation of health education can significantly improve the prevention and treatment of earth-flu disease among residents and students. The use of fluoride stove can reduce the indoor air fluoride concentration.